Dapagliflozin/Metformin hydrochloride
Consumer Medicine Information
What is in this leaflet
This leaflet answers some common questions about XIGDUO XR. It does not contain all 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 XIGDUO XR 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 XIGDUO XR is used for
XIGDUO XR is a prescription medicine used with diet, exercise and sometimes other medicines such as insulin, a sulfonylurea, or a dipeptidyl peptidase (DPP-4) inhibitor, 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.
XIGDUO XR contains two active ingredients, dapagliflozin and metformin hydrochloride. Dapagliflozin is a member of a class of medicines you take by mouth called SGLT-2 (Sodium Glucose Cotransporter-2) inhibitors and metformin belongs to a class of medicines called biguanides. Dapagliflozin and metformin work together to lower blood sugar levels in patients with type 2 diabetes mellitus.
Your doctor may have prescribed this medicine for another reason. Ask your doctor if you have any questions about why this medicine has been prescribed for you.
This medicine is only available with a doctor’s prescription.
XIGDUO XR is not addictive.
Before you take XIGDUO XR
When you must not take it
Do not take XIGDUO XR if you have an allergy to dapagliflozin, or metformin, the active ingredients in XIGDUO XR 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 XIGDUO XR if you have any of the following conditions:
type 1 diabetes mellitus that is well controlled by insulin alone
type 2 diabetes that is already well controlled by diet alone
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.
liver disease
excessive alcohol intake, binge drinking, alcohol dependence
poorly functioning kidneys, severe kidney disease or kidney failure
dehydration, severe blood loss, shock
a severe infection
certain heart or blood vessel problems, including a recent heart attack or severe heart failure (when the heart fails to pump blood effectively)
severe breathing difficulties
blood clots in the lungs (symptoms include coughing, shortness of breath, chest pain and a fast heart rate)
gangrene.
Do not take this medicine if you are pregnant or plan to become pregnant.
The safety of XIGDUO XR in pregnant women has not been established. Insulin is more suitable for controlling blood glucose during pregnancy. Your doctor will replace XIGDUO XR with insulin while you are pregnant.
Do not take XIGDUO XR if you are breastfeeding.
XIGDUO XR is not recommended while you are breastfeeding. Your doctor will discuss the options available to you.
Do not take XIGDUO XR after the use by (expiry) date printed on the pack or if the packaging is torn or shows signs of tampering.
If it has expired or is damaged, return it to your pharmacist for disposal.
XIGDUO XR 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 XIGDUO XR, talk to your doctor or pharmacist.
Before you start to take it
Discard any other medicines containing dapagliflozin or metformin that your doctor might have prescribed to you in the past and that you may still have in your possession.
XIGDUO XR contains dapagliflozin and metformin. If you have more than one medicine containing dapagliflozin or metformin in your possession, you may accidentally take too much (overdose). Accidentally taking too much metformin can cause a very serious side effect called lactic acidosis.
ACCIDENTAL METFORMIN OVERDOSING IS A SIGNIFICANT SAFETY RISK.
Ask your doctor or pharmacist if you are unsure if you have any other medicines containing metformin.
Your doctor or pharmacist will know which other medicines also contain metformin.
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:
kidney, liver or pancreas problems
heart failure
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.
Your doctor will do some tests for kidney function at the start of treatment and regularly while you are on treatment.
Tell your doctor if you drink alcohol.
Alcohol can affect the control of your diabetes. Drinking excessive amounts of alcohol while you are being treated with XIGDUO XR may also lead to serious side effects. Your doctor may suggest you stop drinking or reduce the amount of alcohol you drink.
Tell your doctor if you are lactose intolerant.
XIGDUO XR tablets contain lactose.
Taking other medicines
Tell your doctor or pharmacist if you are taking any other medicines, including any that you get without a prescription from your pharmacy, supermarket or health food shop.
XIGDUO XR may affect how well other medicines work and some medicines can affect how well XIGDUO XR works.
These include:
other medicines used to treat diabetes
medicines that contain alcohol, such as cough and cold syrups
tetracosactrin, a medicine used in people with multiple sclerosis, and in young children to treat some types of seizures (fits)
danazol, a medicine used to treat endometriosis
some medicines used to treat high blood pressure and some heart conditions, including beta-blockers, calcium channel blockers and ACE inhibitors
medicines used to prevent blood clots, such as warfarin
diuretics, also called fluid tablets
chlorpromazine, a medicine used to treat schizophrenia and other mental illnesses
NSAIDs (non-steroidal anti-inflammatory drugs), medicines used to relieve pain, swelling and other symptoms of inflammation, such as aspirin, diclofenac, ibuprofen, meloxicam, naproxen or piroxicam
cimetidine, a medicine used to treat reflux and ulcers
corticosteroids such as prednisone or cortisone
some medicines used to treat asthma such as salbutamol or terbutaline
Your doctor and pharmacist have more information on medicines to be careful with or avoid while taking this medicine.
If you have not told your doctor about any of these things, tell them before you take any XIGDUO XR.
How to take XIGDUO XR
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 XIGDUO XR tablet whole with a full glass of water.
XIGDUO XR tablets must not be chewed or crushed.
How much to take
Your Doctor will tell you how many XIGDUO XR tablets to take and how often you should take them. The dose varies from person to person. Your doctor will decide the right dose for you.
Your doctor may prescribe XIGDUO XR along with certain other medicines that lower blood sugar.
When to take it
XIGDUO XR should be taken with or immediately after food in the evening.
This will reduce the chance of a stomach upset
XIGDUO XR should be taken at approximately the same time each day.
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.
How long to take it
Continue taking your medicine for as long as your doctor tells you. Make sure you keep enough XIGDUO XR to last over weekends and holidays.
XIGDUO XR helps control your condition, but does not cure it. Therefore, you must take XIGDUO XR 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 are not sure what to do, ask your doctor or pharmacist.
If you have trouble remembering to take your medicine, ask your pharmacist for some hints.
If you take too much
Immediately telephone your doctor or the Poisons Information Centre (telephone 13 11 26) for advice, or go to Accident and Emergency at the nearest hospital, if you think that you or anyone else may have taken too much XIGDUO XR. Do this even if there are no signs of discomfort or poisoning.
You may need urgent medical attention.
While you are taking XIGDUO XR
Things you must do
Tell any other doctors, dentists, and pharmacists who are treating you that you are taking XIGDUO XR.
If you are about to be started on any new medicine, tell your doctor, dentist or pharmacist that you are taking XIGDUO XR.
Talk to your doctor if you are having surgery to discuss when to stop taking XIGDUO XR and when to start taking it again.
If you become pregnant while taking XIGDUO XR, tell your doctor immediately.
If you need to have any medical tests while you are taking XIGDUO XR, tell your doctor.
XIGDUO XR may affect the results of some tests.
Keep all of you doctor's appointments so that your progress can be checked.
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.
Your doctor may want to perform blood tests to check your kidneys, liver, heart, vitamin B12 level and levels of cholesterol and fats in your blood while you are taking XIGDUO XR.
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. You may also be more at risk of developing a serious condition called lactic acidosis or diabetic ketoacidosis. At these times, your doctor may temporarily replace XIGDUO XR with insulin.
Make sure that you, your friends, family and work colleagues can recognise the symptoms of hypoglycaemia and hyperglycaemia and know how to treat them.
HYPOGLYCAEMIA
XIGDUO XR 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 XIGDUO XR than prescribed
taking certain other medicines
too little exercise
eating more carbohydrates than normal.
Things you must not do
Do not take XIGDUO XR to treat any other complaints unless your doctor tells you to.
Do not give your medicine to anyone else, even if their symptoms seem similar or they have the same condition as you.
Do not stop taking your medicine or change the dosage without checking with your doctor.
Things to be careful of
Be careful driving or operating machinery until you know how XIGDUO XR affects you.
Although rare, XIGDUO XR 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 XIGDUO XR 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 XIGDUO XR.
All medicines can have side effects. Sometimes they are serious, most of the time they are not. You may need medical attention if you get some of the side effects.
Ask your doctor or pharmacist to answer any questions you may have.
Tell your doctor or pharmacist if you notice any of the following and they worry you:
headache
nausea, vomiting or diarrhoea
stomach pain or discomfort
rash
loss of appetite
loss of taste
back pain.
If any of the following happen, tell your doctor immediately or go to Accident and Emergency at your nearest hospital:
signs of hypoglycaemia (low blood sugar) that persist despite administering sugar as described under WHILE YOU ARE TAKING XIGDUO XR in this leaflet. Signs of low blood sugar may include weakness, trembling or shaking, sweating, light-headedness, headache, dizziness, rapid heart beat, 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.
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).
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 XIGDUO XR: dry sticky mouth, severe thirst, severe diarrhoea or vomiting, dizziness, or urinating less often than normal or not at all.
Genital infections. If you take XIGDUO XR, 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 XIGDUO XR, 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 one of the active ingredients in XIGDUO XR, 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.
IN RARE CASES, METFORMIN, ONE OF THE MEDICINES IN XIGDUO XR, CAN CAUSE A SERIOUS SIDE EFFECT CALLED LACTIC ACIDOSIS.
LACTIC ACIDOSIS IS A MEDICAL EMERGENCY THAT CAN CAUSE DEATH AND MUST BE TREATED IN THE HOSPITAL. LACTIC ACIDOSIS IS CAUSED BY A BUILD-UP OF LACTIC ACID IN YOUR BLOOD.
STOP TAKING XIGDUO XR IF YOU GET ANY OF THE FOLLOWING SYMPTOMS OF LACTIC ACIDOSIS AND SEE YOUR DOCTOR IMMEDIATELY:
You feel very weak and tired.
You have unusual (not normal) muscle pain.
You have trouble breathing.
You have stomach pain with nausea and vomiting, or diarrhoea.
You feel cold, especially in your arms and legs.
You feel dizzy or lightheaded.
You have a slow or irregular heart beat
Your medical condition suddenly changes.
The risk of lactic acidosis is higher in the elderly, those whose diabetes is poorly controlled, those with prolonged fasting, those with certain heart conditions, those who drink alcohol and those with kidney or liver problems.
Occasionally, XIGDUO XR may be associated with changes in your cholesterol or fats in your blood. These can only be found when your doctor does tests from time to time to check your progress.
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 XIGDUO XR
Storage
Keep your XIGDUO XR tablets in the blister until it is time to take them.
If you take XIGDUO XR out of the blister, it will not keep well.
Keep your tablets in a cool dry place where the temperature stays below 30°C.
Do not store XIGDUO XR 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 XIGDUO XR or the tablets have passed their expiry date, ask your pharmacist what to do with any medicine that is left over.
Product description
What XIGDUO XR looks like
XIGDUO XR tablets are available in three strengths:
10mg/500mg, pink, biconvex, capsule shaped, film-coated tablets with '1072' and '10/500' debossed on one side and plain on the other side. Available in blister packs of 7 and 28 tablets.
10mg/1000mg, yellow to dark yellow, biconvex, oval shaped, film-coated tablets with '1073' and '10/1000' debossed on one side and plain on the other side. Available in blister packs of 7 and 28 tablets.
5mg/1000mg, pink to dark pink, biconvex, oval shaped, film-coated tablets with '1071' and '5/1000' debossed on one side and plain on the other side. Available in blister packs of 14 and 56 tablets.
Ingredients
Each XIGDUO XR tablet contains the following active ingredients:
XIGDUO XR 10/500 - dapagliflozin 10 mg and metformin 500 mg
XIGDUO XR 10/1000 - dapagliflozin 10 mg and metformin 1000 mg
XIGDUO XR 5/1000 - dapagliflozin 5 mg and metformin 1000 mg
Plus the following inactive ingredients:
microcrystalline cellulose
lactose
carmellose sodium
hypromellose
crospovidone
silicon dioxide
magnesium stearate
polyvinyl alcohol
titanium dioxide
polyethylene glycol
talc
yellow iron oxide (10mg/1000mg tablets)
red iron oxide (10mg/500mg and 5mg/1000mg tablets)
XIGDUO XR tablets do not contain gluten or sucrose.
