The NHS has issued a crucial advisory to individuals in the UK who are taking a frequently prescribed drug, urging them to immediately seek medical assistance if they encounter any of three specific symptoms. These symptoms are associated with some of the more severe complications linked to the medication dapagliflozin.

Recognized by its brand name Forxiga, dapagliflozin is primarily utilized for managing type 2 diabetes. Beyond this, it is also prescribed to patients dealing with heart failure and chronic kidney disease, broadening its scope of application in treating serious health conditions.

Although precise statistics on dapagliflozin prescriptions within the UK remain elusive, the medication represents a significant financial commitment for the NHS. Annually, approximately £300 million is spent on this drug across England, highlighting its prominence in medical treatments.

Dapagliflozin is sometimes administered in combination with other diabetes medications, available under brand names such as Xigduo, which pairs dapagliflozin with metformin, and Qtern, which combines it with saxagliptin.

Despite its effectiveness, the NHS has cautioned that, like all medications, dapagliflozin can lead to some undesirable side effects. The health service has advised that if individuals experience these side effects, they should contact their doctor or dial 111 without delay.

• You have a very dry or sticky mouth, feel very thirsty, sleepy or tired, are not peeing (or peeing very little), and have a fast heartbeat – these can be signs of dehydration
• You have a high temperature (or feel hot, cold or shivery), get a burning feeling when peeing, have pain in your back or side, or blood in your urine – these can be signs of a urinary tract infection (UTI)
• You get severe pain, tenderness, redness, or swelling in the groin or perineal area accompanied by a high temperature or feeling unwell – this may be a sign of a serious infection called Fournier’s gangrene

While these particular side effects are considered rare, affecting fewer than one in 10,000 people, there are other more prevalent side effects that occur in more than one in 100 users. The NHS underscores the importance of being vigilant and responsive to any adverse reactions.

The NHS said: “They’re usually mild and do not last long. There are things you can do to help cope with them.”

These side effects are:

• Thrush
• Back pain
• Peeing more than normal
• Feeling dizzy
• Mild skin rash

The NHS said: “Speak to a doctor or pharmacist if the advice on how to cope does not help and a side effect is still bothering you or does not go away.”

Taking dapagliflozin with other diabetes medicines, including insulin or sulfonylureas like gliclazide, can also cause your blood sugar can sometimes go too low.

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Some people taking dapagliflozin may also experience diabetic ketoacidosis (DKA). This happens when your body starts to run low on insulin and harmful substances, called ketones, build up in the body. 

Signs of DKA can include:

• Feeling or being sick
• Feeling very thirsty
• Feeling confused or unusually tired
• Having stomach pain
• Breath that smells fruity (like pear drop sweets, or nail varnish)
• Breathing more deeply or faster

The NHS says: “Symptoms usually develop over 24 hours, but can come on faster. Your doctor will show you how to monitor your ketone and blood sugar levels, and what to do if this happens. 

“You’ll learn how to recognise the symptoms of DKA and what to do about it.” You should call 999 if you have a serious allergic reaction (anaphylaxis) to dapagliflozin.