Farxiga interactions: Alcohol, medications, and other factors

Before starting treatment with Farxiga, tell your doctor and pharmacist which prescription, over-the-counter, and other medications you take. Sharing this information with them may help prevent possible interactions. (To learn whether Farxiga interacts with supplements, herbs, or vitamins, see the “Farxiga and other interactions” section below.)

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Here’s a table of drugs that can interact with Farxiga. Keep in mind that this table doesn’t include all drugs that may interact with Farxiga. Some of these interactions are described in detail just below in “Drug interactions in depth.”

* To learn more, see the “Farxiga and other interactions” section below.

Some factors or conditions could prevent your doctor from prescribing Farxiga due to the risk of harm. These are known as contraindications. The contraindications of Farxiga include:

Having had a serious allergic reaction to Farxiga or any of its ingredients

If you have had a serious allergic reaction to Farxiga or any of its ingredients, your doctor will likely not prescribe Farxiga. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.

There aren’t any known interactions between Farxiga and alcohol. However, your doctor may advise you to avoid or limit alcohol consumption during Farxiga treatment.

This is because drinking alcohol while taking the drug may worsen some of Farxiga’s side effects. For example, you may have increased nausea. For information about Farxiga’s side effects, see this article.

Drinking alcohol may also raise your risk of the following serious side effects of Farxiga:

• low blood sugar
• dehydration
• low blood pressure
• ketoacidosis

If you have questions about consuming alcohol with Farxiga, talk with your doctor.

Here’s a closer look at certain drug interactions of Farxiga.

Insulins

Farxiga can interact with insulins, which doctors prescribe to help manage blood sugar levels in some people with diabetes.

Interaction result:Taking Farxiga with insulin can raise your risk of hypoglycemia (low blood sugar level).

Interaction explained:Insulin lowers your blood sugar level and can sometimes cause hypoglycemia. Farxiga also lowers your blood sugar levels. When used on its own, Farxiga doesn’t usually cause hypoglycemia. But if you take it with insulin, it can raise your risk of hypoglycemia.

Examples of insulins: Here are some insulins that may interact with Farxiga:

• insulin lispro (Admelog, Humalog)
• insulin glargine (Lantus, Basaglar, others)
• insulin degludec (Tresiba)

Steps you or your doctor may take:If you take Farxiga with insulin, your doctor may lower your insulin dosage. They may also have you check your blood sugar levels more often.

If you have episodes of hypoglycemia while taking Farxiga with insulin, tell your doctor. They may adjust your dosages of these medications.

If you have questions about taking Farxiga with insulin, talk with your doctor or pharmacist.

Diuretics

Farxiga can interact with diuretics, which are sometimes called water pills. They’re used to treat fluid buildup and high blood pressure.

Interaction result:Taking Farxiga with a diuretic can cause dehydration and low blood pressure.

Interaction explained:Farxiga and diuretics can both increase urination. Taking these drugs together can increase the amount of fluid that your body loses through urination. This can lead to dehydration and low blood pressure. Dehydration can also raise your risk of ketoacidosis and kidney problems, which are possible side effects of Farxiga.

Examples of diuretic drugs: Here are some diuretics that may interact with Farxiga:

• bumetanide (Bumex)
• furosemide (Lasix)

Steps you or your doctor may take:If you take Farxiga with a diuretic, talk with your doctor about how much water you should drink. It’s important to drink enough water or other nonalcoholic fluids to avoid becoming dehydrated. For more information about this, see the “Frequently asked questions” section below.

Talk with your doctor right away if you have symptoms of dehydration or low blood pressure when taking Farxiga with a diuretic. These may include urinating less than usual, dark urine, dizziness, headache, and confusion.

If you have questions about taking Farxiga with a diuretic, talk with your doctor or pharmacist.

Certain blood pressure medications

Farxiga can interact with certain blood pressure medications, particularly angiotensin converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs).

Interaction result:Taking Farxiga with an ACE inhibitor or ARB may cause hypoglycemia (low blood sugar level) and low blood pressure.

Interaction explained:Farxiga, ACE inhibitors, and ARBs don’t usually cause hypoglycemia on their own. However, taking Farxiga with an ACE inhibitor or ARB can cause your blood sugar levels to decrease, which can increase the risk of hypoglycemia.

ACE inhibitors and ARBs are medicines used to lower blood pressure. Although it’s not common, Farxiga can cause low blood pressure. Taking Farxiga with an ACE inhibitor or ARB can raise your risk of low blood pressure.

Examples of ACE inhibitors and ARBs: Here are some ACE inhibitors and ARBs that may interact with Farxiga:

• captopril
• ramipril (Altace)
• losartan (Cozaar)
• valsartan (Diovan)

Steps you or your doctor may take:If you take Farxiga with an ACE inhibitor or ARB, your doctor may want to monitor your blood sugar levels and blood pressure.

Talk with your doctor about whether you should check your blood sugar yourself. You should also talk with your doctor about the symptoms of low blood sugar and what to do if these symptoms occur.

If you have episodes of low blood sugar or symptoms of low blood pressure, such as feeling dizzy, lightheaded, or fainting, talk with your doctor. They may adjust your dosages of Farxiga or blood pressure medication. Or they may recommend switching to a different combination of medications.

If you have questions about taking Farxiga with a blood pressure medication, talk with your doctor or pharmacist.

Farxiga may have other interactions, such as with supplements, foods, vaccines, or even lab tests. You’ll find details below. Keep in mind that the following information does not include all possible interactions with Farxiga.

Farxiga interactions with supplements

Before you start treatment with Farxiga, tell your doctor and pharmacist which supplements, herbs, and vitamins you take. By sharing this information with them, you may help prevent possible interactions.

Farxiga may interact with garlic supplements, which some people take to help manage their blood sugar levels. Both products can decrease your blood sugar levels, which can raise your risk of hypoglycemia (low blood sugar). Talk with your doctor before taking garlic supplements with Farxiga.

If you have questions about other interactions that may affect you, ask your doctor or pharmacist.

Farxiga and herbs

There are no specific reports of herbs interacting with Farxiga. However, that doesn’t mean herbal interactions won’t occur or be recognized in the future. Because of this, it’s important to check with your doctor or pharmacist before taking any of these products during Farxiga treatment.

Farxiga interactions with vitamins and minerals

There are no specific reports of vitamins interacting with Farxiga. However, that doesn’t mean vitamin interactions won’t occur or be recognized in the future. Because of this, you should talk with your doctor or pharmacist before taking any vitamin product with Farxiga.

Farxiga may interact with a mineral called chromium. Some people take this supplement to help manage their blood sugar levels.

However, if you take chromium with Farxiga, both products can decrease your blood sugar levels. This can increase your risk of having hypoglycemia (low blood sugar). Due to this, your doctor may recommend avoiding chromium supplements while taking Farxiga.

It’s also important to note that some multivitamins may also contain minerals, such as chromium. Talk with your doctor to determine which multivitamin is best for you.

Farxiga and food

There were no reports of food interactions with Farxiga.

However, Farxiga can rarely cause a serious side effect called ketoacidosis. You may have a raised risk of this side effect if you follow a ketogenic diet (one that’s low in carbohydrates and high in fat) during Farxiga treatment. You may also have a raised risk of this side effect if you eat or drink less than usual while taking Farxiga.

Before starting Farxiga, talk with your doctor about the type of diet you should follow while taking this medication. While you’re taking Farxiga, tell your doctor if you make any changes to your diet. Also talk with your doctor if you’re eating or drinking less than usual, for example, if you’re unwell.

If you have questions about eating certain foods during Farxiga treatment, talk with your doctor. They can tell you if there are foods to avoid when taking Farxiga.

Farxiga and vaccines

There aren’t any known interactions between Farxiga and vaccines. Talk with your doctor or pharmacist to see whether you’re due for any vaccines.

Farxiga interactions with lab tests

Farxiga may interact with certain lab tests. Specifically, it may interact with certain tests that monitor how well your diabetes is being managed. These include:

• urine glucose – a test that measures the amount of glucose (sugar) in your urine
• 1,5-anhydroglucitol (GlycoMark, others) – a test used to estimate your average blood sugar levels after meals over the past 1–2 weeks

If your doctor prescribes Farxiga, they will recommend different tests to gather this information.

FARXIGA INTERACTION WITH CANNABIS OR CBD

Cannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have not been specifically reported to interact with Farxiga. However, as with any drug or supplement, talk with your doctor before using cannabis in combination with Farxiga. The impact of cannabis may affect how well you stick to your Farxiga treatment plan.

Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.

Certain medical conditions and other factors may increase the risk of interactions with Farxiga. Before you take this drug, be sure to talk with your doctor about your health history. Farxiga may not be the right treatment option if you have certain medical conditions or other factors affecting your health.

Health conditions or factors that might interact with Farxiga include:

• Allergic reaction: If you’ve had an allergic reaction to Farxiga or any of its ingredients, your doctor will likely not prescribe Farxiga. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.
• Type 1 diabetes: Farxiga can cause a serious side effect* called ketoacidosis. If you have type 1 diabetes, you may be at higher risk of this side effect. If you have type 1 diabetes, your doctor will likely not prescribe Farxiga to help manage your blood sugar.
• Pancreatitis: If you have a history of pancreatitis, you may have a raised risk of ketoacidosis with Farxiga. Talk with your doctor about whether Farxiga is right for you.
• Dehydration: Farxiga can sometimes cause dehydration. If you become dehydrated while taking Farxiga, this can raise your risk of low blood pressure, kidney problems, and ketoacidosis. Talk with your doctor about how much water you should drink to prevent dehydration when taking Farxiga.
• Urinary tract infection (UTI): Farxiga commonly causes UTIs. If you have a history of frequent or chronic (long-term) UTIs, you may have a raised risk of this side effect.* Talk with your doctor about whether Farxiga is right for you.
• Genital yeast infection: Farxiga commonly causes genital yeast infections, such as vaginal or penile thrush. If you have a history of genital yeast infections, you may have a raised risk of this side effect.* Talk with your doctor about whether Farxiga is right for you.
• High cholesterol: If you have high cholesterol, taking Farxiga may make this worse. Talk with your doctor about whether Farxiga is right for you.
• Kidney problems: If you have kidney problems, you may have a raised risk of dehydration and low blood pressure with Farxiga. Also, Farxiga may not be right for people with certain kidney problems, such as polycystic kidney disease (numerous cysts in the kidneys). If you have kidney problems, talk with your doctor about whether Farxiga is a good option for you.
• Upcoming surgery: Having surgery while taking Farxiga can increase your risk of ketoacidosis. If you’re due to have surgery, talk with your doctor beforehand. They may have you stop taking Farxiga a few days before your surgery to help reduce your risk of ketoacidosis.
• Breastfeeding: It is unknown whether it’s safe to use Farxiga while breastfeeding. There isn’t enough information to determine whether the drug passes into breast milk or what effects Farxiga may have on a child who is breastfed. Breastfeeding is not recommended while you’re taking Farxiga. If you’re breastfeeding or planning to, talk with your doctor before using Farxiga. They can talk with you about treatment options and ways to feed your child.
• Pregnancy: There haven’t been enough clinical trials to determine whether Farxiga is safe to use while pregnant. Animal studies show that the drug may have harmful effects on the fetus when used during pregnancy. Farxiga is not recommended during the second and third trimesters of pregnancy. If you’re pregnant or planning to become pregnant, tell your doctor before starting Farxiga. They can advise you on the right treatment plan for you.

* For information about Farxiga’s side effects, see this article.

Here are some frequently asked questions about Farxiga and possible interactions.

Is there an interaction between Farxiga and metformin?

No, there’s not usually an interaction between Farxiga and metformin (Glumetza, Fortamet). Doctors commonly prescribe these medications together in people with type 2 diabetes. In fact, a combination medication that contains the active ingredients in both of these drugs (dapagliflozin and metformin) is available. It’s called Xigduo XR.

Farxiga and metformin have a combined effect on managing blood sugar levels in type 2 diabetes. In studies, the combination didn’t increase the risk of hypoglycemia (low blood sugar level).

If you have questions about taking Farxiga with metformin or other medications for diabetes, talk with your doctor or pharmacist.

How much water should you drink when taking Farxiga?

Farxiga increases urination, which can sometimes lead to dehydration. So it’s important to drink enough fluids to avoid dehydration while taking Farxiga. Dehydration can raise your risk of low blood pressure, kidney problems, and ketoacidosis, which are serious side effects* of Farxiga.

When taking Farxiga, the amount of water or other fluids you should drink depends on several factors. These include:

• the medications you take
• any health conditions you have
• the climate where you live
• how much you exercise

Typically, you should drink enough water so that you’re not thirsty for long periods and your urine is pale and clear. Talk with your doctor about how much you should drink each day.

* For information about Farxiga’s side effects, see this article.

Why can’t you have caffeine with Farxiga?

There are no specific reports of Farxiga interacting with caffeine.

However, both Farxiga and caffeine can increase urination. So drinking caffeine with Farxiga could raise your risk of dehydration.

Talk with your doctor about whether you should avoid or limit your caffeine intake while taking Farxiga.

You can take certain steps to help prevent interactions with Farxiga. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan to do the following:

• Let them know if you drink alcohol or use cannabis.
• Tell them about any other medications you take, as well as any supplements, herbs, and vitamins.
• Create a medication list, which your doctor and pharmacist can help you fill out.

It’s also important to read the Farxiga label and other paperwork that may come with the drug. The label may have colored stickers that mention an interaction. And the paperwork, sometimes called the medication guide or patient package insert, may contain details about interactions.

If Farxiga doesn’t come with paperwork, you can ask your pharmacist to print a copy. If you need help reading or understanding this information, ask your doctor or pharmacist.

You can also help prevent interactions with Farxiga by taking it exactly as your doctor prescribes.

Besides learning about interactions, you may want to find out more about Farxiga. These resources might help:

• Overview of Farxiga:For a general overview of Farxiga, you can see this article.
• Side effects:If you’re interested in the side effects of Farxiga, see this article. Another option is to refer to the Farxiga prescribing information.
• Dosage specifics: To learn about the dosage of Farxiga, see this article.
• Drug comparison:For information about how Farxiga compares with Jardiance, read this article.
• Cost: If you’d like to learn about Farxiga and cost, see this article.
• Facts about your condition: For details about diabetes, see our diabetes hub and this list of related articles. For details about heart failure, our heart health hub might be helpful, as well as these related articles.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.