What is Xigduo XR?

Xigduo XR Dosage, forms & strengths

Medically reviewed by Jamie Winn, PharmD

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Xigduo XR (dapagliflozin/metformin) is a combination blood glucose lowering medication that is manufactured by AstraZeneca. It is FDA-approved to be used in combination with diet and exercise to lower blood sugar levels in adults with type 2 diabetes mellitus (T2DM).

Xigduo XR can be used to reduce the risk of complications from heart failure in adults with type 2 diabetes and cardiovascular disease.

In adult patients with chronic kidney dysfunction, Xigduo is used to reduce the risk of end-stage renal disease, hospitalization, and death from heart failure. Xigduo XR is not indicated to treat type 1 diabetes mellitus (T1DM) and can increase the risk of diabetic ketoacidosis in these patients.

How does Xigduo XR work?

Xigduo XR is the combination of 2 classes of medications that are used to improve glycemic control in patients with T2DM. It contains a biguanide medication (metformin) and a sodium-glucose co-transporter 2 inhibitor (dapagliflozin).

Biguanides such as metformin work by reducing the amount of sugar your liver produces. They also decrease the amount of sugar your body absorbs and improves how your body responds to insulin.

SGLT-2 inhibitors such as dapagliflozin work in your kidneys to increase the amount of glucose that is removed by your urine, which lowers your blood sugar levels.

Xigduo XR dosage forms and strengths

2.5 mg dapagliflozin/1,000 mg metformin extended-release tablet
5 mg dapagliflozin/500 mg metformin extended-release tablet
5 mg dapagliflozin/1,000 mg metformin extended-release tablet
10 mg dapagliflozin/500 mg metformin extended-release tablet
10 mg dapagliflozin/1,000 mg metformin extended-release tablet

Xigduo XR dosage

The recommended starting dose of Xigduo XR should be individualized based on your current antidiabetic regimen. If you are taking an evening dose of metformin extended-release, you should skip your last dose before beginning this medication.

If you are not currently taking dapagliflozin, the recommended starting dose of dapagliflozin is 5mg once daily.

If you are taking Xigduo XR for risks associated with cardiovascular disease and chronic kidney disease (CKD), the recommended dose of dapagliflozin is 10mg once daily.

Your doctor can adjust your dose based on how effective this medication is and how well you tolerate it. The maximum daily dose of Xigduo XR is 10mg of dapagliflozin and 2,000mg of metformin hydrochloride (HCl).

Xigduo XR dosage restrictions

There is an increased risk of adverse reactions related to volume depletion in patients with renal impairment. Xigduo XR should not be used if you have severely decreased renal function (eGFR less than 30 mL/min/1.73m), end-stage kidney disease, or are on dialysis.

The use of Xigduo XR is not recommended if you have severe hepatic impairment as it can increase your risk of lactic acidosis.

How to take Xigduo XR

Read the Full Prescribing Information, Patient Information, and Medication Guide that comes with this medication.
Take Xigduo XR exactly as your healthcare provider prescribes it. Do not change your dose or stop taking this medication without talking to them first.
Xigduo XR is typically taken once daily with a meal. Swallow each Xigduo XR tablet whole and don’t cut, crush, or chew them. You may pass an empty shell of a Xigduo XR tablet in your stool.
It is important to continue your diet and exercise program while on Xigduo XR.
Make sure you know the symptoms of hypoglycemia (low blood sugar levels) and how to treat them. Symptoms of hypoglycemia include a fast heartbeat, lightheadedness, extreme hunger, and sweating.
If you miss a dose of Xigduo XR, take it as soon as you remember. If it’s almost time for the next dose, skip the missed dose and take it at your next regularly scheduled time. Do not take an extra dose to make up for any missed dose.
Store Xigduo XR at room temperature between 68°F and 77°F (20°C and 25°C).

Xigduo XR dosage FAQs

What are the most common side effects of Xigduo XR?

The most common possible side effects of Xigduo XR include:

Female genital mycotic infections (yeast infections)
Urinary tract infections (UTIs), including life-threatening urosepsis and pyelonephritis
Diarrhea
Headache
Nausea
Vomiting
Dizziness
Abdominal pain
Back pain
Drowsiness
Constipation
Increased cholesterol levels

Xigduo XR can sometimes cause more serious side effects, including:

Severe, life-threatening allergic reactions (hives, angioedema, and trouble breathing)
Increased risk of lactic acidosis (hypotension, fast or irregular heartbeat, extreme fatigue, trouble breathing, dizziness, or muscle pain)
Low vitamin B12 levels
Severe infections such as Fournier’s gangrene
Low blood glucose levels, especially if taken with insulin or insulin secretagogues (sulfonylureas such as glipizide)

Contact your healthcare professional for medical advice about any adverse effects you experience while taking Xigduo XR. You can report your adverse reactions to the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

What drug interactions occur with Xigduo XR?

The concomitant use of Xigduo XR with other medications may change the way they work or increase the frequency and severity of side effects. Discuss with your doctor whether any of the prescription drugs, over-the-counter medications, vitamins, and herbal supplements you take may interact with this medication, including:

Insulin or oral diabetes medications
Carbonic anhydrase inhibitors such as acetazolamide
Loop diuretics such as furosemide
Nonsteroidal anti-inflammatory drugs (NSAIDs) such as naproxen
Hydrochlorothiazide
Cimetidine
Digoxin

Are there any contraindications or precautions with Xigduo XR?

Xigduo XR should not be taken if you have the following conditions:

an allergy to dapagliflozin, metformin, or any inactive ingredients in Xigduo XR
severe kidney dysfunction, end-stage kidney disease, or are on dialysis
a buildup of acid in your blood (metabolic acidosis)
diabetic ketoacidosis

Before starting Xigduo XR, tell your doctor about your medical conditions, including:

Type 1 diabetes (T1DM)
Kidney problems
Liver disease
History of UTIs
Congestive heart failure (CHF)
History of pancreas problems
You frequently have excessive alcohol intake
Low levels of vitamin B12
Are scheduled for an iodinated contrast imaging procedure (X-ray or CT scan)
Are pregnant, plan on becoming pregnant, or are breastfeeding

Can you take Xigduo XR while you are pregnant or breastfeeding?

While there are no adequate studies on the use of Xigduo XR in pregnant women, animal studies showed it can cause adverse renal (kidney) effects. Xigduo XR is not recommended for use during the second or third trimesters of pregnancy. It is not known if Xigduo XR is found in breast milk during lactation. Because there is a potential for serious adverse effects on the breastfed infant, Xigduo XR is not recommended while breastfeeding. You should always discuss the risks and benefits of any medication with your healthcare provider if you are pregnant, plan on becoming pregnant, or are breastfeeding.

Does Xigduo XR cause glucose in your urine?

Based on the mechanism of action of dapagliflozin, Xigduo XR can cause you to test positive for sugar in your urine.

Can Xigduo XR cause kidney damage?

When used as prescribed, Xigduo XR is relatively safe. Rarely, it can cause kidney problems. You are at an increased risk of this if you have kidney disease, heart failure, or are on blood pressure medications or NSAIDs.

Can you take Xigduo on an empty stomach?

Xigduo XR should be taken once a day with a meal to reduce the risk of upset stomach, nausea, and vomiting.

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The content on this website is intended for information purposes only. It does not constitute medical advice. The information on this website should not be relied upon and is not a substitute for professional medical advice. You should always speak to your doctor regarding the risks and benefits of any treatment.