Common questions about dapagliflozin - Brand name: Forxiga

Dapagliflozin is a type of medicine known as a sodium-glucose cotransporter-2 (SGLT2) inhibitor. It works by lowering blood sugar levels in people with type 2 diabetes. It does this by helping to get rid of extra sugar from your body through your pee.

If you have heart failure, dapagliflozin reduces the amount of work your heart has to do to pump blood around your body. This helps improve the symptoms of heart failure such as breathlessness, tiredness and swelling in your lower legs. It also reduces the chances of your heart getting weaker.

If you have chronic kidney disease it works by reducing pressure and swelling (inflammation) in the kidneys.

Dapagliflozin starts to work after about 2 hours to reduce your blood glucose levels, but it may take up to a week for it to take full effect.

You may not have had any symptoms of diabetes, so you will not necessarily feel any different when you take dapagliflozin. This does not mean that dapagliflozin is not working, so it's important to keep taking it.

Dapagliflozin will help keep your blood sugar level stable and reduce your chances of diabetes-related problems in the future.

If you are taking dapagliflozin for heart failure, it might be a month or 2 before you notice any improvement in symptoms. Although you may not feel different, dapagliflozin is still working to reduce the workload on your heart. This will reduce your chances of your heart failure getting worse.

If you're taking it for chronic kidney disease, you may not feel any different but it helps to slow down how quickly your condition gets worse.

Dapagliflozin is safe to take for a long time. There's no evidence that this medicine harms your general health.

Do not stop taking dapagliflozin without talking to your doctor first. If you stop taking it suddenly, your diabetes, heart failure or chronic kidney disease may get worse.

If this medicine is not working for you or you're bothered by side effects, speak to your doctor. They may be able to recommend another medicine to treat your diabetes.

There are different groups of medicines that can lower blood sugar levels if you have type 2 diabetes:

• metformin
• pioglitazone
• DPP-4 inhibitors or gliptins, such as saxagliptin
• GLP-1 agonists, such as exenatide
• SGLT2 inhibitors, such as dapagliflozin
• insulin

Dapagliflozin is usually prescribed for type 2 diabetes if you cannot take metformin, or if metformin is no longer keeping your blood sugar level under control.

It can be prescribed on its own or in combination with some of these other medicines.

SGLT2 inhibitors all work by increasing the amount of sugar removed from your body when you pee.

These medicines can cause urinary tract infections because of the way they work.

Dapaglifozin is usually added to other heart failure medicines to help control your condition. Other heart failure medicines include:

• ACE inhibitors such as enalapril, lisinopril or ramipril
• angiotensin blockers such as candesartan, losartan or valsartan
• beta blockers such as bisoprolol
• diuretics (tablets that make you pee more) such as furosemide or bumetanide

Dapagliflozin is usually added to other medicines to help control your condition. Other medicines used for chronic kidney disease include:

• angiotensin-converting enzyme (ACE) inhibitors such as enalapril, lisinopril or ramipril
• angiotensin receptor blockers (ARBs) such as candesartan, losartan or valsartan

If you have diabetes, you're entitled to free prescriptions for all of your medicines, not just your diabetes ones.

To claim your free prescriptions, you'll need to have a medical exemption certificate (FP92A). You can get an application form at your GP surgery.

Before having an operation, tell the doctor that you're taking dapagliflozin.

If you have type 2 diabetes, they may tell you to stop taking your dapagliflozin tablets if you need to stop eating before your operation.

Dapagliflozin can cause weight loss because it can increase the amount of sugar you lose from your body when you pee.

Dapagliflozin does not affect any type of contraception, including the combined pill and emergency contraception.

Dapagliflozin does not affect your ability to drive or ride a bike. But if you're taking dapagliflozin together with other diabetes medicines, such as sulfonylureas or insulin, it can cause your blood sugar levels to go too low (hypoglycaemia or a "hypo").

Hypos can reduce your concentration. If this happens to you, do not drive, cycle or use machines or tools until you feel better.

Yes, you can drink alcohol in moderation while taking dapagliflozin. But it's best to drink no more than 2 units per day. Drinking more than this can increase your risk of low blood sugar.

It's a good idea to cut down on foods with added sugar. However, speak to your doctor before starting a low calorie, reduced carbohydrate or ketogenic (keto) diet.

Check nutrition labels, as many foods and drinks are high in sugar. These include:

• sweets
• cakes
• biscuits
• chocolate
• some fizzy drinks
• juice drinks

Also be careful of juices, teas or curries that contain the fruit, karela. This fruit is also known as bitter gourd or bitter melon and is known to lower blood glucose levels.

There are some lifestyle changes you can make to help control the symptoms of type 2 diabetes, heart failure or chronic kidney disease.

These include:

• eating a healthy diet
• losing any excess weight
• not smoking
• cutting down on alcohol – try to keep to the recommended guidelines of no more than 14 units of alcohol a week
• exercising – if you're planning to exercise more than usual, make sure you eat carbohydrates like bread, pasta or cereals before, during or after exercise. Regular physical activity can improve your symptoms and general health. Check with your doctor to see what is appropriate for you. If you have heart failure, you may be advised to attend a cardiac rehabilitation programme that will include advice on exercise