Lexicomp and UpToDate Drug Handouts: Dapagliflozin, Saxagliptin, and Metformin

Patient Education

Dapagliflozin, Saxagliptin, and

Metformin(dap a gli FLOE zin, sax a GLIP tin, & met FOR min)
Warning
Rarely, metformin may cause an acid health problem (lactic acidosis). The risk is higher in
people who have kidney problems, liver problems, heart failure, use alcohol, or take
other drugs like topiramate. The risk is also higher in older people (65 or older) and in
people who are having surgery, an exam or test with contrast, or other procedures. If
lactic acidosis happens, it can lead to other health problems and can be deadly. Kidney
tests may be done while taking this drug.
Do not take this drug if you have a very bad infection, low oxygen, or a lot of fluid loss
(dehydration).
Call your doctor right away if you have signs of too much lactic acid in the blood (lactic
acidosis) like fast breathing, fast or slow heartbeat, a heartbeat that does not feel
normal, very bad upset stomach or throwing up, feeling very sleepy, shortness of breath,
feeling very tired or weak, very bad dizziness, feeling cold, or muscle pain or cramps.

What is this drug used for?

It is used to lower blood sugar in patients with high blood sugar (diabetes).
What do I need to tell my doctor BEFORE I take this drug?
If you are allergic to this drug; any part of this drug; or any other drugs, foods, or
substances. Tell your doctor about the allergy and what signs you had.
If you have any of these health problems: Acidic blood problem, bladder cancer, or type 1
diabetes.
If you have any of these health problems: Kidney disease or liver disease.
If you are dehydrated, talk with your doctor.
If you have had a recent heart attack or stroke.
If you are not able to eat or drink like normal, including before certain procedures or
surgery.
If you are having an exam or test with contrast or have had one within the past 48 hours,
talk with your doctor.
If you take any drugs (prescription or OTC, natural products, vitamins) that must not be
taken with this drug, like certain drugs that are used for HIV, infections, or depression.
There are many drugs that must not be taken with this drug. Your doctor or pharmacist can
tell you if you are taking a drug that must not be taken with this drug.
If you are pregnant or may be pregnant. Do not take this drug if you are in the second or
third trimester of pregnancy.
If you are breast-feeding. Do not breast-feed while you take this drug.
This is not a list of all drugs or health problems that interact with this drug.
Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and
health problems. You must check to make sure that it is safe for you to take this drug with all of your drugs
and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.

What are some things I need to know or do while I take this drug?
Tell all of your health care providers that you take this drug. This includes your doctors,
nurses, pharmacists, and dentists. This drug may need to be stopped before certain types
of surgery as your doctor has told you. If this drug is stopped, your doctor will tell you
when to start taking this drug again after your surgery or procedure.
To lower the chance of feeling dizzy or passing out, have your child rise slowly if your child
has been sitting or lying down. Have your child be careful going up and down stairs.
Do not drive if your blood sugar has been low. There is a greater chance of you having a
crash.
High cholesterol has happened with this drug. If you have questions, talk with the doctor.
Talk with your doctor before you drink alcohol.
It may be harder to control blood sugar during times of stress such as fever, infection,
injury, or surgery. A change in physical activity, exercise, or diet may also affect blood
sugar.
Be careful in hot weather or while being active. Drink lots of fluids to stop fluid loss.
You may see something that looks like the tablet in your stool. This is normal and not a
cause for concern. If you have questions, talk with your doctor.
Bladder cancer has happened in a few more people taking this drug than in those taking
other drugs for diabetes. It is not known if this drug led to these cases of bladder cancer.
Talk with your doctor.
Kidney problems have happened. Sometimes, these may need to be treated in the hospital
or with dialysis.
A severe and sometimes deadly pancreas problem (pancreatitis) has happened with other
drugs like this one.
A rare but very bad infection has happened with drugs like this one. This infection may be
deadly. Get medical help right away if your genitals or the area between your genitals and
rectum becomes tender, red, or swollen, and you have a fever or do not feel well.
Too much acid in the blood or urine (ketoacidosis) and severe urinary tract infections (UTIs)
have happened. Ketoacidosis can be deadly. Both of these may need to be treated in a
hospital.
A skin reaction called bullous pemphigoid has happened with drugs like this one.
Sometimes, people have had to go to the hospital. Call your doctor right away if you have
blisters or if your skin starts to break down.
Heart failure has happened in people taking this drug. Tell your doctor if you have ever had
heart failure or kidney problems. Call your doctor right away if you feel very tired or you
have shortness of breath, a big weight gain, or swelling in the arms or legs.
If you are 65 or older, use this drug with care. You could have more side effects.
There is a chance of pregnancy in women of childbearing age who have not been ovulating.
If you want to avoid pregnancy, use birth control while taking this drug.
What are some side effects that I need to call my doctor about right away?
WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly
side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following
signs or symptoms that may be related to a very bad side effect:
 Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin
with or without fever; wheezing; tightness in the chest or throat; trouble breathing,
swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or
throat.
Signs of dehydration like dry skin, mouth, or eyes; thirst; fast heartbeat; dizziness; fast
breathing; or confusion.
Signs of kidney problems like unable to pass urine, change in how much urine is passed,
blood in the urine, or a big weight gain.
Signs of a pancreas problem (pancreatitis) like very bad stomach pain, very bad back pain,
or very bad upset stomach or throwing up.
Signs of a urinary tract infection (UTI) like blood in the urine, burning or pain when passing
urine, feeling the need to pass urine often or right away, fever, lower stomach pain, or
pelvic pain.
Strong odor to urine.
For females, vaginal yeast infection. Report itching or discharge.
For men, yeast infection of the penis. Report pain, swelling, rash, or discharge.
Low blood sugar can happen. The chance may be raised when this drug is used with other
drugs for diabetes. Signs may be dizziness, headache, feeling sleepy or weak, shaking, fast
heartbeat, confusion, hunger, or sweating. Call your doctor right away if you have any of
these signs. Follow what you have been told to do for low blood sugar. This may include
taking glucose tablets, liquid glucose, or some fruit juices.
Drugs like this one may cause joint pain that can be very bad and disabling. Call your
doctor right away if you have very bad joint pain or any joint pain that does not go away.
What are some other side effects of this drug?
All drugs may cause side effects. However, many people have no side effects or only have minor side effects.
Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not
go away:
Signs of a common cold.
Headache.
It is common to have stomach problems like upset stomach, throwing up, or diarrhea when
you start taking this drug. If you have stomach problems later during treatment, call your
doctor right away. This may be a sign of an acid health problem in the blood (lactic
acidosis).
These are not all of the side effects that may occur. If you have questions about side effects, call your doctor.
Call your doctor for medical advice about side effects.
You may report side effects to your national health agency.
You may report side effects to the FDA at 1-800-332-1088. You may also report side effects at
https://www.fda.gov/medwatch.

How is this drug best taken?

Use this drug as ordered by your doctor. Read all information given to you. Follow all instructions closely.
Take in the morning.
Take this drug with food.
Swallow whole. Do not chew, break, or crush.
Drink lots of noncaffeine liquids unless told to drink less liquid by your doctor.
Keep taking this drug as you have been told by your doctor or other health care provider,
 even if you feel well.
If you cannot drink liquids by mouth or if you have upset stomach, throwing up, or diarrhea
that does not go away; you need to avoid getting dehydrated. Contact your doctor to find
out what to do. Dehydration may lead to new or worse kidney problems.
Have blood work checked as you have been told by the doctor. Talk with the doctor.
Check your blood sugar as you have been told by your doctor.
Follow the diet and workout plan that your doctor told you about.
If you are on a low-salt or salt-free diet, talk with your doctor.
This drug may affect certain lab tests. Tell all of your health care providers and lab workers
that you take this drug.
What do I do if I miss a dose?
Take a missed dose as soon as you think about it, with food.
If it is less than 12 hours until the next dose, skip the missed dose and go back to your
normal time.
Do not take 2 doses at the same time or extra doses.
How do I store and/or throw out this drug?
Store at room temperature in a dry place. Do not store in a bathroom.
Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain
unless you are told to do so. Check with your pharmacist if you have questions about the
best way to throw out drugs. There may be drug take-back programs in your area.
General drug facts
If your symptoms or health problems do not get better or if they become worse, call your
doctor.
Do not share your drugs with others and do not take anyone else's drugs.
Some drugs may have another patient information leaflet. If you have any questions about
this drug, please talk with your doctor, nurse, pharmacist, or other health care provider.
This drug comes with an extra patient fact sheet called a Medication Guide. Read it with
care. Read it again each time this drug is refilled. If you have any questions about this
drug, please talk with the doctor, pharmacist, or other health care provider.
If you think there has been an overdose, call your poison control center or get medical care
right away. Be ready to tell or show what was taken, how much, and when it happened.
Consumer Information Use and Disclaimer
This information should not be used to decide whether or not to take this medicine or any other medicine. Only
the healthcare provider has the knowledge and training to decide which medicines are right for a specific
patient. This information does not endorse any medicine as safe, effective, or approved for treating any patient
or health condition. This is only a brief summary of general information about this medicine. It does NOT
include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects,
or risks that may apply to this medicine. This information is not specific medical advice and does not replace
information you receive from the healthcare provider. You must talk with the healthcare provider for complete
information about the risks and benefits of using this medicine.

Last Reviewed Date

2020-03-03
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© 2020 Wolters Kluwer Clinical Drug Information, Inc. and its affiliates and/or licensors. All rights reserved.