Does Farxiga Cause Pancreatitis?
No, Farxiga (dapagliflozin) is not recognized as causing pancreatitis according to major diabetes guidelines, and pancreatitis is not listed as a safety concern for SGLT2 inhibitors by the American Diabetes Association. 1
Guideline-Based Evidence
The most authoritative evidence clearly distinguishes SGLT2 inhibitors from other diabetes medications regarding pancreatitis risk:
The American Diabetes Association's 2025 Standards of Care does not list pancreatitis as a safety concern for SGLT2 inhibitors, including dapagliflozin. 1 This is in stark contrast to GLP-1 receptor agonists and DPP-4 inhibitors, which carry specific pancreatitis warnings. 1, 2
The ADA specifically suggests considering SGLT2 inhibitors because they have no associated pancreatitis risk while offering cardiovascular and renal benefits, making them a safer alternative for patients at high risk for pancreatitis. 1
The American College of Cardiology's 2018 Expert Consensus on novel diabetes therapies lists multiple cautions for SGLT2 inhibitors (volume depletion, bone fractures with canagliflozin, mycotic genital infections, euglycemic ketoacidosis, amputation risk with canagliflozin) but makes no mention of pancreatitis. 3
Clinical Management Approach
If a patient on dapagliflozin develops pancreatitis, investigate other common causes first:
- Gallstones and biliary disease (the most common cause of pancreatitis) 1
- Hypertriglyceridemia (particularly important as diabetes patients often have elevated triglycerides) 1
- Alcohol use 1
- Concomitant medications with established pancreatitis risk (GLP-1 receptor agonists, DPP-4 inhibitors, thiopurines) 1, 2
The ADA recommends continuing dapagliflozin in patients without other pancreatitis risk factors, given the substantial benefits of SGLT2 inhibitors for cardiovascular outcomes, heart failure, and chronic kidney disease. 1
Important Caveats About Case Reports
While isolated case reports exist describing pancreatitis in patients taking dapagliflozin 4, 5, 6 or other SGLT2 inhibitors 7, 8, these cases have significant confounding factors:
- The published cases involved patients with hypertriglyceridemia (a well-established independent cause of pancreatitis) 4, 5
- Some cases involved concurrent acute illnesses (pseudomembranous colitis) that could precipitate pancreatitis 4
- Temporal association does not establish causation, especially when other risk factors are present 6
Common Pitfall to Avoid
Do not confuse euglycemic diabetic ketoacidosis (a recognized SGLT2 inhibitor complication) with pancreatitis. 3 While some case reports describe both conditions occurring simultaneously 4, 5, these are separate entities. The euglycemic DKA is a known SGLT2 inhibitor risk that requires specific monitoring, particularly during acute illness or surgical stress. 3