Xigduo XR is a combination medication that contains dapagliflozin (an SGLT2 inhibitor) and metformin (a biguanide). It's taken along with a healthy diet and exercise to treat Type 2 diabetes in people ages 10 years and older. In addition, dapagliflozin in Xigduo XR can help lower the risk of worsening heart failure or chronic kidney disease (CKD) in certain people. Xigduo XR (dapagliflozin / metformin) is taken by mouth once daily in the morning. It's best to take this medication with food since it might cause stomach upset. Other possible side effects include yeast infection, cold symptoms, and urinary tract infection (UTI).
Xigduo XR (dapagliflozin / metformin) is a combination of two medications.
Dapagliflozin is a sodium-glucose cotransporter 2 (SGLT2) inhibitor. It lowers blood sugar levels by getting rid of extra sugar through the urine. It also helps your body get rid of sodium (salt) and water, which takes stress off the heart and kidneys.
Metformin is a biguanide that lowers blood sugar levels by lowering the amount of sugar that your liver makes, as well as the amount of sugar the body absorbs through the intestines. It also makes your body more sensitive to the effects of insulin.
Source: DailyMed
Side effects that you should report to your care team as soon as possible:
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
Combines two medications into one pill for convenience
Only taken once a day in the morning
Lowers your risk for certain complications of diabetes, such as heart and kidney problems
Might cause you to urinate more often
Need to take with a meal to prevent stomach upset
Raises risk of genital and urinary tract infections
Swallow Xigduo XR (dapagliflozin / metformin) whole and don't crush, cut, or chew it because this could affect the way the medication works for you.
Take Xigduo XR (dapagliflozin / metformin) with food. The metformin in this medication can cause stomach problems, including diarrhea, nausea, vomiting, and belly pain. Food can help lower the risk of these side effects.
If you feel nauseous, have trouble breathing, or have a racing heart, stop taking Xigduo XR (dapagliflozin / metformin) and get medical attention right away. These can be signs of too much lactic acid in your blood, which sometimes can require treatment in the hospital.
If you have nausea, vomiting, tiredness, or fruity breath, stop taking Xigduo XR (dapagliflozin / metformin) and get medical attention right away. These can be signs of another serious condition called ketoacidosis, which can be life-threatening.
It's best to avoid alcohol when possible during treatment with Xigduo XR (dapagliflozin / metformin). Drinking alcohol with this medication can cause dangerously low blood sugar. Alcohol can also raise your risk of having too much acid in your blood. If it's difficult for you to stop drinking alcohol completely, ask your prescriber what's a safer limit for you.
Xigduo XR (dapagliflozin / metformin) can cause genital yeast infections or urinary tract infections. Make sure to practice good hygiene to lower your risk of these infections. Let your prescriber know right away if you experience pain while urinating, stomach pain, blood in the urine, genital itching, or discharge from the genitals.
If you're scheduled for a major surgery where you need to fast, let your primary care provider know ahead of time. They might ask you to pause your treatment with Xigduo XR (dapagliflozin / metformin) a few days before your surgery. This helps lower your risk of having dangerous acid levels in the body. Follow up with your prescriber after surgery to discuss when you should restart Xigduo XR (dapagliflozin / metformin).
It's important to have a healthy and balanced diet and exercise regularly to keep your blood sugar under control. Make sure to work with your care team on a diet and exercise plan while taking Xigduo XR (dapagliflozin / metformin).
You might sometimes see a soft mass in your stools that looks like the Xigduo XR (dapagliflozin / metformin) tablet. This is the inactive ingredients from the medication and isn't harmful.
Talk to your prescriber if you're pregnant, since Xigduo XR (dapagliflozin / metformin) can potentially cause harm to babies. They can talk with you about safer options to manage diabetes during pregnancy.
Xigduo XR (dapagliflozin / metformin) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Risk factors: Kidney or liver problems | Heart failure or heart attack | Age 65 years or older | Not eating food or fasting before surgery | Drinking large amounts of alcohol | Imaging procedure using contrast dye | Taking certain medications that affect the kidneys or acid-base balance
Metformin in Xigduo XR (dapagliflozin / metformin) can cause a rare, but serious medical condition called lactic acidosis (too much lactic acid in your blood). If left untreated, this condition can lead to other health problems, including organ failure, which can be life-threatening. Discuss with your primary care provider about your medical history before starting Xigduo XR (dapagliflozin / metformin) and any planned procedures during treatment. They can check for your risk of lactic acidosis. Get medical attention right away if you experience fast breathing, irregular heartbeat, or weakness. These can be signs that you have too much lactic acid in your blood.
Risk factors: Lowered calorie intake | After surgery | Sudden fever | Pancreas problems | Stopping or lowering dose of insulin | Drinking too much alcohol
Dapagliflozin in Xigduo XR (dapagliflozin / metformin) can cause a rare but serious medical condition called diabetic ketoacidosis (DKA). This condition happens when you don't have enough insulin to help your body use blood sugar as a source of energy. When this occurs, your body gets energy another way by breaking down fat into a type of acid called ketone. But it can be dangerous when too many acidic ketones build up in the blood. Seek medical attention right away if you notice signs and symptoms of ketoacidosis, such as trouble breathing, vomiting, belly pain, dry skin and mouth, feeling very tired, and fruity-smelling breath.
Risk factors: 65 years and older | History of kidney problems | Taking certain loop diuretics (water pills) | Low salt (sodium) diet
Xigduo XR (dapagliflozin / metformin) can cause low levels of fluids in the body because dapagliflozin might cause you to urinate more. This can lead to dehydration, low blood pressure, or sudden kidney injury. Very rarely, the kidney problems can require hospitalization or dialysis. You're at higher risk for these problems if you have kidney problems or are an older adult. If you have any risk factors for low fluid levels, talk with your prescriber about how you can safely take Xigduo XR (dapagliflozin / metformin). You might need to get blood and urine tests done before or during treatment so your provider can check your kidney health. Speak with your care team if you feel dizzy, confused, chest pain, or notice you're urinating less than usual while taking Xigduo XR (dapagliflozin / metformin). These might be symptoms of dehydration, low blood pressure, or kidney problems.
Risk factors: History of urinary tract infections (UTIs) or genital yeast infections
Dapagliflozin in Xigduo XR (dapagliflozin / metformin) might raise your risk of genital and urinary tract infections, including yeast and fungal infections. Your risk of a yeast infection is higher if you've had frequent or long-term genital yeast infections in the past. In rare cases, these genital infections can be serious and life-threatening, and they might require hospitalization or surgery. Let your prescriber know if you have genital itching, pain while urinating, cloudy urine, or back pain. These can be signs of a genital yeast infection or kidney infection. Get medical attention right away if you have symptoms of a more serious infection, like pain, swelling, or redness in the genital area, along with fever and weakness.
Risk factors: Long-term use of metformin | Lower than average calcium or vitamin B12 intake or absorption
Taking diabetes medications that contain metformin, including Xigduo XR (dapagliflozin / metformin), for a long period of time can cause your vitamin B12 levels to drop. Having low vitamin B12 levels can lead to a higher risk of anemia. Your prescriber will check your vitamin B12 levels through blood work every 2 to 3 years. If needed, your prescriber might recommend that you take vitamin B12 supplementation. Let your care team know if you frequently have low energy, dizziness, muscle problems, or tingling or numbness in your hands and feet.
Although extremely rare, people who took dapagliflozin have developed a very serious skin infection called necrotizing fasciitis. If you develop this type of infection, your prescriber will ask you to stop taking Xigduo XR (dapagliflozin / metformin) and get treated with antibiotics right away. Get medical help as soon as possible if you notice swelling, redness, tenderness, in the skin area around the genitals.
Risk factors: Changes in diet and exercise | Drinking alcohol | Taking other diabetes medications
Xigduo XR (dapagliflozin / metformin) can raise the risk of dangerously low blood sugar when taken together with other diabetes medications, such as insulin and sulfonylureas. You might also be at risk of having low blood sugar if you've recently changed your diet, exercise, and drinking habits. Very low blood sugar can be life-threatening. Symptoms of low blood sugar include feeling shaky; feeling nervous, anxious, or confused; sweating; and having fast heartbeat, body chills, low energy, and hunger. Make sure you know how to check your blood sugar if you get these symptoms and what to do if you have low blood sugar. Talk to your prescriber about your risk for low blood sugar.
Your prescriber will help determine your starting dose of Xigduo XR (dapagliflozin / metformin) based on the doses of your current diabetes medications and health conditions.
If you're not already taking dapagliflozin, the typical starting dose of dapagliflozin is 5 mg by mouth once daily. If you have heart failure or kidney problems, the typical recommended dose of dapagliflozin is 10 mg once daily.
The maximum dose of Xigduo XR is 10 mg/2000 mg (dapagliflozin / metformin) by mouth once daily.
Severe kidney problems
Sudden or long-term high levels of acid in your body (e.g., diabetic ketoacidosis)
Type 2 diabetes in adults
Lowering the risk of death due to heart problems in adults with Type 2 diabetes and heart disease
Lowering the risk of hospitalization and death due to heart problems in adults with Type 2 diabetes and heart failure
Lowering the risk of worsening kidney problems, hospitalization, and death due to heart problems in adults with Type 2 diabetes and chronic kidney disease (CKD)
By providing your email, you consent to receive marketing communications from GoodRx, which may include content and/or data related to men’s health, women's health, reproductive care, or sexual health. You agree to the GoodRx Terms of Use and acknowledge the Privacy Policy. You can unsubscribe at any time.
AstraZeneca Pharmaceuticals LP. (2024). Xigduo XR- dapagliflozin and metformin hydrochloride tablet, film coated, extended release [package insert]. DailyMed.
Centers for Disease Control and Prevention. (2024). About necrotizing fasciitis.
National Kidney Foundation. (2023). Dialysis.
Research prescriptions and over-the-counter medications from A to Z, compare drug prices, and start saving.