Dapagliflozin
Pronunciation: dap-a-gli-FLOE-zin.
Last medically reviewed: August 14, 2026, by Dr. Rina Basnet, MBBS, MD (Internal Medicine).
- Generic name
- dapagliflozin
- Drug class
- Sodium-glucose cotransporter 2 (SGLT2) inhibitor
- Form
- Film-coated tablet
- Route
- Oral
- Legal status
- Availability varies by country
Prescription required in Australia
Trade names by country: United States · United Kingdom · Canada · Australia · India · Nepal · New Zealand · China
Australia: Forxiga, Dapagliflozin (Sandoz), Glixafor, Dapagliflozin (AZN), Dapagliflozin (Viatris) · Full directory
What dapagliflozin is and how it works
Dapagliflozin blocks SGLT2, a transporter in the kidneys. This increases urinary glucose excretion and causes a mild diuretic/natriuretic effect. Its heart and kidney benefits are not limited to glucose lowering, so some people without diabetes receive it for heart failure or chronic kidney disease. (1) (2)
The reason it was prescribed matters. Dosing, kidney-function recommendations, monitoring, and age limits can differ by indication and country. Use the label supplied with your own medicine and ask your prescriber or pharmacist when guidance differs online.
Mechanism of action: how dapagliflozin works
Dapagliflozin selectively inhibits SGLT2 in the proximal renal tubule, reduces reabsorption of filtered glucose and sodium, and increases urinary glucose excretion. The U.S. label reports about 78% oral bioavailability, approximately 91% protein binding, primary UGT1A9 metabolism, and a mean terminal half-life around 12.9 hours after a 10 mg dose. (1) (2) (4)
What dapagliflozin is used for
Type 2 diabetes
Used with diet and activity measures to improve glycaemic control in adults and, in the United States and European Union, children aged 10 years and older. Product approvals differ by country. (1) (2) (4)
Heart failure
Used in adults to reduce specified heart-failure outcomes. The exact authorised wording varies by regulator. (1) (2)
Chronic kidney disease
Used in adults with chronic kidney disease for regulator-defined kidney and cardiovascular outcomes. This does not mean it is suitable for every kidney condition or every eGFR level. (1) (2)
Before taking dapagliflozin
Do not take / not appropriate for
- Do not take a product if you have had a serious hypersensitivity reaction to dapagliflozin or one of that product’s ingredients. (United States label; check local product information) (1)
- Dapagliflozin does not treat diabetic ketoacidosis and is not approved in the United States to improve glycaemic control in type 1 diabetes. (United States) (1)
Tell your clinician about
- kidney or liver disease, low blood pressure, dehydration, or a prescribed fluid restriction
- recurrent urinary or genital infections, or problems urinating
- pancreatitis, pancreatic surgery, or another condition that reduces insulin production
- insulin use, missed insulin, a ketogenic diet, fasting, reduced food intake, or heavy alcohol use
- vomiting, diarrhoea, fever, acute illness, or planned surgery/procedure
- pregnancy, plans for pregnancy, or breastfeeding
- all medicines, vitamins, supplements, and herbal products
How to take dapagliflozin
- Take the prescribed tablet once daily, with or without food, at about the same time each day.
- Do not take more, take it more often, or change the strength because of information on this page.
- Do not stop routinely without speaking to the prescriber. Sudden interruption can worsen the condition being treated; urgent ketoacidosis instructions are an exception.
- During vomiting, diarrhoea, fever, reduced intake, or dehydration, contact the clinical team promptly and follow any sick-day plan they have provided. Follow a prescribed fluid restriction rather than generic advice to drink extra.
Surgery and prolonged fasting
Tell the surgeon, dentist, anaesthetist, and prescriber that you take dapagliflozin. The current U.S. label says to withhold Farxiga for at least 3 days, if possible, before surgery or procedures associated with prolonged fasting and to resume only when clinically stable and oral intake has resumed. Follow the timing in your own country’s product information and your clinical team’s plan. (1) (5)
Missed dose
Do not take two doses at the same time or double the next dose.
United States
The June 2026 U.S. prescribing-information section says to take a missed dose as soon as possible and not to double the next dose. The Medication Guide on the same label still says to skip it if it is almost time for the next dose. Because those directions are not fully harmonised, do not double and ask the dispensing pharmacist or prescriber if the timing is uncertain. (1)
United Kingdom
NHS guidance says to take it when remembered unless the next dose is within 12 hours; if it is, skip the missed dose and take the next at the usual time. (6)
Other countries
Use the patient leaflet supplied with your medicine or ask a pharmacist, because local directions may differ.
Overdose
If you take more than prescribed, contact a local poison information service, pharmacist, or urgent medical service now and take the medicine pack with you if advised. Call emergency services for collapse, seizure, difficulty breathing, or inability to wake. Do not wait for predicted symptoms; the U.S. label reports no development-program overdose cases and says haemodialysis removal has not been studied. (1) (5) (6)
Side effects
Side-effect frequency varies by indication, other medicines, and the product information used in your country. This list is not complete.
Genital fungal infection (thrush)
What to notice: itching, soreness, redness, or unusual discharge
What to do: Contact a pharmacist or clinician if symptoms develop, are severe, or keep returning. (1) (6)
Urinary tract infection symptoms
What to notice: burning or pain when urinating, needing to urinate often, or lower abdominal discomfort
What to do: Seek clinical advice; fever, chills, back/side pain, vomiting, or feeling very unwell can signal a more serious infection. (1) (6)
Urinating more often
What to notice: an increase in urine volume or frequency
What to do: Contact the clinical team if this is troublesome or is accompanied by dizziness, faintness, very dry mouth, or reduced intake. (1) (6)
Volume depletion or low blood pressure
What to notice: dizziness, faintness, weakness, very dry mouth, or difficulty keeping fluids down
What to do: Contact the clinical team promptly. Risk may be higher with older age, impaired kidney function, low blood pressure, or diuretics. (1)
Low blood glucose when used with insulin or an insulin secretagogue
What to notice: sweating, shaking, hunger, dizziness, confusion, or symptoms in the person’s diabetes plan
What to do: Follow the prescribed hypo plan and contact the diabetes team if episodes occur. Do not reduce insulin or another medicine by yourself. (1) (6)
Serious warnings
Ketoacidosis — urgent
Symptoms: nausea, vomiting, abdominal pain, unusual tiredness or malaise, shortness of breath, confusion, or marked thirst; glucose may be below the level usually expected in diabetic ketoacidosis
Action: Seek urgent medical assessment immediately. A clinician or emergency service will decide whether dapagliflozin needs to be stopped -- tell them you take an SGLT2 inhibitor. (1) (5)
Fournier’s gangrene (necrotising infection of the genital/perineal area) — urgent
Symptoms: pain, tenderness, redness, or swelling around the genitals or perineum, especially with fever, malaise, or feeling very unwell
Action: Seek urgent medical care immediately. This rare infection needs prompt treatment. (1) (6)
Serious urinary infection — urgent
Symptoms: fever or chills, burning urination, pain in the back or side, vomiting, or feeling very unwell
Action: Seek urgent clinical assessment because kidney infection or sepsis may need prompt treatment. (1) (6)
Serious allergic reaction — emergency
Symptoms: swelling of the face, lips, tongue, or throat; trouble breathing or swallowing; collapse; or a severe widespread rash
Interactions
| Medicine or test | Effect | Action |
|---|---|---|
| Insulin or insulin secretagogues such as sulfonylureas | The risk of hypoglycaemia can increase. | The prescriber may adjust the other medicine. Do not alter it yourself. (1) (2) |
| Lithium | An SGLT2 inhibitor may reduce serum lithium concentration. | Lithium concentrations may need more frequent monitoring during initiation and dosage changes. (1) |
| Diuretics and medicines that lower blood pressure | They can add to volume depletion or low-blood-pressure risk in susceptible people. | Tell the prescriber and report dizziness, faintness, vomiting, diarrhoea, or reduced intake. (1) (6) |
| Urine glucose testing | Dapagliflozin causes urinary glucose and therefore positive urine glucose tests. | Do not use urine glucose testing to assess glycaemic control while taking an SGLT2 inhibitor; use the clinician-recommended method. (1) |
| 1,5-anhydroglucitol (1,5-AG) assay | Results are unreliable for assessing glycaemic control with an SGLT2 inhibitor. | Use an alternative clinician-selected method. (1) |
Pregnancy, breastfeeding, kidney/liver function, age
Kidney function
Dapagliflozin is used for chronic kidney disease, but its glucose-lowering effect and initiation rules depend on eGFR, indication, and country. Kidney impairment is not a single universal contraindication. Your prescriber should use current local product information. (1) (2) (4)
Liver impairment
Tell the prescriber about liver disease. Severe hepatic guidance differs by jurisdiction, so a universal dose statement is unsafe. (1) (4)
Pregnancy
Tell the prescriber promptly if you are pregnant, may be pregnant, or plan pregnancy. The U.S. label does not recommend Farxiga in the second and third trimesters; NHS guidance says to avoid dapagliflozin during pregnancy. The underlying diabetes or heart-failure condition also needs treatment planning. (1) (6)
Breastfeeding
Dapagliflozin is not recommended while breastfeeding in the current U.S. label, and NHS guidance advises avoiding it. Discuss an alternative plan with the clinical team. (1) (6)
Children and adolescents
U.S. and EU information supports type 2 diabetes use from age 10, but pediatric heart-failure and CKD uses are not established in the U.S.; approvals differ by country. New Zealand’s available data sheet states pediatric safety and effectiveness have not been established. (1) (2) (4)
Older adults
No U.S. dose change is recommended based only on age, but older people can have more hypotension/volume-depletion reactions and often need closer assessment of kidney function and medicines. (1)
Monitoring
Before starting
- reason for treatment and local approved indication
- kidney function
- volume status and low-blood-pressure risk
- current medicines and ketoacidosis risk factors
During treatment
- kidney function and volume status as clinically indicated
- glucose/HbA1c only when relevant to diabetes care
- symptoms of ketoacidosis, genital or urinary infection, and low blood pressure
- lithium concentration when co-treated, according to the prescriber
Storage
Keep the medicine in its original packaging, out of sight and reach of children, and follow the temperature and disposal instructions on your own pack. Do not use a single global temperature rule because authorised product instructions differ.
United States: Farxiga: store at 20°C to 25°C; permitted excursions are 15°C to 30°C. (1)
For healthcare professionals and students
Summary only. Use current local approved product information and clinical guidance for prescribing decisions.
United States
Indication: Glycaemic control in type 2 diabetes, age 10 years and older
Dose summary: 5 mg orally once daily; may increase to 10 mg once daily for additional glycaemic control.
Renal context: At eGFR ≥45 mL/min/1.73 m², same dosage as normal renal function. Not recommended solely to improve glycaemic control below 45 because effectiveness is reduced. (1)
United States
Indication: Adult heart failure, CKD, or reduction of heart-failure hospitalisation risk in specified type 2 diabetes populations
Dose summary: 10 mg orally once daily.
Renal context: Same dose at eGFR ≥25 mL/min/1.73 m². Initiation below 25 is not recommended; if eGFR falls below 25 during therapy, 10 mg may be continued for labelled kidney/heart outcomes. (1)
European Union
Indication: Type 2 diabetes, chronic heart failure, or chronic kidney disease
Dose summary: 10 mg once daily in the EMA overview; consult the current product information for all special-population details.
Renal context: Do not substitute U.S. thresholds; use the current EU product information. (2)
New Zealand
Indication: Authorised uses in the current Medsafe data sheet
Dose summary: 10 mg once daily.
Renal context: No dosage adjustment based on renal function; glucose-lowering efficacy is reduced below eGFR 45. The data sheet says not to use in severe hepatic impairment and does not establish pediatric use, illustrating why U.S./EU guidance must not be copied globally. (4)
Hepatic guidance
United States: no dose adjustment for mild, moderate, or severe hepatic impairment, with individual benefit-risk assessment in severe impairment. New Zealand: do not use in severe hepatic impairment. Verify each jurisdiction independently.
Overdose note
No overdose reports occurred in the U.S. clinical development programme. Consult Poison Help/medical toxicology and use supportive care based on clinical status; removal by haemodialysis has not been studied. (1) (2) (4)
Frequently asked questions
What is dapagliflozin used for?
It is used for type 2 diabetes and, in adults, certain heart-failure and chronic-kidney-disease outcomes. The exact approved indication varies by country. (1) (2)
Can dapagliflozin cause ketoacidosis if my glucose is not very high?
Yes. Ketoacidosis can occur with glucose below the level usually expected in diabetic ketoacidosis. Seek urgent medical assessment immediately for nausea or vomiting, abdominal pain, unusual tiredness, shortness of breath, confusion, or marked thirst that could represent ketoacidosis -- a clinician or emergency service will decide on next steps, including whether to stop the medicine. (1)
What should I do before surgery?
Tell every clinician involved that you take dapagliflozin. The current U.S. label says to withhold Farxiga for at least three days, if possible, before surgery or a procedure with prolonged fasting and to restart only when stable and eating. Follow your own country’s product information and clinical plan. (1) (5)
Can I take dapagliflozin if I have kidney disease?
Dapagliflozin is used to treat some adults with chronic kidney disease, but suitability and initiation depend on the indication, eGFR, and country. Do not use a single online cutoff to decide; ask the prescriber to apply current local product information. (1) (2)
Does dapagliflozin cause low blood glucose?
The risk is especially important when dapagliflozin is combined with insulin or a medicine that stimulates insulin release. Follow the prescribed hypo plan and do not reduce another medicine without the clinical team. (1) (2)
Why is glucose found in my urine?
Dapagliflozin works partly by increasing urinary glucose. Urine glucose tests will therefore be positive and should not be used to judge glycaemic control while taking an SGLT2 inhibitor. (1)
Is dapagliflozin safe during pregnancy or breastfeeding?
Guidance differs by region, but current U.S. and UK sources do not recommend use in important pregnancy/breastfeeding circumstances. Contact the prescriber promptly for an alternative treatment plan; the underlying condition also needs safe management. (1) (6)
Are Farxiga and Forxiga the same as dapagliflozin?
They are brand names for dapagliflozin products in specific countries. Approved strengths, ingredient form, indications, and instructions can differ, so use the leaflet for the product supplied to you. (1) (2) (3)
What is the mechanism of action of dapagliflozin?
Dapagliflozin selectively inhibits SGLT2 in the proximal renal tubule, reduces reabsorption of filtered glucose and sodium, and increases urinary glucose excretion. The U.S. label reports about 78% oral bioavailability, approximately 91% protein binding, primary UGT1A9 metabolism, and a mean terminal half-life around 12.9 hours after a 10 mg dose. (1) (2) (4)
References
- dapagliflozin — Prescribing Information · · accessed · source 1
- Forxiga EPAR and product informationEuropean Medicines Agency · European Union · dated 2026-03-12 · accessed 2026-07-20 · source 2
- FORXIGA 10 mg product information, DIN 02435470Health Canada Drug Product Database · Canada · dated 2025-01-22 · accessed 2026-07-20 · source 3
- FORXIGA New Zealand Data SheetMedsafe New Zealand · New Zealand · dated 2023-06-14 · accessed 2026-07-20 · source 4
- Dapagliflozin: MedlinePlus Drug InformationMedlinePlus, U.S. National Library of Medicine · United States · dated 2026-06-15 · accessed 2026-07-20 · source 5
- DapagliflozinNHS · United Kingdom · dated 2026-06-26 · accessed 2026-07-20 · source 6
- Active ingredient: Dapagliflozinnull · null · accessed 2026-08-14 · source 7
- FORXIGA TABLET 5MG, SIN14541Pnull · null · accessed 2026-08-14 · source 8
- FORXIGA TABLET 10MG, SIN14542Pnull · null · accessed 2026-08-14 · source 9
- Forxiga 10 mg film-coated tabletsnull · null · accessed 2026-08-14 · source 10
- Approved additional indication record for Forxiganull · null · accessed 2026-08-14 · source 11
- Registered medical product directory — dapagliflozin ingredient searchnull · null · accessed 2026-08-14 · source 12
- India products — Oxra 5 mg and 10 mg dapagliflozin tabletsnull · null · accessed 2026-08-14 · source 13
- India products — Daparyl and Dapavel dapagliflozin-only tabletsnull · null · accessed 2026-08-14 · source 14
- 2025 medicine price publication — 安达唐 dapagliflozin tabletsnull · null · accessed 2026-08-14 · source 15
- Forxiga 5 mg film-coated tablets — prescription only medicinenull · null · accessed 2026-08-14 · source 16
- Sodium glucose co-transporter 2 inhibitorsnull · null · accessed 2026-08-14 · source 17
- Public medicine-safety notice identifying dapagliflozin as a prescription medicinenull · null · accessed 2026-08-14 · source 18
- Dapagliflozin ingredient product listnull · null · accessed 2026-08-14 · source 19
- DAPAGLIFLOZIN TABLET, FILM COATED [PRASCO LABORATORIES] — US prescribing information (DailyMed SPL)U.S. National Library of Medicine (DailyMed) · US · accessed 2026-08-14 · source 20
- FARXIGA — FDA approval record (Drugs@FDA NDA202293)U.S. Food and Drug Administration · US · accessed 2026-08-14 · source 21
- dapagliflozin — RxNorm normalized drug concept (RXCUI 1488564)U.S. National Library of Medicine (RxNorm) · US · accessed 2026-08-14 · source 22
Brand names by country
Single-ingredient dapagliflozin names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.
Priority countries
United States
- Farxiga (1)current · 5 mg, 10 mg · AstraZeneca Pharmaceuticals LP
United Kingdom
Canada
- FORXIGA
Australia
- Forxigalisted
- Dapagliflozin (Sandoz)listed
- Glixaforlisted
- Dapagliflozin (AZN)listed
- Dapagliflozin (Viatris)listed
India
- Forxigamanufacturer-confirmed in India · AstraZeneca Pharma India Limited
- Oxracurrent India product listing · 5 mg, 10 mg · Sun Pharmaceutical Industries Limited
- Daparylcurrent India product listing · 5 mg, 10 mg · Intas Pharmaceuticals Ltd
- Dapavelcurrent India product listing · 5 mg, 10 mg · Intas Pharmaceuticals Ltd
- Glucretacurrent India product listing · Torrent Pharmaceuticals Ltd
Nepal
- ForxigaDDA register; valid to 2029-02-14 · 5 mg, 10 mg · AstraZeneca Pharmaceuticals LP; importer Shub Labh Pharma Link
- DapaguardDDA register; valid to 2031-05-30 · 5 mg, 10 mg · Siddhartha Pharmaceuticals Limited
- Dapastar-5DDA register; valid to 2031-06-11 · 5 mg · Nepal Remedies Ltd
- DamglipDDA register; valid to 2031-04-11 · 10 mg · Arya Pharmalab Pvt Ltd
- DapatusDDA register; valid to 2030-11-02 · 5 mg, 10 mg · Arrow Pharmaceuticals Limited
New Zealand
- Forxiga (4)current data sheet · 10 mg · AstraZeneca
China
- 安达唐 (Āndátáng)current Chinese government-listed trade name · 10 mg · AstraZeneca
View brands in additional countries.
Singapore
Forxiga
United Arab Emirates
Forxiga
Philippines
Forxiga
South Africa
Forxiga
Ireland
Forxiga
Malaysia
Forxiga
Saudi Arabia
Forxiga, Dapxiga, Forsdapa
Nigeria
Dapaziga, Dapzin, Dapiflozin