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Xigduo XR
Xigduo XR is a combination oral medication used to improve blood sugar control in adults with type 2 diabetes. It contains dapagliflozin, a SGLT2 inhibitor, and metformin, a biguanide. Xigduo XR works by reducing the amount of glucose produced by the liver, improving the body's response to insulin, and promoting the excretion of excess glucose through urine. It is not used for treating type 1 diabetes or diabetic ketoacidosis and is typically prescribed alongside diet and exercise to enhance its effectiveness.
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Frequently Asked Questions
How long does it take for Xigduo XR to start lowering blood sugar?
Xigduo XR begins working within a few days, but it may take 2-4 weeks to see the full effects on blood sugar levels.
Can I take Xigduo XR if I have kidney problems?
Xigduo XR is not recommended for patients with severe kidney impairment. Your doctor will monitor your kidney function before and during treatment to determine if it is safe for you.
What should I do if I miss a dose of Xigduo XR?
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular schedule. Do not double the dose.
Can I lose weight while taking Xigduo XR?
Yes, some patients may experience weight loss while taking Xigduo XR, primarily due to the dapagliflozin component, which causes glucose to be excreted through urine.
Is Xigduo XR safe for long-term use?
Xigduo XR is generally safe for long-term use, but regular monitoring of kidney function, blood sugar levels, and other parameters is important. Always follow your healthcare provider’s recommendations.
Comprehensive Drug Guide
How Does Xigduo XR Work?
- Dapagliflozin (SGLT2 inhibitor): Reduces glucose reabsorption in the kidneys, promoting glucose excretion in urine, which lowers blood sugar levels.
- Metformin (biguanide): Reduces glucose production in the liver and improves insulin sensitivity, which helps lower blood sugar and enhance the body’s response to insulin.
Common Dosages
- 5 mg dapagliflozin / 500 mg metformin
- 5 mg dapagliflozin / 1000 mg metformin
- 10 mg dapagliflozin / 500 mg metformin
- 10 mg dapagliflozin / 1000 mg metformin
The typical dosing starts with the lower dose and can be adjusted based on the patient's blood sugar control and tolerance to the medication.
Typical Dosing
- The recommended starting dose is usually one tablet of 5 mg/500 mg once daily with meals.
- Depending on response and tolerance, the dose can be increased to a maximum of 10 mg/2000 mg per day, taken in divided doses with meals.
Typical Dosing
FDA Approved Indications
- Type 2 diabetes mellitus in adults, to improve glycemic control when used alongside diet and exercise.
Who Shouldn't Take Xigduo XR?
- Severe kidney impairment or end-stage renal disease (ESRD)
- Metabolic acidosis, including diabetic ketoacidosis
- Hypersensitivity to dapagliflozin, metformin, or any component of the drug
Advice From The Pharmacist
- Xigduo XR should be taken with food, usually with breakfast, to reduce the risk of gastrointestinal side effects from metformin.
- Stay well-hydrated while taking Xigduo XR to avoid dehydration, especially since dapagliflozin increases glucose excretion in urine, which may lead to fluid loss.
- Monitor blood sugar levels regularly to ensure the medication is effectively controlling your diabetes.
- Avoid excessive alcohol consumption while taking Xigduo XR, as it can increase the risk of lactic acidosis, a rare but serious side effect associated with metformin.
- Contact your healthcare provider if you develop symptoms of urinary tract infections or yeast infections, as these are more common with SGLT2 inhibitors.
Side Effects of Xigduo XR
Common Side Effects
- Urinary tract infections (UTIs)
- Genital yeast infections
- Nausea
- Diarrhea
- Headache
Uncommon/Severe Side Effects
- Lactic acidosis (from metformin)
- Dehydration and hypotension (from dapagliflozin)
- Ketoacidosis (a rare but serious complication)
- Kidney dysfunction or worsening kidney function
Risks and Warnings of Xigduo XR
- Lactic Acidosis: Metformin, one of the components of Xigduo XR, can cause a rare but serious condition called lactic acidosis, which requires emergency medical attention. Symptoms include rapid breathing, stomach pain, muscle pain, and weakness.
- Dehydration: Dapagliflozin increases glucose excretion in urine, which can lead to dehydration and low blood pressure, especially in elderly patients or those on diuretics.
- Genital Infections: SGLT2 inhibitors like dapagliflozin can increase the risk of genital yeast infections and urinary tract infections due to increased glucose levels in the urine.
- Ketoacidosis: Although rare, SGLT2 inhibitors have been associated with an increased risk of ketoacidosis, even in patients with type 2 diabetes.
Interactions with Xigduo XR
Common Drug Interactions
- Diuretics: Taking Xigduo XR with diuretics can increase the risk of dehydration and low blood pressure.
- Insulin or insulin secretagogues: Using Xigduo XR with insulin or other medications that lower blood sugar (like sulfonylureas) may increase the risk of hypoglycemia (low blood sugar).
- Alcohol: Alcohol can increase the risk of lactic acidosis and hypoglycemia. Limit alcohol consumption while taking Xigduo XR.
Alternatives to Xigduo XR
- Jardiance (empagliflozin/metformin): Another combination of an SGLT2 inhibitor and metformin used for type 2 diabetes.
- Invokamet (canagliflozin/metformin): Similar combination therapy for type 2 diabetes management.
- Metformin alone: Often used as first-line therapy for type 2 diabetes, with other medications added if needed.
