Dapagliflozin (dap-ah-gli-flows-in)
Consumer Medicine Information
What is in this leaflet
This leaflet answers some common questions about FORXIGA. It does not contain all of the available information. It does not take the place of talking to your doctor or pharmacist.
All medicines have risks and benefits. Your doctor has weighed the risks of you taking FORXIGA against the benefits they expect it will have for you.
If you have any concerns about taking this medicine, ask your doctor or pharmacist.
Keep this leaflet with the medicine.
You may need to read it again.
What FORXIGA is used for
FORXIGA is a prescription medicine used with diet, exercise and sometimes other medicines (which may include metformin; insulin; a sulfonylurea medicine such as gliclazide, glimepiride and glibenclamide; or a dipeptidyl peptidase-4 inhibitor [DPP 4 inhibitor] such as sitagliptin or saxagliptin or a glucagon like peptide 1 [GLP-1] receptor agonist such as exenatide) to control the levels of blood sugar (glucose) in patients with type 2 diabetes mellitus.
Type 2 diabetes mellitus
Type 2 diabetes mellitus (also called non-insulin-dependent diabetes mellitus, or NIDDM) is the condition of having high levels of blood sugar (hyperglycaemia). This is usually because your body does not make enough insulin and /or the insulin that your body produces does not work as well as it should. Left uncontrolled, the build-up of high levels of sugar in your blood can lead to serious medical problems.
The main goal of treating type 2 diabetes is to control your blood sugar to a normal level. Lowering and controlling blood sugar may help prevent or delay complications of diabetes, which include kidney disease, blindness and amputation.
FORXIGA is a member of a class of medicines you take by mouth called SGLT-2 (Sodium Glucose Cotransporter-2) inhibitors that lower blood sugar levels in patients with type 2 diabetes mellitus.
FORXIGA lowers the level of your blood sugar by removing the excess sugar from the body in the urine.
FORXIGA by itself is unlikely to cause low blood sugar (hypoglycaemia) because it does not interfere with the insulin hormone that regulates blood sugar.
Your doctor may have prescribed this medicine for another reason. Ask your doctor if you have any questions about why FORXIGA has been prescribed for you.
This medicine is only available with a doctor's prescription.
FORXIGA is not addictive.
Before you take FORXIGA
When you must not take it
Do not take FORXIGA if you have:
Poorly functioning kidneys since FORXIGA requires good functioning kidneys to work well
An allergy to dapagliflozin, the active ingredient in FORXIGA or any of the other ingredients listed at the end of this leaflet.
Some of the symptoms of an allergic reaction may include shortness of breath, wheezing or difficulty breathing; swelling of the face, lips, tongue or other parts of the body; rash, itching or hives on the skin or you may feel faint.
Do not take FORXIGA after the use by (expiry) date printed on the pack.
Do not take FORXIGA if the packaging is torn or shows signs of tampering.
If it has expired or is damaged, return it to your pharmacist for disposal.
FORXIGA is not recommended for use in children.
It has not been studied in children younger than 18 years old.
If you are not sure whether you should start taking FORXIGA, talk to your doctor or pharmacist.
Before you start to take it
Tell your doctor if you have any allergies to:
any other medicines
any other substances such as foods, dyes or preservatives
Tell your doctor or pharmacist if you have, or have had, any medical conditions, especially the following:
type 1 diabetes mellitus
kidney, liver or pancreas problems
you are taking a medicine for high blood pressure or taking a water pill (diuretic)
frequently get genital or urinary tract infections (infections of the bladder, kidney, or tubes that carry urine)
an illness that will make you dehydrated such as diarrhoea or a severe infection.
diabetic ketoacidosis. This is a symptom of uncontrolled diabetes, in which substances called ketone bodies build up in the blood. You may notice this as rapid weight loss, feeling sick or being sick, stomach pain, excessive thirst, fast and deep breathing, confusion, unusual sleepiness or tiredness, a sweet smell to your breath, a sweet or metallic taste in your mouth, or a different odour to your urine or sweat.
Tell your doctor if you are pregnant or intend to become pregnant.
The safety of FORXIGA in pregnant women has not been established. FORXIGA must not be used during the second and third trimesters of your pregnancy. If you are pregnant, stop taking FORXIGA and speak with your doctor immediately as good control of your type 2 diabetes (control your blood sugar) is important while you are pregnant and it is not known if FORXIGA will harm your unborn baby.
Tell your doctor if you are breastfeeding or plan to breastfeed.
FORXIGA should not be used while breastfeeding or if planning to breastfeed. It is not known if FORXIGA will pass into your breast milk. Talk with your doctor about the best way to feed your baby if you are taking FORXIGA.
Tell your doctor if you are lactose intolerant.
FORXIGA tablets contain lactose.
Taking other medicines
Tell your doctor if you are taking any other medicines, including any that you buy without a prescription from your pharmacy, supermarket or health food shop.
FORXIGA can be taken with most other medicines.
If you have not told your doctor about any of these things, tell them before you take any FORXIGA.
How to take FORXIGA
Follow all directions given to you by your doctor or pharmacist carefully.
They may differ from the information contained in this leaflet.
If you do not understand the instructions on the pack ask your doctor or pharmacist for help.
How to take it
Swallow your FORXIGA tablet with a full glass of water.
How much to take
The dose of FORXIGA is one 10 mg tablet once a day. You should not take more than one FORXIGA tablet per day.
Your doctor may prescribe FORXIGA along with certain other medicines that lower blood sugar.
When to take it
FORXIGA should be taken once daily at any time of the day regardless of meals.
Taking your tablets at the same time each day will have the best effect. It will also help you remember when to take the tablets.
FORXIGA tablets can be taken with or without food.
How long to take it
Continue taking the tablets for as long as your doctor tells you. Make sure you keep enough FORXIGA to last over weekends and holidays.
FORXIGA helps control your condition, but does not cure it. Therefore, you must take FORXIGA every day.
If you forget to take it
If it is almost time for your next dose, skip the dose you missed and take your next dose when you are meant to.
Otherwise, take it as soon as you remember, and then go back to taking your medicine as you would normally.
Do not take a double dose to make up for the dose that you missed.
If you have trouble remembering when to take your medicine, ask your pharmacist for some hints.
If you take too much
Immediately telephone your doctor or the Poisons Information Centre (13 11 26) for advice, or go to Accident and Emergency at your nearest hospital if you think that you or anyone else may have taken too much FORXIGA. Do this even if there are no signs of discomfort or poisoning.
You may need urgent medical attention.
While you are taking FORXIGA
Things you must do
Tell any other doctors, dentists, and pharmacists who are treating you that you are taking FORXIGA.
If you are about to be started on any new medicines, tell your doctor, dentist or pharmacist that you are taking FORXIGA.
Make sure that you, your friends, family and work colleagues can recognise the symptoms of hypoglycaemia and hyperglycaemia and know how to treat them.
It is important to have regular check-ups with your doctor or diabetes centre.
Like for all diabetic patients it is important to check your feet regularly and adhere to any other advice regarding foot care given by your doctor.
Tell your doctor if you experience rapid weight loss, feeling sick or being sick, stomach pain, excessive thirst, fast and deep breathing, confusion, unusual sleepiness or tiredness, a sweet smell to your breath, a sweet or metallic taste in your mouth, or a different odour to your urine or sweat. These symptoms could be a sign of diabetic ketoacidosis.
Talk to your doctor if you are having surgery to discuss when to stop taking FORXIGA and when to start taking it again.
HYPOGLYCAEMIA
FORXIGA does not normally cause hypoglycaemia, although you may experience it if you take certain other medicines, such as insulin or a sulfonylurea.
Hypoglycaemia can occur suddenly. Initial signs may include:
weakness, trembling or shaking
sweating
lightheadedness, dizziness, headache or lack of concentration
irritability, tearfulness or crying
hunger
numbness around the lips and tongue.
If not treated promptly, these may progress to:
loss of co-ordination
slurred speech
confusion
fits or loss of consciousness.
If you experience any of the symptoms of hypoglycaemia, you need to raise your blood glucose immediately.
You can do this by doing one of the following:
eating 5 to 7 jelly beans
eating 3 teaspoons of sugar or honey
drinking half a can of non-diet soft drink
taking 2 to 3 concentrated glucose tablets.
Unless you are within 10 to 15 minutes of your next meal or snack, follow up with extra carbohydrates such as plain biscuits, fruit or milk.
Taking this extra carbohydrate will prevent a second drop in your blood glucose level.
HYPERGLYCAEMIA
If you notice the return of any of the signs of hyperglycaemia, contact your doctor immediately.
Your doctor may need to consider additional or other treatments for your diabetes.
The risk of hyperglycaemia is increased in the following situations:
uncontrolled diabetes
illness, infection or stress
taking less FORXIGA than prescribed
taking certain other medicines
too little exercise
eating more carbohydrates than normal.
Tell your doctor if you:
become ill
become dehydrated
are injured
have a fever
have a serious infection
are having surgery (including dental surgery).
Your blood glucose may become difficult to control at these times.
If you become pregnant while taking FORXIGA, tell your doctor immediately.
If you need to have any medical tests while you are taking FORXIGA, tell your doctor.
FORXIGA may affect the results of some tests.
Visit your doctor regularly for check ups.
Your doctor may want to perform blood tests to check your kidneys, liver, heart, and levels of cholesterol and fats in your blood while you are taking FORXIGA.
Things you must not do
Do not take FORXIGA to treat any other complaints unless your doctor tells you to.
Do not give this medicine to anyone else, even if their symptoms seem similar or they have the same condition as you.
Things to be careful of
Be careful driving or operating machinery until you know how FORXIGA affects you.
Although rare, FORXIGA may cause dizziness in some people. Low blood sugar levels may also slow your reaction time and affect your ability to drive or operate machinery.
Make sure you know how you react to FORXIGA before you drive a car, operate machinery or do anything else that could be dangerous if you are dizzy or lightheaded.
Side effects
Tell your doctor or pharmacist as soon as possible if you do not feel well while you are taking FORXIGA.
All medicines can have side effects. Sometimes they are serious, most of the time they are not. You may need medical treatment if you get some of the side effects.
Ask your doctor or pharmacist to answer any questions you may have.
Side effects of FORXIGA include:
hypoglycaemia (see below)
genital infections as suggested by irritation of the genitals
urinary tract infections
back pain
changes in the amount of cholesterol or fats in your blood
sore throat
headache
diarrhoea
Low blood sugar (hypoglycaemia) may become worse in people who already take another medication to treat diabetes, such as sulfonylureas or insulin. Tell your doctor if you take other diabetes medicines. If you have symptoms of low blood sugar, you should check your blood sugar and treat if low, then call your doctor. Signs of low blood sugar may include weakness, trembling or shaking, sweating, light-headedness, headache, dizziness, rapid heartbeat, lack of concentration, tearfulness or crying, irritability, hunger and numbness around the lips and fingers. Do not drive a car if you have signs of low blood sugar.
If any of the following happen, tell your doctor immediately or go to Accident and Emergency at your nearest hospital.
Kidney problems. If you have kidney problems you should use FORXIGA only if your doctor tells you to.
Volume depletion (loss of needed fluids from the body; dehydration). Tell your doctor if you are unable to keep fluids down or if you have any of these symptoms of too much loss of body fluids (volume depletion or dehydration) while taking FORXIGA: dry sticky mouth, severe thirst, severe diarrhoea or vomiting, dizziness, or urinating less often than normal or not at all.
severe allergic reaction (may include shortness of breath, wheezing or severe difficulty in breathing; shock, swelling of the face, lips, tongue or other parts of the body; skin rash, itching or hives on the skin, hayfever, or you may feel faint)
Genital infections. If you take FORXIGA, you may be at a greater risk for genital infections. Tell your doctor if you experience painful urination, soreness and more severe irritation or redness and swelling of your genitals, or an unpleasant odour or discharge associated with your genitals.
Urinary tract infection. If you take FORXIGA, you may be at a greater risk for urinary tract infections. If you have symptoms, such as burning or pain when you pass urine, more frequent or urgent need to urinate, fever, chills, or blood in the urine, contact your doctor as soon as possible.
Diabetic ketoacidosis. In rare cases dapagliflozin, the active ingredient in FORXIGA, may cause a serious side effect called diabetic ketoacidosis. Symptoms of diabetic ketoacidosis may include feeling sick or being sick, difficulty breathing, severe thirst, feeling weak and tired, confusion, a sweet smell to your breath, a sweet or metallic taste in your mouth, a strange odour to your urine or sweat and frequent urination. The risk of developing diabetic ketoacidosis may be increased with prolonged fasting, excessive alcohol consumption, dehydration, sudden reductions in insulin dose, or a higher need of insulin due to major surgery or serious illness.
These are very serious side effects. You may need urgent medical attention or hospitalisation.
Other side effects not listed here may occur in some patients. Tell your doctor or pharmacist if you notice anything that is making you feel unwell.
Do not be alarmed by this list of possible side effects.
You may not experience any of them.
After taking FORXIGA
Storage
Keep your FORXIGA tablets in the blister until it is time to take them.
If you take FORXIGA out of the blister it will not keep well.
Keep it in a cool dry place where the temperature stays below 30°C.
Do not store it or any other medicine in the bathroom or near a sink. Do not leave it in the car or on a window sill.
Heat and dampness can destroy some medicines.
Keep it where children cannot reach it.
A locked cupboard at least one-and-a-half metres above the ground is a good place to store medicines.
Disposal
If your doctor tells you to stop taking FORXIGA or the tablets have passed their expiry date, ask your pharmacist what to do with any that are left over.
Product description
What FORXIGA looks like
FORXIGA tablets are available in one strength i.e. 10 mg. The tablets are film-coated, yellow, biconvex and diamond-shaped with "10" engraved on one side and "1428" engraved on the other side.
FORXIGA tablets are available in blister packs of 7 and 28.
Ingredients
Each FORXIGA tablet contains dapagliflozin 10 mg as the active ingredient.
Plus the following inactive ingredients:
microcrystalline cellulose
lactose
crospovidone
silicon dioxide
magnesium stearate
polyvinyl alcohol
titanium dioxide
polyethylene glycol
talc
yellow iron oxide
FORXIGA tablets do not contain gluten or sucrose.
