Forxiga (dapagliflozin) is a once-daily tablet prescribed for type 2 diabetes, heart failure, and chronic kidney disease. It works by removing excess sugar and fluid through the urine [1][2]. The key points to know are genital and urinary infections, dehydration, the rare risk of ketoacidosis, and the need to plan for sick days and for Ramadan with your doctor.
What is Forxiga and why is it prescribed?
Forxiga (Forxiga) is the brand name for the active ingredient dapagliflozin (Dapagliflozin). In Jordan it is available as 10 mg tablets, as shown in the ClinicsJo drug directory. It is available only with a prescription [1]. It belongs to the class of sodium-glucose cotransporter 2 inhibitors (SGLT2 inhibitors) [2].
The medicine is prescribed for three main conditions, and a patient may have more than one of them:
| Condition | Purpose of the medicine |
|---|---|
| Type 2 diabetes | Lowers blood sugar and reduces the risk of hospitalization for heart failure in some adults with diabetes [2] |
| Heart failure | Reduces the risk of hospitalization and death in adults with the condition [2] |
| Chronic kidney disease | Reduces the risk of disease progression, hospitalization due to heart problems, and death in some adults [2] |
The heart and kidney benefits are not limited to people with diabetes. A doctor may prescribe it for heart failure or chronic kidney disease even if blood sugar is normal. Type 2 diabetes is only one of the three conditions. To learn more about this condition, you can read the page on type 2 diabetes.
How does the medicine work and how is it taken?
The medicine helps the kidneys get rid of glucose (sugar) and excess fluid through the urine [2]. It may also reduce the workload on the heart as it pumps blood [1]. For this reason, many people notice that they urinate more than usual.
- One tablet is taken once daily, with or without food, and preferably at the same time each day [1][2].
- The doctor may start with a low dose and increase it when needed. The usual dose set by your doctor or pharmacist is the reference [2].
- Most patients need the medicine over the long term [1].
- The medicine controls the disease but does not cure it, so the patient continues taking it even if they feel better [2].
If you forget a dose, take it as soon as you remember, unless it is 12 hours or less until the next dose. In that case, skip the missed dose. Never double the dose [1]. You can find more details in What should I do if I miss a dose of diabetes medication?.
If you take more than the prescribed dose, contact your pharmacist or doctor quickly, because an overdose can sometimes be dangerous [1].
Do not stop the medicine suddenly on your own, as blood sugar may rise [1]. This is a general rule for all diabetes medicines [3]. The medicine remains part of a plan that includes healthy eating, physical activity, and follow-up with your doctor [3].
Is Forxiga suitable for everyone?
No. Some conditions require careful assessment before starting, and some rule out the medicine.
Conditions in which it is prohibited or should be avoided
- Type 1 diabetes: The medicine is not suitable for this group [1]. The drug directory states that when it was tried in these patients, the risk of ketoacidosis increased, so it remains prohibited for them. Read about type 1 diabetes.
- Previous ketoacidosis linked to this medicine, according to the drug directory.
- Pregnancy and breastfeeding: Avoiding it during pregnancy is advised because the information is not sufficient to prove its safety for the fetus [1]. It is also avoided during breastfeeding because it may pass into breast milk [1][2].
- Previous allergy to the medicine or to one of its ingredients [1]. If you suffer from a drug allergy, tell your doctor the details.
Conditions that require caution and assessment
The medicine may not suit people who have liver problems, people who take medicines to lower blood pressure, or people who have recurrent urinary tract infections [1]. Also tell your doctor if you are uncircumcised, follow a ketogenic diet, drink alcohol regularly, or have pancreatitis, low blood pressure, or kidney or liver disease [2]. According to the drug directory, an elderly person who is dehydrated is assessed before starting. Cases of severe kidney impairment are decided by a specialist, because the kidney benefits are documented even at low filtration levels.
What are the common and serious side effects?
Not everyone experiences side effects, but it is useful to know the signs so you can act early.
| Symptom | What it may mean | What is recommended |
|---|---|---|
| Urinating more than usual, especially at night | An expected effect of the medicine [1][2] | Tell your doctor if it bothers you or persists [2] |
| Itching or thick white vaginal discharge, or redness, itching, and rash on the penis | A genital fungal infection [1][2] | See a doctor for assessment and treatment |
| Burning, frequent urination, or pain on urination, with fever or chills | A urinary tract infection that may be severe [1][2] | Contact a doctor immediately [2] |
| Dry mouth, dark urine, reduced sweating, dizziness on standing | Dehydration or low blood pressure [2] | Drink fluids as directed by your doctor, and stand up slowly [2] |
Prevention of genital infections starts with hygiene: keep the sensitive area clean and dry it well, as the drug directory indicates.
Among the common side effects mentioned in the references are fungal infections, back pain, frequent urination, and low blood sugar that causes dizziness or fainting [1]. If you feel drowsy or dizzy, do not drive or operate machinery until it passes [1]. The risk of hypoglycemia is higher when combined with insulin or sulfonylureas, so the doctor may reduce the dose of the other medicine, not you.
Among the rare but serious risks: severe allergic reaction (swelling of the throat or tongue and difficulty breathing), ketoacidosis, and Fournier’s gangrene, a rare but serious infection that affects the genital and perineal area [1]. Its signs are severe pain, swelling, redness, and blisters, and it may be accompanied by fatigue and fever [1][2].
What is ketoacidosis and how do I recognize it?
Diabetic ketoacidosis is an emergency condition in which ketones build up in the blood. This medicine can cause a rare form of it [1]. One of the most dangerous aspects is that it can occur with normal or near-normal blood sugar, which is called euglycemic ketoacidosis. Symptoms may be overlooked because the glucose meter does not show a high number.
Watch for these symptoms:
- Nausea, vomiting, and stomach pain [2]
- Unusual severe fatigue or confusion [1][2]
- Difficulty breathing [2]
- Intense thirst or breath with a sweet odor [1]
If these symptoms appear, it is recommended to stop the medicine and contact your doctor immediately or seek emergency care. If possible, ketones in the urine should be tested even if blood sugar is below 250 mg/dL [2]. Risks increase with alcohol, a low-carbohydrate diet, eating or drinking too little due to illness or surgery, and infections [2]. Do not rely on urine glucose strips during treatment, as their results become meaningless because the medicine itself removes sugar through the urine.
When should Forxiga be temporarily stopped? Sick-day rules
Dehydration and ketoacidosis are more likely when eating and drinking decline or fluids are lost. For this reason, patients on these medicines are asked to obtain a written sick-day plan from their doctor.
The references state that vomiting, diarrhea, or high fever can cause dehydration, and you should consult your pharmacist or doctor or follow their previous instructions [1]. The usual rule adopted by doctors, as in the drug directory, includes temporarily stopping the medicine in these situations and resuming it after recovery:
- Severe vomiting or diarrhea.
- Not eating or drinking.
- Before surgery: the doctor usually asks for the medicine to be stopped at least 3 days before, and you must inform the surgeon or dentist that you take it [2].
Do not apply this rule on your own. Contact your doctor or pharmacist to determine when to stop the medicine and when to resume it. Infections, fever, injuries, and severe stress may change blood sugar and your need for the medicine, so ask your doctor in advance what to do in those cases [2].
Can I fast during Ramadan while taking Forxiga?
There is no single answer that suits everyone. The decision is individual and is made by your doctor. It depends on the type of disease, how well blood sugar is controlled, heart and kidney function, and other medicines. The important thing is to make a plan well before Ramadan, not on its first days.
Risks to discuss with your doctor:
- Dehydration: The medicine increases urination, and prolonged fasting in hot weather reduces fluids. Good hydration distributed between iftar and suhoor is helpful, as described in the drug directory. The references recommended drinking an adequate amount of water as determined by your doctor or pharmacist [2].
- Ketoacidosis: Eating or drinking too little is a risk factor [2].
- Low blood sugar: If you take insulin or sulfonylureas with it.
Questions to ask your doctor:
- Is fasting safe in my case?
- What is the best time to take the tablet during Ramadan?
- Will the doses of my other medicines change?
- What symptoms require breaking the fast or contacting you?
What are the drug interactions and how do I monitor my condition?
Tell your doctor and pharmacist about all the medicines, prescriptions, vitamins, and herbs you take [1][2]. The most important points mentioned in the references are:
- Diuretics such as furosemide: may increase dehydration [1].
- Other diabetes medicines such as gliclazide: their dose may need adjustment [1].
- Medicines that lower blood pressure, and lithium [1].
You can eat and drink normally with the medicine, following the diabetes diet you were given, and reducing alcohol because it may lower blood pressure [1]. A diet helps protect your heart and kidneys. Read our articles on diabetes and heart disease, diabetic kidney disease and early screening, and diabetes complications.
Keep your appointments with your doctor and the laboratory, as you may be asked for tests to monitor your response to the medicine, and tell the laboratory that you take it before any test [2]. It is helpful to keep a written list of your medicines and carry it with you [2]. The Jordan Food and Drug Administration (JFDA) regulates medicines in Jordan, so obtain your medicine from a licensed pharmacy.
When should I see a doctor and when should I go to the emergency department?
See your doctor or pharmacist soon if:
- Symptoms of a fungal or urinary infection appear, or any side effect that bothers you or does not go away [1][2].
- You have vomiting, diarrhea, or fever, to determine the appropriate action with the medicine [1].
- Dizziness on standing recurs or signs of dehydration appear [2].
- You are pregnant, are planning a pregnancy, or want to breastfeed [1].
Call emergency services (911) or go to the nearest emergency department if:
- Nausea, vomiting, abdominal pain, severe fatigue, or difficulty breathing appear, even if blood sugar is normal [2].
- Swelling of the throat or tongue, severe rash, or difficulty breathing appears [1].
- Severe pain, swelling, redness, and blisters appear in the genital area or between it and the anus, with fever and malaise [1][2].
- You faint, cannot be woken, or have a seizure [2].
If you are asked to go to the emergency department, do not drive yourself. Take the medicine box, its leaflet, and any other medicines with you [1].
How do I find the right doctor in Jordan?
Diabetes cases are usually managed by an endocrinology and diabetes specialist. A person with heart failure or chronic kidney disease is often followed up with a cardiologist or nephrologist as well, and it helps for your doctors to share reports. You can search by your governorate: Amman, Irbid, or Zarqa, or other governorates.
What to check on a doctor's profile:
- Specialty, qualifications, and experience in diabetes, heart, or kidney care.
- Clinic location, working hours, and the contact or booking methods available on the profile.
- Listed services, such as diabetes consultation and diabetes care.
ClinicsJo does not provide online consultations or prescriptions. It helps you find a doctor and get in touch with them.
Questions to ask at the appointment:
- Is Forxiga suitable for my condition, or is there an alternative?
- What is my written sick-day plan and what should I do before surgery?
- How do I manage fasting during Ramadan?
- What tests do I need, and how often?
- Do I need to adjust my other medicines?
This article is for health education only and does not replace consultation with a doctor or pharmacist.
Frequently asked questions
Is Forxiga only for diabetes?
No. Forxiga is prescribed for type 2 diabetes, for heart failure, and for chronic kidney disease. A doctor may prescribe it for heart failure or kidney disease even if the patient does not have diabetes. The reason and the usual dose are determined by your doctor based on your condition and tests.
How many times a day is Forxiga taken?
It is usually taken as one tablet once daily, with or without food, and preferably at the same time each day. The usual dose is determined by your doctor or pharmacist. Do not increase the dose or stop the medicine suddenly without consultation, as blood sugar may rise.
Does Forxiga cause fungal infections?
Yes, it may increase the risk of genital fungal infections in both women and men, because sugar is excreted in the urine. Hygiene and keeping the area clean and dry help prevent them. If itching, discharge, or redness appears, see your doctor for assessment and treatment.
What should I do if I have vomiting or diarrhea while taking Forxiga?
Vomiting, diarrhea, and fever can cause dehydration. Contact your doctor or pharmacist to find out whether to temporarily stop the medicine, how to replace fluids, and when to resume it after recovery. If abdominal pain, severe fatigue, or difficulty breathing appears, go to the emergency department.
Can a person with diabetes fast during Ramadan while taking Forxiga?
It depends on the individual. You should see your doctor well before Ramadan to assess safety and to create a plan that covers medicine timing, hydration between iftar and suhoor, adjustment of other medicines, and the symptoms that require breaking the fast. Do not decide on your own.
Is Forxiga safe during pregnancy or breastfeeding?
It is advised to avoid it during pregnancy because the information is not sufficient to prove its safety for the fetus, and also during breastfeeding because it may pass into breast milk. If you are pregnant, planning a pregnancy, or breastfeeding, tell your doctor so they can choose a suitable alternative.
Sources and references
- Dapagliflozin: a medicine used to treat type 2 diabetes — NHS (UK National Health Service). Accessed: 2026-10-26.
- Dapagliflozin: MedlinePlus Drug Information — MedlinePlus — U.S. National Library of Medicine. Accessed: 2026-10-26.
- Diabetes Medicine | Insulin — MedlinePlus — U.S. National Library of Medicine. Accessed: 2026-10-26.