Diabetes

Your medication has been changed to dapagliflozin (it may have been prescribed previously as the branded item Forxiga) because it works just as well as your previous medication. Dapagliflozin is now available at lower cost, which helps the NHS care for more patients. This change has been recommended by NHS England and approved by your local doctors.

Yes. Dapagliflozin and your previous medication (Forxiga, empagliflozin, canagliflozin, or ertugliflozin) are all from the same family of medicines called SGLT2 inhibitors. NICE (the National Institute for Health and Care Excellence) considers them to have similar effectiveness. Both are taken once daily and work in the same way.

Start taking dapagliflozin 24 hours after your last dose of your old medication. For example:

• If you take your last dose of old medication on Monday morning, start dapagliflozin on Tuesday morning
• Continue taking it once daily at the same time each day

Most patients will be taking the standard dose of dapagliflozin 10mg once daily, regardless of what dose you were on before. If you have any liver problems then the starting dose may be 5mg.

• Keep taking your current tablets you have in the normal way
• Only start taking your new dapagliflozin the day after you have finished your old tablets
• Do not throw them in the bin or flush them down the toilet, if you find any old medicines always return any unused tablets to your pharmacy for safe disposal.

Because dapagliflozin works in the same way as your previous medication, you should not experience any new side effects. The common side effects (such as increased urination or genital or urinary infections) are the same across all SGLT2 inhibitors. If you had no side effects with your old medication, you're unlikely to have them with dapagliflozin.

Dapagliflozin will now appear on your medication list when you order your repeat prescription. You can order it in the same way you normally order your medications (NHS APP, online, or at your pharmacy). Your old medication will be removed from your list. If you have an old list of your medicines make sure you use a new one and let your pharmacy know about the change so they know you are expecting the new medicine.

If you've received the message about switching but haven't collected your dapagliflozin yet, contact your pharmacy or GP practice. They can arrange for you to collect dapagliflozin so there's no gap in your treatment.

This is a routine, safe change between equivalent medications. However, if you have specific concerns not covered in this information, you can contact your GP practice to discuss them. The practice team can answer your questions and help reassure you about the change.

If you experience severe or unusual symptoms after switching.

• If you have questions about taking your other medications
• If you're unsure when to start your new medication
• If you haven't received your new prescription

Yes. Continue taking all your other medications as normal. Dapagliflozin is simply replacing your previous SGLT2 inhibitor (Forxiga, empagliflozin, canagliflozin, or ertugliflozin). All your other medications remain the same.

No. Dapagliflozin is equally effective at managing your blood sugar, diabetes and/or heart failure. You should not notice any change in how well your condition is controlled. Continue with your regular monitoring as advised by your healthcare team.

“Cheaper" doesn't mean lower quality. Dapagliflozin costs less simply because the patent expired - the medicine itself has not changed and is just as effective. NICE (the independent body that assesses medicines for the NHS) confirms these medications work equally well. The NHS needs these savings to fund the new medicines and treatments as they become available.

Contact your Community Pharmacist or your GP practice if you have any concerns about this medication change.