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Metformin Effect On A1c

Significant Reduction In A1c Levels When Patients Need More

Significant Reduction In A1c Levels When Patients Need More

Postmarketing cases of metformin-associated lactic acidosis have resulted in death, hypothermia, hypotension, and resistant bradyarrhythmias. Symptoms included malaise, myalgias, respiratory distress, somnolence, and abdominal pain. Laboratory abnormalities included elevated blood lactate levels, anion gap acidosis, increased lactate/pyruvate ratio, and metformin plasma levels generally >5 mcg/mL. Risk factors include renal impairment, concomitant use of certain drugs, age >65 years old, radiological studies with contrast, surgery and other procedures, hypoxic states, excessive alcohol intake, and hepatic impairment. Steps to reduce the risk of and manage metformin-associated lactic acidosis in these high risk groups are provided in the Full Prescribing Information. If lactic acidosis is suspected, discontinue XIGDUO XR and institute general supportive measures in a hospital setting. Prompt hemodialysis is recommended. Contraindications Warnings and Precautions Hypotension: Dapagliflozin causes intravascular volume contraction, and symptomatic hypotension can occur. Assess and correct volume status before initiating XIGDUO XR in patients with impaired renal function, elderly patients, or patients on loop diuretics. Monitor for hypotension. Ketoacidosis has been reported in patients with type 1 and type 2 diabetes receiving dapagliflozin. Some cases were fatal. Assess patients who present with signs and symptoms of metabolic acidosis for ketoacidosis, regardless of blood glucose level. If suspected, discontinue XIGDUO XR, evaluate and treat promptly. Before initiating XIGDUO XR, consider risk factors for ketoacidosis. Patients on XIGDUO XR may require monitoring and temporary discontinuation in situations known to predispose to ketoacidosis. Acute Kidney Injury and Impai Continue reading >>

Januvia + Metformin: Strong A1c Lowering Vs Metformin Alone1

Januvia + Metformin: Strong A1c Lowering Vs Metformin Alone1

As an adjunct to diet and exercise for appropriate patients with type 2 diabetes In a clinical study including initial combination of sitagliptin + metformin, strong A1C lowering beyond metformin alone at week 24 (primary end point)a View Study Design 4 > aResults are adjusted for a 0.2% mean A1C increase for placebo; bP<0.001 vs respective monotherapies. LS = least squares; APaT = all-patients-as-treated. When added to a sulfonylurea (glimepiride) or insulin, patients treated with sitagliptin + metformin experienced a mean increase in body weight Percentage of patients with ≥1 episode of hypoglycemia over 24 weeks (APaT population) When added to a sulfonylurea (glimepiride) or insulin, patients treated with sitagliptin + metformin experienced increased incidence of hypoglycemia 12.2% for patients treated with JANUVIA + glimepiride ± metformin vs 1.8% for placebo + glimepiride ± metformin; 15.5% for patients treated with JANUVIA + insulin ± metformin vs 7.8% for placebo + insulin ± metformin. A lower dose of sulfonylurea or insulin may be required to reduce the risk of hypoglycemia. Established tolerability profile: Similar weight change with JANUVIA + metformin vs metformin alone1 Weight loss for sitagliptin + metformin was similar to metformin alone LS mean change from baseline at 24 weeks ranged from –1.3 lb to –2.9 lb (APaT population). When added to a sulfonylurea (glimepiride), patients treated with sitagliptin + metformin experienced a mean increase in body weight +1.8 lb for patients treated with JANUVIA + glimepiride ± metformin vs –0.9 lb for placebo + glimepiride ± metformin; +0.2 lb for patients treated with JANUVIA + insulin ± metformin vs +0.2 lb for placebo + insulin ± metformin. Important Information JANUVIA is indicated as an adjunct to Continue reading >>

Metformin: Improving Insulin Sensitivity

Metformin: Improving Insulin Sensitivity

Metformin is the only medication in the biguanides category of blood glucose-lowering drugs approved by the U.S. Food and Drug Administration (FDA). Metformin has been available in the United States since the mid-1990s, when it received FDA approval. You may also know it by its brand name when it was under patent, Glucophage. Metformin is now widely available as a relatively inexpensive generic medication. Metformin’s main action is to decrease the overproduction of glucose by the liver, a common problem in prediabetes and type 2 diabetes. The action of metformin helps lower blood sugar levels particularly during the night to keep fasting glucose levels under control, but it also helps control blood glucose throughout the day. Metformin also increases the uptake of glucose by your muscles. Overall, metformin decreases insulin resistance and improves insulin sensitivity, thereby helping the insulin your body still makes work more effectively. People with prediabetes and in the early years of type 2 diabetes often continue to make some insulin, just not enough to control blood sugar levels alone. Metformin is not formally approved for use in prediabetes, and any use to treat prediabetes is considered off-label by providers. Since its approval, metformin has become the most commonly recommended blood glucose-lowering medication to treat type 2 diabetes. In recent years it has significantly replaced sulfonylureas, such as glipizide and glyburide. Today both the American Diabetes Association (ADA), the European Association for the Study of Diabetes (EASD), and the American Association of Clinical Endocrinologists (AACE) generally recommend that people with type 2 diabetes start taking metformin when they are diagnosed to help treat insulin resistance and maximize insulin s Continue reading >>

The Effect Of Oral Antidiabetic Agents On A1c Levels

The Effect Of Oral Antidiabetic Agents On A1c Levels

Abstract OBJECTIVE Previous reviews of the effect of oral antidiabetic (OAD) agents on A1C levels summarized studies with varying designs and methodological approaches. Using predetermined methodological criteria, we evaluated the effect of OAD agents on A1C levels. RESEARCH DESIGN AND METHODS The Excerpta Medica (EMBASE), the Medical Literature Analysis and Retrieval System Online (MEDLINE), and the Cochrane Central Register of Controlled Trials databases were searched from 1980 through May 2008. Reference lists from systematic reviews, meta-analyses, and clinical practice guidelines were also reviewed. Two evaluators independently selected and reviewed eligible studies. RESULTS A total of 61 trials reporting 103 comparisons met the selection criteria, which included 26,367 study participants, 15,760 randomized to an intervention drug(s), and 10,607 randomized to placebo. Most OAD agents lowered A1C levels by 0.5−1.25%, whereas thiazolidinediones and sulfonylureas lowered A1C levels by ∼1.0–1.25%. By meta-regression, a 1% higher baseline A1C level predicted a 0.5 (95% CI 0.1–0.9) greater reduction in A1C levels after 6 months of OAD agent therapy. No clear effect of diabetes duration on the change in A1C with therapy was noted. CONCLUSIONS The benefit of initiating an OAD agent is most apparent within the first 4 to 6 months, with A1C levels unlikely to fall more than 1.5% on average. Pretreated A1C levels have a modest effect on the fall of A1C levels in response to treatment. Type 2 diabetes is a chronic, progressive disease that requires ongoing attention to lifestyle and pharmacotherapy to achieve and maintain optimal glucose control (1). Declining β-cell function and increasing insulin resistance over time lead to deteriorating glycemic control and the ne Continue reading >>

Onglyza Is Proven To Lower A1c Levels

Onglyza Is Proven To Lower A1c Levels

Important Safety Information Do not take ONGLYZA if you: are allergic to any of its ingredients. Serious allergic reactions can occur with ONGLYZA and may include swelling of the face, lips or throat, difficulty swallowing or breathing, swelling of the skin, hives, rash, itching, flaking, or peeling. If you have these symptoms, stop taking ONGLYZA and contact your doctor right away Serious side effects can happen in people who take ONGLYZA: Inflammation of the pancreas (pancreatitis) which may be severe and lead to death. Before taking ONGLYZA, tell your doctor if you ever had pancreatitis, gallstones, history of alcoholism, or high triglyceride levels. Stop taking ONGLYZA and contact your doctor right away if you have pain in your stomach area (abdomen) that is severe and will not go away. The pain may be felt going from your abdomen through to your back. The pain may happen with or without vomiting. These may be symptoms of pancreatitis Heart failure. Before taking ONGLYZA tell your doctor if you have ever had heart failure or problems with your kidneys. Contact your doctor right away if you have any of the following symptoms of heart failure: increasing shortness of breath or trouble breathing, especially when you lie down; an unusually fast increase in weight; swelling or fluid retention, especially in the feet, ankles or legs; unusual tiredness Low blood sugar. When ONGLYZA is used with certain other diabetes medicines to treat high blood sugar, such as a sulfonylurea or insulin, the risk of low blood sugar (hypoglycemia) is higher. Symptoms of low blood sugar include shaking, hunger, sweating, headache, rapid heartbeat, change in mood, and change in vision. Follow your doctor’s instructions for treating low blood sugar Joint pain. Some people who take medicines Continue reading >>

Effect Of Pioglitazone Compared With Metformin On Glycemic Control And Indicators Of Insulin Sensitivity In Recently Diagnosed Patients With Type 2 Diabetes

Effect Of Pioglitazone Compared With Metformin On Glycemic Control And Indicators Of Insulin Sensitivity In Recently Diagnosed Patients With Type 2 Diabetes

Pioglitazone, a thiazolidinedione, improves glycemic control primarily by increasing peripheral insulin sensitivity in patients with type 2 diabetes, whereas metformin, a biguanide, exerts its effect primarily by decreasing hepatic glucose output. In the first head-to-head, double-blind clinical trial comparing these two oral antihyperglycemic medications (OAMs), we studied the effect of 32-wk monotherapy on glycemic control and insulin sensitivity in 205 patients with recently diagnosed type 2 diabetes who were naive to OAM therapy. Subjects were randomized to either 30 mg pioglitazone or 850 mg metformin daily with titrations upward to 45 mg (77% of pioglitazone patients) and 2550 mg (73% of metformin patients), as indicated, to achieve fasting plasma glucose levels of less than 7.0 mmol/liter (126 mg/dl). Pioglitazone was comparable to metformin in improving glycemic control as measured by hemoglobin A1C and fasting plasma glucose. At endpoint, pioglitazone was significantly more effective than metformin in improving indicators of insulin sensitivity, as determined by reduction of fasting serum insulin (P = 0.003) and by analysis of homeostasis model assessment for insulin sensitivity (HOMA-S; P = 0.002). Both OAM therapies were well tolerated. Therefore, pioglitazone and metformin are equally efficacious in regard to glycemic control, but they exert significantly different effects on insulin sensitivity due to differing mechanisms of action. The more pronounced improvement in indicators of insulin sensitivity by pioglitazone, as compared with metformin monotherapy in patients recently diagnosed with type 2 diabetes who are OAM-naive, may be of interest for further clinical evaluation. Most studies of sex hormones and insulin resistance (IR) have focused on androgens Continue reading >>

Metformin Forever

Metformin Forever

Metformin controls the insulin resistance of people who have type 2 diabetes so well that, if possible, all of us should be taking it. That’s what Roderic Crist, M.D., told me at the annual convention of the American Society of Bariatric Physicians in Denver this weekend. Dr. Crist specializes in family medicine in Cape Girardeau, Missouri. “Not everybody can take every drug,” he added, when I followed up our conversation by calling him at his office after he returned home. “But most of the time people can take metformin if they take it carefully.” Doctors increasingly prescribe it not only for type 2 diabetes but also for insulin resistance, polycystic ovary syndrome, and non-alcoholic fatty liver disease. Roughly one-third of Dr. Crist’s patients have diabetes. Well over half, if not two-thirds of the people he sees are insulin resistant. “I treat insulin resistance with that drug even if they aren’t fully diabetic.” he says. “If they have high triglyceride levels and low HDL levels, particularly if they are centrally obese, they should probably be on metformin. It helps slow the progression of the disease from one thing to the next.” But he goes further. He prescribes metformin to almost all of his patients who have type 2 diabetes — no matter how low their A1C level is. And he tells his patients that their levels should be 5.0 or less — not the American Diabetes Association’s less stringent recommendation of 7.0 or less. “If their A1C is at 5, their diabetes is in complete remission. So I have that as a goal.” And he still prescribes metformin to them after they reach that goal. “The two important issues are that it will prevent progression and it should be used in the earliest phases of insulin resistance. We vastly underutilize me Continue reading >>

A1c Reduction Vs Metformin

A1c Reduction Vs Metformin

I was wondering if anybody can confirm what I heard from my cardiologist. He said that 1000 mg metformin would make for 0.5 a1c reduction. I am 44 and 198 pounds. Still about 5-10 pounds in the wrong direction When I was diagnosed Type 2 in Dec 2010. My A1C was 10.7 and my weight 237 pounds. Started with 1000 mg metformin/20 mg simvastatin. Thru exercise/healthy eating my last A1C 2m ago was 5.5 and cholesterol was normal (70ish). Since last couple of months I went to 500 mg metformin and 2.5 mg simvastatin (been decreasing simvastatin gradually in 2011.) Basically, my belief is that diet/exercise/low stress would heal better than drugs and I want to get off metformin and simvastatin altogether. I typically do 30 min cardio in the morning, take 9 floors (210 steps) to my office at lunch time, and series of pushups and situps at night 6 days a week. I found 1000 mg of metformin was not enough for me. Over the past few years I have raised it to the max- 25550 mg. That keeps my bgs close to 100 most of the day. I let myself go to 110-120 after meals but prefer to be close to 100. I do about an hour-90 minutes of exercise most days, mostly walking. I lost weight for about 3 years but have been at 120-124 for about 2+ years. I would like to lose another few pounds but my body seems happy with my body set point. I was on a statin for about 15 months but it started to destroy my muscles so I stopped it. So far the Metformin has no side effects except good bgs and it actually helps in other ways, so I think I will stay on it although my bgs are good. When I was dx'd my bgs were in the 200-300 range and HbA1c was almost 11. So I have seen almost a 6 point drop. Although I have lost close to 30 pounds I was not overweight, high end of normal to start. 115 pounds, Breast Cancer d Continue reading >>

Metformin | Diabetesnet.com

Metformin | Diabetesnet.com

Thu, 11/18/2010 - 15:57 -- Richard Morris Two drugs from the biguanide class, metformin and phenformin, were developed in 1957. Unfortunately, phenformin reached the U.S. market first and resulted in several deaths from lactic acidosis. When this risk surfaced, phenformin was pulled from drugstore shelves worldwide. Metformin was eventually found to be 20 times less likely to cause lactic acidosis, but it was tainted by the history of its cousin. Metformin first became available in France in 1979 and has been widely used in Europe since then, but it was not cleared for use in Type 2 diabetes in the U.S. until 1994. Target Organ: Liver, secondary effects on muscle and fat. Action: Lower glucose production by liver, increase number of insulin receptors Side Effects: bloating, fullness, nausea, cramping, diarrhea, vit B12 deficiency, headache, metallic taste, agitation, lactic acidosis Contraindications: DKA, alcoholism, binge drinking, kidney or liver disease, congestive heart failure, pregnancy, use of contrast media, surgery, heart attack, age > 80 Metformin is a chemical kin to the French lilac plant, which was noted in the early 1900’s to lower the blood sugar. However, French lilac, like phenformin, turned out to be too toxic for use in humans. Metformin, with a much shorter action time than phenformin, has a much lower risk for severe side effects and is quite safe for use by anyone who is otherwise healthy. In fact, in the major UKPDS study, it was the only drug that reduced diabetes-related death rates, heart attacks, and strokes. It should not be used by those who use more than two ounces or two drinks of alcohol a day, who have congestive heart failure, or who have significant kidney, liver, or lung disease. Metformin lowers fasting blood glucose levels by an Continue reading >>

Can Metformin Lower A1c For Patients With Type 1 Diabetes?

Can Metformin Lower A1c For Patients With Type 1 Diabetes?

Home / Conditions / Obesity / Can Metformin Lower A1c For Patients With Type 1 Diabetes? Can Metformin Lower A1c For Patients With Type 1 Diabetes? Insulin resistance has been proposed as one of the causes of poor glycemic control in youth with type 1 diabetes who have excess weight or obesity. To compare the effect of metformin vs. placebo on hemoglobin A1c (HbA1c), total daily dose (TDD) of insulin, and other parameters in youth with T1D who have excess weight or obesity they did a 9-mo randomized, double-blind, placebo-controlled trial of metformin and placebo in 28 subjects (13m/15) of ages 10-20 years (y), with HbA1c >8% (64 mmol/mol), BMI >85%, and T1D > 12 months and was conducted at a university outpatient facility. The metformin group consisted of 15 subjects (8 m/ 7f), of age 15.0 2.5 y; while the control group was made up of 13 subjects (5m/ 8f), of age 14.5 3.1y. All participants employed a self-directed treat-to-target insulin regimen based on a titration algorithm of (-2)-0-(+2) units to adjust their long-acting insulin dose every 3rd day from -3 mo through +9 mo to maintain fasting plasma glucose (FPG) between 90-120 mg/dL (5.0-6.7 mmol/L). Pubertal maturation was determined by Tanner stage. It was assumed that the metformin therapy will improve glycemic control in youth with T1D and excess weight or obesity, similar to those with type 2 diabetes. Youth with type 1 diabetes (T1D) who have excess weight or obesity often have suboptimal glycemic control. Though insulin resistance has been proposed as one of the causes of this poor glycemic control, the role of adjunctive metformin, an insulin sensitizer, on glycemic control in these patients is unclear. Metformin is a biguanide, which acts principally by increasing insulin sensitivity in the liver by inhib Continue reading >>

Metformin For Prediabetes

Metformin For Prediabetes

Prediabetes is, for many people, a confusing condition. It’s not quite Type 2 diabetes — but it’s not quite nothing, either. So how concerned should you be about it? For years, the jargon-filled names given to this condition — impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) — may have made the task of taking it seriously more difficult. But in 2002, the American Diabetes Association (ADA), along with the U.S. Department of Health and Human Services, inaugurated the term “prediabetes” to convey the likely result of not making diet or lifestyle changes in response to this diagnosis. In 2003, the threshold for prediabetes was lowered from a fasting glucose level of 110 mg/dl to one of 100 mg/dl. Then, in 2008, the American Diabetes Association (ADA) began recommending the drug metformin for some cases of prediabetes — specifically, for people under age 60 with a very high risk of developing diabetes, for people who are very obese (with a body-mass index, or BMI, of 35 or higher), and for women with a history of gestational diabetes. The ADA also said that health-care professionals could consider metformin for anyone with prediabetes or an HbA1c level (a measure of long-term blood glucose control) between 5.7% and 6.4%. But according to a recent study, metformin is still rarely prescribed for prediabetes. The study, published in April in the journal Annals of Internal Medicine, found that only 3.7% of people with prediabetes were prescribed metformin over a three-year period, based on data from a large national sample of adults ages 19 to 58. According to a Medscape article on the study, 7.8% of people with prediabetes with a BMI of 35 or higher or a history of gestational diabetes were prescribed metformin — still a very low rate for t Continue reading >>

Metformin And Insulin Resistance

Metformin And Insulin Resistance

About a year ago, my endocrinologist determined that I was exhibiting signs of insulin resistance. In short, my body requires more than the average amount of insulin to cover carbohydrate. She suggested that I start taking metformin, noting that it would do two things for me: It would decrease the amount of insulin I need to take and it would help curb my appetite, thus resulting in weight loss. When I first got on it, I thought it was great. My blood sugar levels improved, my appetite was in fact curbed, and all seemed wonderful — until I stopped taking my metformin. As a high school senior, I had atrocious sleeping habits! That, coupled with the fact that taking metformin was really killing my appetite, was causing me to become exhausted and get some pretty severe headaches. Looking back on it now, it’s very clear that the metformin wasn’t the problem, it was me. However, as a stubborn senior in high school, I was determined to maintain my sleeping habits, as I deemed them completely normal and in accordance with the typical behavior exhibited by my peers (boy, how I’ve changed…). So, I stopped the metformin. The last three weeks or so, I’ve been back on metformin regularly. I decided to start it up again after my last appointment with my CDE. Thus far, it’s really been working wonders and my blood sugars have decreased substantially! Where my 30-day average was hovering around 190 just a few weeks ago, it has now dropped to 137! I was seriously shocked when I saw how much my average fell. For the most part, my blood sugar levels are in range, but I have had my fair share of lows as well. Managing metformin really is a science that can change on a daily basis depending on my activity level. For example, the first two weeks that I was back on metformin, I Continue reading >>

Effect Of Metformin Glycinate On Glycated Hemoglobin A1c Concentration And Insulin Sensitivity In Drug-naive Adult Patients With Type 2 Diabetes Mellitus

Effect Of Metformin Glycinate On Glycated Hemoglobin A1c Concentration And Insulin Sensitivity In Drug-naive Adult Patients With Type 2 Diabetes Mellitus

Go to: Abstract This study evaluated the effect of metformin glycinate on glycated hemoglobin A1c (A1C) concentration and insulin sensitivity in drug-naive adult patients with type 2 diabetes mellitus (T2DM). A randomized, double-blind, placebo-controlled clinical trial was carried out in 20 patients with drug-naive T2DM. Ten subjects received metformin glycinate (1,050.6 mg) once daily during the first month and force-titrated twice daily during the second month. Ten additional patients received placebo as the control group. Before and after the intervention, metabolic profile including A1C and insulin sensitivity (euglycemic-hyperinsulinemic clamp technique) was estimated. A1C concentrations decreased significantly with metformin glycinate administration (8.0±0.7% vs. 7.1±0.9%, P=0.008) before and after the intervention, respectively. There were significant differences in changes from baseline of A1C between groups (0.0±0.7% vs. −1.0±0.5% for placebo and metformin glycinate groups, respectively; P=0.004). A reduction of ≥1% in A1C levels was reached in 60.0% of patients with metformin glycinate administration (P=0.02). Insulin sensitivity was not modified by the intervention. Administration of metformin glycinate during a 2-month period showed a greater decrease in A1C concentrations than placebo in a selected group of drug-naive adult patients with T2DM. Go to: In accordance with several algorithms for the medical treatment of patients with type 2 diabetes mellitus (T2DM), metformin hydrochloride along with lifestyle changes is the first line of treatment to achieve metabolic goals and, in combination with other oral agents or insulin, provides an efficacious therapeutic option.1,2 Metformin is a biguanide that activates the 5′-AMP-activated protein kinase Continue reading >>

Diabetes Medications After Metformin: And The Winner Is

Diabetes Medications After Metformin: And The Winner Is

Most people with type 2 diabetes will most likely have been prescribed metformin at some point. There are few places in medicine where everyone agrees on step 1, but metformin breaks the rules here and has been declared the first line champ. Because of metformin’s effect on A1C, low incidence of hypoglycemia, low cost and protective effects on the heart, it has earned the top spot in most clinical practice guidelines. But many people with diabetes don’t reach their A1C goal with diet and metformin alone, or can’t tolerate metformin’s not-so-friendly effects on the stomach. The time may come to add a second diabetes medication. With numerous classes of drugs used to treat diabetes, how is the second drug chosen? Why does one person get a prescription for Januvia or Victoza, while someone else might be given Onglyza or Glipizide? Prescribers of diabetes drugs have more choices than ever before. While this seems like it would be an advantage (and it clearly is!), the decision-making process for the second, third, and any other medications needed is not always simple. There isn’t a clear-cut answer to the best drug to be added to metformin. Studies comparing the various treatment options have not shown a winner in terms of a drug being the best at decreasing A1C or having the least amount of side effects. So what’s a prescriber to do? By looking at all of the diabetes drug classes through the same lens, the prescribing decision can be made a little bit easier. This means that we can compare each drug on a set of features to see how they stack up side by side. What are the qualities of the drugs that factor into the decision? Cost – Is a generic version available? Insurance vs no insurance? Is the copay affordable if the drug is at the top tier? Efficacy – Ho Continue reading >>

Not At Goal On Metformin?

Not At Goal On Metformin?

Ask your doctor about fighting type 2 diabetes harder by adding the pill that starts with “f” If you’re not reaching your A1C goal on metformin, you should know that adding once-daily FARXIGA to metformin therapy helped some patients lower their A1C more than metformin alone. The results of a clinical trial showed that patients taking FARXIGA 5 mg added on to metformin had an A1C reduction of 0.7 versus 0.3 with metformin alone. Although not a weight loss or blood pressure drug, FARXIGA may also provide weight loss and blood pressure benefits when taken with metformin. The results of a clinical trial showed that patients taking FARXIGA added on to metformin to lower their A1C also lost an average of 6.6 pounds, versus 2 pounds with metformin alone at 12 weeks. And results from the same study showed that taking FARXIGA added on to metformin also helped to lower systolic blood pressure. Remember, only your doctor can tell you if adding FARXIGA to your current metformin therapy could make a difference for you. Individual results may vary. Do not take FARXIGA if you have severe kidney problems or are on dialysis. Your healthcare provider should do blood tests to check how well your kidneys are working before and during your treatment with FARXIGA. FARXIGA may cause serious side effects including: Dehydration (the loss of body water and salt), which may cause you to feel dizzy, faint, lightheaded, or weak, especially when you stand up (orthostatic hypotension). You may be at a higher risk of dehydration if you have low blood pressure; take medicines to lower your blood pressure, including water pills (diuretics); are 65 years of age or older; are on a low salt diet, or have kidney problems FARXIGA has been tested in 24 clinical studies that looked at its benefits and s Continue reading >>

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