Key takeaways:
Farxiga (dapagliflozin) is a medication used for Type 2 diabetes, heart failure, and chronic kidney disease. Urinary tract infections (UTIs) are a common side effect of Farxiga.
Some experts believe Farxiga causes UTIs because it removes extra glucose (sugar) from your body through your urine. Bacteria and other germs are attracted to the glucose around the genital area. But the evidence is mixed on whether this is true.
If you develop a UTI while taking Farxiga, contact your primary care provider right away. Untreated UTIs can cause more serious infections to the kidneys and body.
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There are several treatment options for people living with Type 2 diabetes. If you also have heart or kidney disease, there’s a chance you may be taking Farxiga (dapagliflozin). This oral medication can help protect your heart and kidneys while lowering your blood glucose (sugar). But it’s not without its side effects.
A common concern many people have when taking Farxiga is the risk of urinary tract infections (UTIs). But how often does this side effect happen? And is it possible to lower your risk of UTIs while taking Farxiga?
How does Farxiga work?
Farxiga is a sodium-glucose cotransporter-2 (SGLT2) inhibitor. It primarily works in your kidneys to prevent your body from reabsorbing glucose and sodium (salt). This extra glucose and sodium leaves your body through your urine. This helps lower blood glucose levels. It also takes stress off the heart and kidneys.
Farxiga comes as 5 mg and 10 mg oral tablets. It’s FDA approved to:
Treat Type 2 diabetes in adults and children ages 10 and older
Lower the risk of being hospitalized for heart failure in adults with Type 2 diabetes and heart disease or risk factors for developing heart disease
Lower the risk of hospitalization and cardiovascular death in adults with heart failure
Lower the risk of worsening kidney function, cardiovascular death, being hospitalized for heart failure, and developing end-stage kidney disease in adults with chronic kidney disease
Why does Farxiga increase your risk of UTIs?
There’s some debate as to whether Farxiga causes UTIs.
Some experts believe that Farxiga raises the risk of UTIs because of how it works. As mentioned, it helps remove extra glucose through your urine. Bacteria and other germs are attracted to glucose around your genitals. They can grow and multiply, which may lead to UTIs for some people.
In one of Farxiga’s clinical trials that earned it FDA approval, between 7% and 15% of people taking Farxiga developed UTIs. This was compared to about 4% of people taking a placebo (a pill with no medication). In that study, the 10 mg Farxiga dose seemed to have a higher risk of UTIs than the 5 mg dose.
But not all experts agree that Farxiga causes UTIs. Some studies show that people with Type 2 diabetes taking SGLT2 inhibitors, such as Farxiga, have a similar risk of UTIs as people not taking them. These experts believe that UTIs are caused by diabetes — not Farxiga. And there is a known connection between the two. If you have diabetes, you have a greater risk of UTIs, regardless of what medications you take.
Despite the mixed evidence, the FDA warns that serious UTIs are possible while taking Farxiga. Rarely, people taking SGLT2 inhibitors have experienced life-threatening UTIs. The agency recommends seeking treatment at the first sign of these infections. Common symptoms include burning while urinating and a greater urgency to go.
Do UTIs from Farxiga happen to both women and men?
Yes. Both women and men can develop UTIs while taking Farxiga. But in general, women with Type 2 diabetes are more likely to develop them than men with the condition.
Should you stop taking Farxiga if you have a UTI?
No. You shouldn’t stop taking Farxiga if you develop a UTI. This won’t help treat the infection. And it could cause the condition you’re taking Farxiga for to worsen. Don’t stop taking Farxiga unless your prescriber tells you to.
Prevention first: Experts review tips to help stop urinary tract infections (UTIs) before they start.
Get UTI relief now. Read about the best ways to get rid of a UTI — fast.
Other side effects: Learn more about other notable Farxiga side effects — from nausea to yeast infections — and how to manage them.
If you have symptoms of a UTI, contact your primary care provider. You’ll likely need an antibiotic to treat the infection. Your healthcare team may also suggest over-the-counter medications to relieve symptoms, such as phenazopyridine (AZO).
How can you prevent UTIs from Farxiga?
You may not always be able to prevent UTIs while taking Farxiga. But there are tips that may help lower your overall risk of UTIs:
Make sure you’re well hydrated. Try to limit alcohol and beverages with caffeine.
Avoid holding your urine. Urinate when you have the urge to go.
Regularly clean your genital area with water or a mild soap.
Urinate after having sex. This is more applicable to women than men.
Wipe from front to back after using the bathroom. This is also more applicable to women.
Consider drinking unsweetened cranberry juice or taking a cranberry supplement. But avoid cranberry cocktail products.
What complications can result from an untreated UTI?
If a UTI isn’t treated, it can lead to serious health problems like kidney infections or sepsis.
A kidney infection happens when germs from the bladder move up to the kidneys. In rare cases, this can permanently damage the kidneys.
Sepsis is a life-threatening complication of untreated UTIs. It happens when your body tries to fight an infection but ends up causing inflammation all over. It can cause your organs to shut down. Sepsis needs to be treated in a hospital.
What other side effects can happen with Farxiga?
UTIs are one of several possible Farxiga side effects. Most people experience mild issues that they can manage at home. But, while rare, serious side effects are also possible.
Mild side effects include:
Genital fungal (yeast) infections
Frequent urination (even without having a UTI)
Nausea
Slightly raised cholesterol
Cold-like symptoms
Back pain
Constipation
Rare but serious side effects include:
Hypoglycemia (low blood glucose)
Dehydration, which can lead to kidney damage
Ketoacidosis (too much acid in the blood)
Severe infections of the genital area, such as Fournier’s gangrene
The bottom line
Farxiga (empagliflozin) is a medication used to treat Type 2 diabetes, heart failure, and kidney disease. Farxiga may raise the risk of urinary tract infections (UTIs). Some experts think this is because the medication removes extra glucose (sugar) from your body through your urine. The extra glucose attracts bacteria or other germs to the genitals, which may lead to UTIs.
If you develop a UTI while taking Farxiga, don’t stop taking it. Contact your primary care provider. They can help treat your infection. Untreated UTIs can lead to serious complications.
Why trust our experts?
References
AstraZeneca Pharmaceuticals LP. (2024). Farxiga - dapagliflozin tablet, film coated [package insert].
Ferrannini, E., et al. (2010). Dapagliflozin monotherapy in type 2 diabetic patients with inadequate glycemic control by diet and exercise. Diabetes Care.
Hu, Y., et al. (2020). Fournier gangrene associated with sodium-glucose cotransporter-2 inhibitors: A pharmacovigilance study with data from the U.S. FDA adverse event reporting system. Journal of Diabetes Research.
Nasim, W., et al. (2022). Sodium-glucose cotransporter 2 inhibitors and urinary tract infection: Is there room for real concern? Kidney360.
National Institute of Diabetes and Digestive and Kidney Diseases. (2024). Definition and facts of kidney infection (pyelonephritis).
Nitzan, O., et al. (2015). Urinary tract infections in patients with type 2 diabetes mellitus: Review of prevalence, diagnosis, and management. Diabetes, Metabolic Syndrome and Obesity.
Padda, I. S., et al. (2023). Sodium-glucose transport protein 2 (SGLT2) inhibitors. StatPearls.
U.S. Food and Drug Administration. (2022). FDA revises labels of SGLT2 inhibitors for diabetes to include warnings about too much acid in the blood and serious urinary tract infections.
