From the Guidelines
You should not stop antibiotics without consulting your healthcare provider if you're experiencing recurrent urinary tract infections (UTIs) while taking Farxiga (dapagliflozin). Farxiga, a medication used for diabetes management, increases glucose in the urine which can create a favorable environment for bacterial growth, potentially contributing to recurrent UTIs, as highlighted in the context of managing such infections 1. Your doctor may consider several options: adjusting your antibiotic regimen (possibly using prophylactic antibiotics at a lower dose for prevention), temporarily suspending Farxiga while treating the active infection, or potentially switching to another diabetes medication if UTIs become a persistent problem. The decision depends on the severity of your infections, your diabetes control, and your overall health status.
Key Considerations
- Completing your prescribed antibiotic course for any active infection to prevent antibiotic resistance and ensure the infection is fully cleared is crucial.
- Maintaining good hydration, urinating after sexual activity, and proper hygiene can help reduce UTI risk while on Farxiga.
- The American Urological Association (AUA), Canadian Urological Association (CUA), and Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction (SUFU) guideline on recurrent uncomplicated urinary tract infections in women emphasizes the importance of appropriate management to prevent inappropriate use of antibiotics and improve clinical outcomes 1.
Management Approach
Given the potential for Farxiga to contribute to UTI recurrence, a comprehensive management plan should be developed in consultation with your healthcare provider, considering both your diabetes management and UTI prevention. This may involve:
- Regular monitoring of UTI episodes and adjustment of treatment strategies as needed.
- Discussion of the risks and benefits of continuing Farxiga versus switching to an alternative diabetes medication.
- Implementation of non-antibiotic prevention strategies to reduce UTI recurrence.
From the Research
Recurrent UTI and Antibiotics
- Recurrent urinary tract infections (UTIs) are a common problem that can be challenging to manage, with a substantial socioeconomic burden on healthcare systems 2.
- Treatment strategies for recurrent UTIs include antibiotic and non-antibiotic approaches, as well as holistic management approaches 2.
Cranberry Products for UTI Prevention
- Cranberry products have been shown to reduce the risk of UTIs in certain populations, including women with recurrent UTIs, children, and people susceptible to UTIs following interventions 3.
- The active ingredient in cranberries, proanthocyanidins, has been found to inhibit the adherence of E. coli to the urothelial cells lining the bladder, which can help prevent UTIs 3, 4.
- However, the evidence for the effectiveness of cranberry products in preventing UTIs is not consistent across all populations, and more research is needed to fully understand their benefits and limitations 3.
Farxiga (Dapagliflozin) and UTIs
- Dapagliflozin, a sodium glucose cotransporter 2 (SGLT2) inhibitor, has been found to increase the risk of UTIs in patients with type 2 diabetes, although the infections are generally mild to moderate and clinically manageable 5.
- The increased risk of UTIs with dapagliflozin is thought to be related to the drug's mechanism of action, which involves increasing glucosuria (glucose in the urine) 5.
Stopping Antibiotics on Farxiga
- There is no direct evidence to suggest that stopping antibiotics on Farxiga (dapagliflozin) will prevent recurrent UTIs 2, 3, 4, 6, 5.
- However, using cranberry products or other non-antibiotic approaches may be a useful adjunct to antibiotic treatment for preventing recurrent UTIs in certain populations 3, 4.