Dapagliflozin Switch Scheme
Switching to Dapagliflozin
This page is for patients taking a SGLT2 inhibitor (Canagliflozin, Empagliflozin or Ertugliflozin). Thank you for taking the time to read this page. We want to have a telephone conversation with you in the near future about changing from this medication and it would be helpful if you have read this information in preparation for that call.
Why are we switching you to Dapagliflozin?
You have been prescribed an SGLT2 inhibitor (Canagliflozin, Empagliflozin or Ertugliflozin) to help manage your diabetes, heart failure and/or chronic kidney disease (CKD).
Dapagliflozin belongs to the same family of medicines, called SGLT2 inhibitors, and works in the same way. It provides the same health benefits, has fewer drug interactions and is now more cost-effective as it has recently come off patent.
It will come as no surprise that NHS resources are tighter than ever and everyone working within the NHS must do all we can to make the best use of them.
Current NHS England and Herefordshire and Worcestershire ICB guidance recommend Dapagliflozin as the first line treatment option for patients as it is currently the most cost-effective, which helps the NHS make the best use of its resources and ensure that funding can be used to support patients and services across the NHS.
Dapagliflozin
£3.50
Cost per month:
Empagliflozin
£36.59
Canagliflozin
£39.20
Ertugliflozin
£29.40
Switching to Dapagliflozin should not affect how well your condition is managed or cause any new side effects compared with your current treatment.
The National Institute for Health and Care Excellence (NICE) appraisals have concluded that all SGLT2 inhibitors have similar efficacy and safety for the treatment of type 2 diabetes.
Our local cardiologists and endocrinologists are fully aware of and supportive of this proposed change, which is in line with the available evidence and national guidance.
How would I switch?
The switch is easy.
Just finish the Empaglifozin / Canagliflozin / Ertuglifozin tablets that you have remaining at home and re-order your Dapagliflozin prescription in the normal way when it is due.
It is important that you do not take both the old and the new tablets at the same time.
What should I expect after switching to dapagliflozin?
Most people do not notice any difference after switching to dapagliflozin as the side effect profile is similar to your previous medicine.
No extra blood tests will be needed as a result of the switch, and your usual monitoring will continue as normal.
Patients on insulin or sulfonylureas (gliclazide, glipizide, glimepiride or tolbutamide) who currently monitor their blood glucose levels at home are advised to do so closely after switching, to reduce the risk of low glucose levels. This is standard practice when adjusting any glucose lowering therapy.
What are the side effects of dapagliflozin?
Dapagliflozin belongs to the same group of medicines as your current treatment (SGLT2 inhibitors). The possible side effects are therefore similar to those you have already been advised about, including:
A small increased risk of urine and genital infections.
Very rarely, Fournier's gangrene, a serious infection, has been reported with medicines in this group. Please seek urgent medical help if you develop pain, redness, swelling, fever or any unusual symptoms in the genital area.
Diabetic ketoacidosis (DKA) is a rare but serious side effect of SGLT inhibitors. If you develop stomach pain, nausea or vomiting, fast or deep breathing, unusual sleepiness, a sweet-smelling breath or a metallic taste in your mouth, stop taking this medication and seek urgent medical help.
Sick Day Rules
A reminder for patients taking either dapagliflozin, canagliflozin, empagliflozin or ertugliflozin of the sick day rules: temporarily stop canagliflozin, empagliflozin, ertugliflozin or dapagliflozin during acute illness, especially if you are too unwell to eat or drink. Stop this medicine 3 days prior to major surgery. Restart once you have fully recovered and are eating and drinking normally.
This leaflet provides further information on how to manage when you are not feeling well. Diabetes and being ill | Managing when you're sick | Diabetes UK
If you notice any new or worrying side‑effects, seek advice from healthcare professionals.
How do I let you know if I am happy to switch?
If you are receiving a text for this, you should have been given an appointment date and time to discuss the switch. If unsure, check your NHS app.
If not, please contact our practice to make an appointment with our Clinical Pharmacist.
What if I have further questions?
Please contact our practice to make an appointment with our Clinical Pharmacist.
I’d like to read up on the medicine options beforehand…
Click the link below to view the patient information leaflet for dapagliflozin, the first line SGLT inhibitor:
Click the links below to view the patient information leaflets for the other non-formulary SGLT inhibitors:
What if I’m not happy to switch?
We hope we’ve given you reassurance here that the switch really is easy, and you’d be happy to help with our efforts to support your local NHS, but if you are absolutely against the change, you can let us know in writing either through post or email, addressing to Clinical Pharmacist Team.