Dapagliflozin / Metformin

Xigduo XR

Xigduo XR is a prescription FDA-approved medication used to manage blood glucose (sugar) levels in individuals with diabetes type 2. It combines two active ingredients, dapagliflozin, and metformin, which work together to reduce sugar absorption, limit liver sugar production, and enhance insulin efficiency. Xigduo XR is taken once daily, preferably in the morning with food, to minimize gastrointestinal discomfort. It’s important for patients to discuss their complete health history with their healthcare provider to ensure the medication is safe based on individual health conditions and other medications being taken.

Product Overview

Xigduo XR is an oral medication specifically designed for the management of blood sugar levels in adults diagnosed with type 2 diabetes. This combination drug includes dapagliflozin, a sodium-glucose co-transporter 2 (SGLT2) inhibitor, and metformin, a biguanide. Together, these ingredients work by reducing the amount of glucose absorbed from the gut, decreasing glucose production in the liver, and improving insulin sensitivity which helps in better glucose uptake by the cells.

The usual regimen involves taking Xigduo XR once daily in the morning along with food to help reduce potential stomach upset. It is crucial for patients to swallow the tablet whole to ensure the proper release and absorption of the medication. Before starting Xigduo XR, patients must inform their healthcare provider about any existing conditions like kidney or liver issues, heart problems, or severe allergies. This is vital as Xigduo XR can interact with other medications and may not be suitable for everyone, especially those with a history of diabetic ketoacidosis or severe renal impairment. Regular blood tests to monitor kidney function, liver function, and blood cell counts are recommended to avoid complications.

Potential side effects range from mild, such as nausea and urinary tract infections, to severe, including the risk of lactic acidosis, a life-threatening condition. Immediate medical attention is necessary if symptoms of serious side effects occur. Patients are also advised to maintain a balanced diet and regular exercise regime and closely monitor their blood sugar levels as part of an overall diabetes management plan. Consulting with a healthcare provider regularly to adjust the dosage or address any concerns is essential for the safe and effective use of Xigduo XR.

What Are the Uses of Xigduo XR?

Xigduo XR is primarily prescribed to help control blood sugar levels in individuals with type 2 diabetes. It is also used for patients with type 2 diabetes who have chronic kidney disease, heart failure, or heart disease—or those at high risk for heart disease—to help prevent several serious health issues:

• Reduction in the need for urgent heart failure treatment or hospitalization.
• Prevention of kidney problems from getting worse.
• Decrease in the risk of dying from heart-related issues.

[Note: Xigduo XR is not suitable for treating type 1 diabetes. Additionally, it may be prescribed for other conditions as deemed appropriate by your healthcare provider.]

What Are the Forms & Strengths of Xigduo XR?

Xigduo XR comes in the form of oral tablets and is available in 5 strengths:

• 2.5 mg/1000 mg (dapagliflozin/metformin) tablets
• 5 mg/500 mg (dapagliflozin/metformin) tablets
• 5 mg/1000 mg (dapagliflozin/metformin) tablets
• 10 mg/500 mg (dapagliflozin/metformin) tablets
• 10 mg/1000 mg (dapagliflozin/metformin) tablets

What Are the Recommended Dosage of Xigduo XR?

Your healthcare provider will decide the best starting dose of Xigduo XR for you based on the dosages of any other diabetes medications you are currently taking.

• Starting Dose for Dapagliflozin: If you are not already taking dapagliflozin, the usual initial dose is 5 mg, taken orally once every day.
• Dose for Heart or Kidney Issues: If you have heart failure or kidney problems, the recommended dose is usually increased to 10 mg once daily.
• Maximum Daily Dose: The highest dose you can take of Xigduo XR is a combination of 10 mg dapagliflozin and 2000 mg metformin, taken once a day.

[Note: Remember, these recommendations may vary from person to person. Discuss it with your doctor, and they’ll customize your dosage accordingly.]

How to Use Xigduo XR?

Take Xigduo XR extended-release tablets exactly as your doctor prescribes. Be sure to follow all the directions on your prescription label and read any medication guides or instruction sheets provided to you. Your doctor may occasionally adjust your dosage.

Directions for Use:

• Xigduo XR is typically taken once a day, in the morning.
• Always take the tablet with food to help avoid stomach upset.
• Swallow the tablet whole without crushing, chewing, or breaking it.

Managing Blood Sugar Levels:

• Be alert for symptoms of low blood sugar (hypoglycemia), such as hunger, dizziness, irritability, confusion, anxiety, or shakiness. To quickly manage low blood sugar, consume a fast-acting source of sugar like fruit juice, hard candy, crackers, raisins, or non-diet soda.
• Your doctor might provide you with a glucagon injection kit for severe hypoglycemia. Make sure your family or close friends know how to administer this injection if needed.
• Look out for signs of high blood sugar (hyperglycemia), such as increased thirst or more frequent urination.

Adjustments During Specific Conditions:

• Stress, surgery, illness, alcohol use, exercise, or skipping meals can affect your blood sugar levels. Consult your doctor before making any changes to your dose or medication schedule.
• Inform your doctor if you experience ongoing vomiting or diarrhea or if you are sweating more than usual, as these conditions can lead to dehydration.

Additional Precautions:

• Notify any doctor who treats you that you are taking Xigduo XR, especially if you need surgery or medical tests.
• This medication is part of a comprehensive treatment program that includes diet, exercise, weight control, blood sugar testing, and special medical care.
• Your doctor may advise you to take additional vitamin B12. 

[Note: Your doctor will decide the right amount for you based on your condition, following guidelines and studies on the drug. They’ll adjust it as needed over time.]

How Does Xigduo XR Work?

Xigduo XR is a medication designed to prevent your blood sugar levels from becoming too high. Here’s how it helps manage your blood sugar:

1. Reduces Sugar Absorption: Xigduo XR decreases the amount of sugar your body absorbs from the food and drinks you consume.
2. Limits Sugar Production: It also reduces the amount of sugar that your liver produces.
3. Enhances Insulin Efficiency: Xigduo XR improves the effectiveness of your body’s insulin, which is a hormone that helps your body use sugar for energy.
4. Increases Sugar Excretion: This medication helps your body eliminate sugar through urine.
5. Lowers Health Risks: By aiding your body in getting rid of excess sugar, salt, and water, Xigduo XR also reduces the risk of complications related to heart failure, diabetes, heart disease, and kidney issues.

Important Safety Information for Using Xigduo XR

What Are the Side Effects of Xigduo XR?

Common Side Effects of Xigduo XR: Xigduo XR may cause certain side effects, which typically last only a short time—from a few days to a couple of weeks. If these side effects persist, become bothersome, or intensify, you should promptly contact your healthcare provider. Common side effects of Xigduo XR may include:

• Headache
• Common cold symptoms
• Yeast infection of the penis or vagina
• Diarrhea
• Kidney or bladder infections

Serious Side Effects of Xigduo XR: Xigduo XR can cause serious side effects. This list does not include all possible severe side effects from the medication. If you encounter any serious side effects while using Xigduo XR, immediately reach out to your healthcare provider. For life-threatening side effects or if you believe you are experiencing a medical emergency, call 911 or your local emergency services without delay. Some serious side effects of Xigduo XR include:

• Dehydration. Signs may include:
  • Seizures
  • Difficulty catching your breath or chest pain/pressure
  • Confusion
  • Extreme thirst
  • Swelling in your legs, ankles, and feet
  • Unsteadiness
  • Peeing less than normal
  • Weakness or unusual tiredness
  • Dizziness or lightheadedness
  • Loss of appetite/nausea
• Diabetic Ketoacidosis (DKA). Signs may include:
  • Difficulty breathing
  • Your breath smells fruity or sweet
  • Feeling very tired, woozy, or confused
  • Nausea/vomiting
  • Very high blood sugar levels
  • Stomach pain
• Lactic Acidosis. Signs may include:
  • Stomach pain
  • Drowsiness
  • General ill feeling
  • Difficulty breathing
  • Muscle pain
• Severe Allergic Reactions. Signs may include:
  • Joint pain
  • Nausea or vomiting
  • Trouble swallowing or throat tightness
  • Skin rash, itching, or pale red bumps on the skin called hives
  • Swelling of the mouth, face, tongue, lips, or throat
  • Wheezing or breathing problems
  • Dizziness, feeling, lightheaded, or fainting
  • Fever or general ill feeling
  • Racing heart
  • Stomach cramps
  • Swollen lymph nodes
• Necrotizing Fasciitis (Fournier’s Gangrene). Signs may include:
  • General feeling of discomfort or illness
  • Fever
  • Redness, pain, tenderness, or swelling of the perineum (of and around the genitals and anus)
• Urosepsis and Pyelonephritis. Signs may include:
  • Vomiting, upset stomach, and nausea
  • Pain in your lower side, back, or groin
  • Fever and chills
  • Needing to pee a lot or feeling pain when you pee
  • Cloudy, dark, pee that smells bad, or bloody pee
  • Loss of appetite
• Low Blood Sugar (Hypoglycemia). Signs may include:
  • Crankiness or anxiety
  • Feeling jittery or shakiness
  • Fast heartbeat
  • Blurry vision
  • Sweating
  • Headache
  • Hunger
  • Dizziness or confusion
  • Seizures
  • Slurred speech
• Vitamin B12 Deficiency. Signs may include:
  • Shortness of breath
  • Cold hands and feet
  • Lightheadedness, dizziness, or feeling like you are about to pass out
  • Unusual weakness or tiredness
  • Fast or abnormal heartbeat
  • Pale or yellowish skin
• Increase your risk of a fracture (broken bone)

[Note: Remember, this list may not cover all possible side effects. Always consult with your healthcare giver for medical advice about side effects.]

Are There Any Warnings for Xigduo XR? 

Xigduo XR is a prescription medication and should only be used by the individual to whom it was prescribed. Ensure to follow your healthcare provider’s instructions carefully.

Usage Instructions:

• Do not share Xigduo XR with others, even if they have the same health conditions. It could be harmful.
• Store Xigduo XR out of reach of children to ensure their safety.
• Sometimes, you might notice remnants resembling the tablet in your stool. This occurrence is normal and shouldn’t cause worry.
• Swallow Xigduo XR tablets whole; do not chew, cut, or crush them.

Potential Effects on Fertility:

• For women who have not undergone menopause, Xigduo XR may cause ovulation, increasing the likelihood of pregnancy. Discuss contraceptive methods with your healthcare provider if you are not planning to become pregnant.

Health Condition Monitoring:

• If you experience significant stressors such as fever, trauma, infection, or surgery, your diabetes medication needs may alter. Consult with your healthcare provider to determine if adjustments are needed.
• Be proactive in learning how to prevent, recognize, and manage extremes in blood sugar levels, such as hypoglycemia and hyperglycemia, as well as other complications related to diabetes.

Risk Awareness:

• Older adults, especially those over 65, may face higher risks of specific side effects from Xigduo XR. It’s important to discuss these potential risks with your healthcare provider.
• Individuals with kidney issues should also be aware of increased risks for side effects. Ensure your healthcare provider is aware of any kidney problems you might have.

Dietary Recommendations:

• Taking Xigduo XR in the morning with food can help reduce stomach upset.

Medical Testing:

• Be aware that Xigduo XR can cause your urine to test positive for glucose.
• Before starting Xigduo XR, your healthcare provider will perform tests to assess your kidney function and hydration levels to ensure the drug is safe for you to begin.

What Are the Xigduo XR Precautions?

• Risk Factors for Diabetic Ketoacidosis: When discussing your health with your healthcare provider, it’s crucial to mention any conditions or factors that may increase your risk for diabetic ketoacidosis, mainly if you are prescribed Xigduo XR. These risk factors can influence how your body responds to treatment and may necessitate closer monitoring or a change in medication to ensure your safety. Key risk factors include:
  • Type 1 Diabetes or Past Episodes of Diabetic Ketoacidosis
  • Changes in Insulin Use
  • Recent Surgery or Serious Infection
  • Dietary Habits
  • Alcohol Consumption
  • Pancreatic Health
  • Dehydration Risks
• Risk Factors for Lactic Acidosis: If you are being treated with Xigduo XR, it’s important to communicate any conditions that may predispose you to lactic acidosis to your healthcare provider. Understanding these risk factors can help your doctor decide whether to monitor you more closely or to consider an alternative medication for your treatment. Key risk factors include:
  • Kidney Problems
  • Liver Issues
  • Heart Conditions
  • Alcohol Consumption
  • Use of Contrast Dyes and Procedures
  • Dehydration
  • Severe Infections or Stroke
• Genital Yeast Infections: If you have experienced yeast infections in the past, using Xigduo XR might increase the likelihood of such infections recurring. Based on this history, your healthcare provider might recommend an alternative treatment.
• Kidney or Bladder Issues: Share any past experiences with kidney or bladder infections, or if you have had difficulty urinating. These conditions can influence the effectiveness and safety of Xigduo XR, and an alternative medication may be more suitable.
• Upcoming Surgery: If you have any surgery scheduled, it’s important to discuss with your healthcare provider the appropriate times to pause and resume taking Xigduo XR. This precaution helps manage the risk of complications during and post-surgery.
• Pregnancy: Xigduo XR may pose risks during pregnancy, potentially harming an unborn baby. Inform your healthcare provider immediately if you are pregnant or planning to become pregnant. They may suggest a different diabetes management plan during your pregnancy.
• Breastfeeding: Currently, it is unclear if Xigduo XR passes into breast milk. If you are breastfeeding, discuss with your healthcare provider whether you should continue breastfeeding or if it would be safer to stop taking Xigduo XR. They will provide guidance based on the latest research and your health situation.

What Are the Contraindications of Xigduo XR?

• Allergies to Ingredients: If you are allergic to any component of Xigduo XR, you should not use this medication. This includes allergies to:
  • Farxiga
  • Dapagliflozin
  • Metformin
  • Glumetza
  • Fortamet
  • Any other medicine containing metformin
• Your pharmacist can provide a full list of the ingredients in Xigduo XR to ensure it is safe for you.
• Kidney Problems and Chronic Kidney Disease: Do not use Xigduo XR if you suffer from chronic kidney disease, particularly if you have polycystic kidney disease or if you have recently taken medications like prednisone, which can suppress your immune system.
• Kidney Function: Xigduo XR is not suitable for individuals whose kidneys do not function properly. 
• Metabolic Acidosis, Including Diabetic Ketoacidosis: People with a history of metabolic acidosis or diabetic ketoacidosis should avoid using Xigduo XR. 

What If You Missed a Dose of Xigduo XR?

If you forget to take a dose of Xigduo XR, take it as soon as you remember. However, if it’s almost time for your next scheduled dose, skip the one you missed and just take the next one. Do not take two doses at once to catch up.

[Note: If you have missed a dose of your medication and are unsure about when to take the next one, immediately consult your doctor or pharmacist.]

What Happens If You Take Too Much of Xigduo XR?

If you think you’ve taken too much Xigduo XR, seek immediate medical assistance. You can call 911 or contact the Poison Control Center at 800-222-1222 for guidance.

[Note: If you consumed more than the recommended dose, get medical help right away or call the Poison Help line at 1-800-222-1222.]

How to Store a Xigduo XR?

Xigduo XR oral tablets should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place.

[Note: Discuss with your healthcare professional about the proper disposal of any unused medicine and any questions you may have regarding its storage.]

Does Xigduo XR Interact with other Medicines?

Xigduo XR and Other Medications: It’s crucial to inform your healthcare provider about all the medications you’re currently taking. This includes prescription drugs, over-the-counter medicines, vitamins and minerals, herbal products, and any other supplements. Before starting Xigduo XR, particularly discuss if you are using:

• Lithium: This is used for treating certain mental health conditions.
• Diuretics: Often referred to as water pills, these help reduce fluid retention and can lower blood pressure.
• Carbonic Anhydrase Inhibitors: Examples include acetazolamide (Diamox), methimazole, zonisamide (Zonegran), and topiramate (Topamax). These medications affect how your body handles fluids and electrolytes.
• Other Diabetes Medications: Tell your doctor about any other drugs you use to manage your diabetes.

Does Xigduo XR Interact with Foods or Drinks?

There are no specific interactions between Xigduo XR and most foods or drinks. However, certain dietary choices can impact how well the medication works and your overall health while on it:

• Low-Salt Diet: Following a low-salt diet while taking Xigduo XR could increase your risk of becoming dehydrated.
• Ketogenic Diet: Being on a ketogenic diet may raise your chances of developing ketoacidosis, a serious condition that needs to be monitored closely.
• Alcohol Consumption: Drinking alcohol frequently or in large amounts can heighten your risk of diabetic ketoacidosis or lactic acidosis. While it’s unclear if alcohol directly affects Xigduo XR, it can influence your blood sugar levels. It’s advisable to limit your alcohol intake to prevent these risks.

[Note: This isn’t a complete list, and there could be other drugs that interact with Xigduo XR. Make sure to tell your doctor about any prescription, over-the-counter medicines, and herbal products you’re taking.]

What Are the Xigduo XR Alternatives?

If Xigduo XR isn’t suitable for you, there are other medications available that can manage blood sugar levels in people with type 2 diabetes. Your doctor can guide you to alternatives that might be better suited for your specific health needs. Some common alternatives include:

• Jentadueto (linagliptin/metformin)
• Farxiga (dapagliflozin)
• Invokana (canagliflozin)
• Actoplus Met (pioglitazone/metformin)
• Amaryl (glimepiride)
• Xigduo XR (dapagliflozin/metformin extended-release [ER])
• Trulicity (dulaglutide)
• Precose (acarbose)
• Glyxambi (empagliflozin/linagliptin)
• Synjardy XR (empagliflozin/metformin ER)
• Glyburide/metformin
• Kombiglyze XR (saxagliptin/metformin ER)
• Jardiance (empagliflozin)
• Invokamet ER (canagliflozin/metformin ER)
• Glucotrol XR (glipizide extended release)
• Synjardy (empagliflozin/metformin)
• Steglatro (ertugliflozin)
• Metformin ER
• Novolog Flexpen (insulin aspart)
• Nesina (alogliptin)
• Actos (pioglitazone)
• Victoza (liraglutide)
• Janumet XR (sitagliptin/metformin extended-release)
• Tresiba (insulin degludec)
• Rybelsus (semaglutide)
• Humalog Kwikpen (insulin lispro)
• Ozempic (semaglutide)
• Humalog Mix 50/50 (insulin lispro protamine/insulin lispro)
• Humulin N (insulin NPH)
• Januvia (sitagliptin)
• Mounjaro (tirzepatide)
• Metformin
• Levemir Flextouch (insulin detemir)
• Soliqua (insulin glargine/lixisenatide)
• Miglitol
• Onglyza (saxagliptin)
• Basaglar Kwikpen (insulin glargine)
• Humulin 70/30 (insulin NPH/insulin regular)
• Diabeta (glyburide)
• Jentadueto XR (linagliptin/metformin ER)
• Prandin (repaglinide)
• Humulin R (insulin regular)
• Tradjenta (linagliptin)
• Nateglinide
• Kazano (alogliptin/metformin)
• Invokamet (canagliflozin/metformin)
• Xultophy (insulin degludec/liraglutide)

[Note: Your doctor will choose what’s best for you. Don’t use any of these alternative medications without consulting your healthcare provider. Taking them by yourself may cause serious side effects.]

Xigduo XR Cost & Coupons

Managing the cost of Xigduo XR, a medication for type 2 diabetes, can be challenging due to its high retail prices in the US. A cost-effective alternative is to buy Xigduo XR online from Canada, where prices are often more affordable. Polar Bear Meds is a trusted Canadian pharmacy that offers competitive pricing for Xigduo XR. To save even more, US residents can use the Xigduo XR coupon code “WELCOMEPB10” at checkout to receive a 10% discount on their first order. Additionally, by joining the referral program, customers can earn extra savings, including a free coupon for future purchases. Secure your Xigduo XR supply from Canada and take advantage of significant cost savings.

Frequently Asked Questions

Does Xigduo XR cause weight loss?

Xigduo XR is not specifically designed for weight loss or to lower blood pressure. However, AstraZeneca notes that it could help users lose about 3% of their body weight on average and might also reduce systolic blood pressure. Results can differ from person to person.

Should I take Xigduo XR in the morning or at night?

Xigduo XR should be taken with or just after your evening meal to minimize the risk of stomach upset. It’s important to take the medication at about the same time every day to achieve the best results. Consistency in the timing helps maintain the effectiveness of the medication throughout the treatment period.

Does Xigduo work immediately?

Dapagliflozin, an active ingredient in Xigduo, reduces blood glucose levels approximately two hours after intake. However, it might take up to a week to realize its full effects. Often, individuals with diabetes do not experience noticeable symptoms, so you may not feel any immediate change when you start taking dapagliflozin.

When should I stop taking Xigduo?

You should discontinue Xigduo and consult your doctor immediately if you experience any signs of dehydration or other serious side effects. Dehydration is characterized by significant fluid loss from the body and is considered an uncommon but potentially serious condition, affecting up to 1 in 100 people taking this medication. Prompt medical attention is crucial in managing these effects safely and effectively.

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