Xigduo XR (dapagliflozin and metformin)

Description

Xigduo XR combines two active ingredients, Dapagliflozin and Metformin, to effectively manage blood sugar levels in adults. Metformin works by reducing glucose production in the liver and enhancing the body's insulin sensitivity, while Dapagliflozin aids in eliminating excess glucose through urine by targeting the kidneys. This medication is classified as a sodium-glucose cotransporter 2 (SGLT2) inhibitor and a biguanide. It is commonly prescribed by healthcare providers as part of a holistic treatment approach that includes diet and exercise for individuals with type 2 diabetes. The goal is to improve glycemic control and decrease the risk of hospitalization for heart failure in those with cardiovascular disease.

Directions

Typically, patients take one tablet once daily in the morning with a meal. It’s recommended to use Xigduo XR alongside a balanced diet and regular exercise routine. If a dose is missed, it should be taken as soon as remembered, unless close to the next scheduled dose, in which case the missed dose should be skipped. It's important not to double up on doses. Patients should be aware that they may need to temporarily discontinue Xigduo XR if they have limited food or fluid intake, experience dehydration, or are undergoing specific types of X-ray or scanning procedures.

Ingredients

Dapagliflozin and Metformin Hydrochloride extended-release are the active ingredients in Xigduo XR.

Contraindications

Avoid taking or using this medication if any of the following apply:

• Individuals with severe kidney impairment, end-stage renal disease, or dialysis
• Patients with a known hypersensitivity to Dapagliflozin or Metformin, or any other component of Xigduo XR
• Those experiencing diabetic ketoacidosis, a serious complication of diabetes
• Patients with acute or chronic metabolic acidosis, including diabetic ketoacidosis, with or without coma

Cautions

• Prior to starting treatment with Xigduo XR, make sure to disclose the following to your healthcare provider:
• Any existing health conditions
• Known allergies
• A complete list of medications you are currently using
• Your status regarding pregnancy or breastfeeding

• Watch for lactic acidosis symptoms like muscle pain, trouble breathing, stomach pain, feeling cold, dizziness, and irregular heartbeat. Discontinue if suspected.
• Regularly check ketone levels in patients at risk for diabetic ketoacidosis. Stop treatment if ketoacidosis is suspected and monitor until it resolves.
• Before starting Xigduo XR, check and correct volume status especially in older adults, those with kidney issues or low blood pressure, and those on diuretics.
• Look for signs of urinary tract infections such as pain during urination, frequent urination, and fever, and treat promptly if found.
• Reduce insulin or insulin secretagogue doses when used with Xigduo XR to lower the risk of hypoglycemia.
• Be alert for symptoms of necrotizing fasciitis of the perineum, such as genital or perineal pain, redness, swelling, fever, or feeling unwell, and treat urgently if suspected.
• Xigduo XR may reduce vitamin B12 levels; monitor blood parameters annually.
• Watch for and address genital mycotic Infections as needed.

Side Effects

Xigduo XR side effects may include yeast infections, urinary tract infections, headaches, nasal congestion, sore throat, diarrhea, and tiredness. These side effects are generally manageable but can affect daily activities.

Important health concerns with Xigduo XR include dehydration, particularly in older adults or those on diuretics, which might cause symptoms like dizziness or fainting. Serious urinary tract infections that may require hospitalization can occur, as can severe low blood sugar when used with other diabetes medications. A rare but critical condition known as necrotizing fasciitis of the perineum may develop, necessitating immediate medical care. Long-term use could also result in vitamin B12 deficiency. If experiencing symptoms of serious allergic reactions or unusual severe pains, medical attention should be sought immediately.

References:

1. Xigduo XR (dapagliflozin and metformin) Product Monograph. Wilmington, DE: AstraZeneca Pharmaceuticals LP; 2023.
2. Xigduo XR (dapagliflozin and metformin) Drug Label Information. Wilmington, DE: AstraZeneca Pharmaceuticals LP; 2023.

About Dr. Gerardo Sison (Page Author)

An honors graduate of the University of Florida, Dr. Sison started his pharmacy career in a community setting, extending his services to hospitals and clinics over time. He has also worked in medication therapy management, advising patients on proper medication use for their chronic health conditions. Read More....