Farxiga

Medically Reviewed by Dr. Harshi Dhingra, M.D.

Last Reviewed: Jul 21, 2022

Warnings

Farxiga Risks, Warnings, and Complications

Farxiga can cause serious health problems, especially in certain high-risk patients. Some of the risks of Farxiga therapy include:

Serious Urinary Tract Infections and Genital Infections: Taking Farxiga can lead to an increased risk of genital infections, including vaginal yeast infections and urinary tract infections (UTIs). This includes serious urinary tract infections like pyelonephritis and urosepsis that may require hospitalization. Contact your doctor without delay if you experience symptoms such as pain or burning while urinating; cloudy, bloody, or foul-smelling urine; lower abdominal, back, or side pain; fever, shivering, nausea, vomiting, and fast heart rate. Also, call your doctor if you experience signs and symptoms of genital yeast infections such as redness, pain, swelling, or foul-smelling discharge in the genitals.
Kidney Damage: In a small number of people, Farxiga can cause kidney damage. The risk is higher in elderly patients, people with a history of kidney disease or impaired renal function, and people who are taking certain blood pressure medications (water pills). Your doctor will check kidney function before starting you on Farxiga and during treatment. Call your doctor if you experience symptoms like urinating less than usual and dizziness (signs of dehydration) which can put you at risk of kidney damage and low blood pressure.
Diabetic Ketoacidosis: Patients treated with Farxiga for type 2 diabetes mellitus can experience a life-threatening condition called diabetic ketoacidosis. In this condition, the body makes too many ketones that make the blood acidic. The risk is higher in people who are sick, who drink alcohol, who are eating fewer calories, or who have recently increased their insulin dose. Signs and symptoms of early ketoacidosis include severe thirst and frequent urination. Check your ketones and seek medical attention immediately if you experience headache, muscle aches, breath with a fruity odor, nausea, vomiting, stomach pain, and tiredness.
Severe Hypoglycemia: Farxiga and other diabetes medications are used to improve blood sugar control. However, these medications can occasionally lead to hypoglycemia (low blood sugar). Very low blood sugar levels are potentially life-threatening. Risk factors include taking insulin or other oral medicines to control type 2 diabetes mellitus. The risk is also higher in people with recent changes in diet, exercise, and alcohol consumption. Signs and symptoms of low blood sugar include shakiness, nervousness, anxiety, fast heartbeat, sweating, chills, weakness, confusion, low energy, and excessive hunger. Talk to your doctor and make sure you understand the symptoms of low blood sugar, when and how to check for hypoglycemia, and what to do if you have it.

If you are at a high risk of complications from Farxiga use, your doctor or pharmacist can adjust the dose or offer alternative treatments.

Precautions Before Starting Farxiga

Tell your healthcare provider if you have ever had an allergic reaction to Farxiga, any ingredients in Farxiga tablets, or any other medications. Your pharmacy can give you a list of ingredients.

Give your healthcare provider a complete medical history. Farxiga may not be right for people with certain medical conditions such as heavy alcohol use or binge drinking, low salt diet, heart failure, pancreatic disease and pancreatitis, urinary tract infections, problems urinating, genital yeast infections, low blood pressure, kidney disease, or liver disease. Tell your doctor if you are on dialysis for severe kidney disease - Farxiga may not be suitable for you.

Also, tell your doctor if you have recently had an illness, surgery, changes in diet or exercise, or dehydration (nausea, vomiting, being out in the sun, and sweating a lot).

Men should tell their doctor if they are uncircumcised.

Give your doctor a complete list of all your medications, including prescription drugs, over-the-counter medicines, vitamins, dietary supplements, and herbal products. This can help avoid serious drug interactions between Farxiga and your other medications.

Tell your doctor if you are pregnant, could be pregnant, plan to get pregnant, or are breastfeeding.

Talk to your doctor about the symptoms of high blood sugar and low blood sugar and what to do if they occur.

Precautions During Use of Farxiga

Keep all your medical and lab appointments while on Farxiga. Your doctor may want to check how well the medication works to improve glycemic control (blood sugar levels). Your healthcare provider may order certain laboratory tests to monitor your kidney function during treatment with this medication.

Tell lab personnel you are taking Farxiga because this medicine can affect glucose levels in your urine.

Alcohol can affect blood sugar levels. Avoid drinking alcohol while taking Farxiga.

Farxiga can cause lightheadedness, dizziness, and fainting. These symptoms occur if you go too quickly from a sitting or lying position to standing. This is more likely to happen in the first few days of initiating therapy with Farxiga. Tell your doctor if this occurs. To prevent this problem, get up slowly from a lying position and rest your feet on the ground for a few minutes before standing up.

Tell your doctor if there are any major changes in your diet, exercise levels, or weight; if you become dehydrated or if you are eating or drinking less due to an illness that causes nausea, vomiting, and diarrhea; or if you are undergoing surgery, have an infection and/or fever, are experiencing unusual stress, or have suffered an injury. These conditions can lead to fluctuations in blood sugar levels and may affect the amount of Farxiga you need.

Tell your health care professionals you are on Farxiga before undergoing any surgery, including dental procedures. You will likely be asked to temporarily stop taking Farxiga before a surgical procedure.

Call your doctor if you become pregnant while on Farxiga. Do not breastfeed while on this medicine.

Farxiga Drug Interactions

Taking Farxiga with some other medications can affect how the medications work. Drug interactions between medications can also increase the risk of serious adverse reactions. Your physician may choose different diabetes medications for you, change the dose or frequency of one or both medicines, and/or closely monitor you for side effects if there are known interactions between Farxiga and your other medications.

There can be potential interactions between Farxiga and the following medications:

Aspirin and other nonsteroidal anti-inflammatory medications (NSAIDs) such as naproxen (Aleve, Naprosyn) and ibuprofen (Advil, Motrin)
Blood pressure medications called angiotensin-converting enzymes (ACE) inhibitors, such as captopril, enalapril (Vasotec, in Vaseretic), benazepril (Lotensin, in Lotrel), lisinopril (in Zestoretic), perindopril (Aceon, in Prestalia), fosinopril, moexipril (Univasc, in Uniretic), trandolapril (Mavik, in Tarka), and ramipril (Altace)
Blood pressure medications called angiotensin receptor blockers (ARB) such as candesartan (Atacand, in Atacand HCT), azilsartan (Edarbi, in Edarbyclor), eprosartan (Teveten), losartan (Cozaar, in Hyzaar), olmesartan (Benicar, in Azor, in Benicar HCT, in Tribenzor), and irbesartan (Avapro, in Avalide)
Water pills
Other diabetes medications such as glimepiride (Amaryl, in Duetact), glyburide (DiaBeta, Glynase), glipizide (Glucotrol), repaglinide (Prandin, in Prandimet), tolbutamide, and insulin

This list does not describe all possible Farxiga interactions. Give your healthcare professionals a complete list of your medications, including prescription drugs, over-the-counter medicines, vitamins, dietary supplements, and herbal products. Also, tell your health care provider if you smoke, drink alcohol, or use illegal drugs because some of these substances can cause serious health complications when used with prescription drugs.

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