Farxiga Interactions: Alcohol, Medications, and Others

Certain health conditions or other factors could raise your risk of harm if you take Farxiga. In such cases, your doctor may not prescribe Farxiga for you. These are known as contraindications.

If you’ve had an allergic reaction to Farxiga, this is a contraindication. If you‘ve had an allergic reaction to Farxiga or any of its ingredients, your doctor likely won’t prescribe Farxiga. This is because taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better options for you.

If you drink, you should avoid drinking large amounts of alcohol while taking Farxiga.

A rare but serious side effect of Farxiga is ketoacidosis. Drinking alcohol in large quantities increases this risk.

If you have questions about consuming alcohol while taking Farxiga, talk with your doctor.

Before you start taking Farxiga, tell your doctor and pharmacist about any prescription and over-the-counter drugs you take. Sharing this information with them may help prevent possible interactions. (To learn whether Farxiga interacts with supplements, herbs, and vitamins, see the “Are there other interactions with Farxiga?” section below.)

If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist.

The table below lists drugs that may interact with Farxiga. Keep in mind that this table does not include all drugs that may interact with Farxiga.

* For more information about these interactions, see the “Drug interactions explained” section below

Learn more about certain drug interactions that can occur with Farxiga.

Interaction with insulin

Farxiga may interact with insulin. Like Farxiga, insulin drugs are prescribed to help manage blood sugar levels in people with type 2 diabetes. For this purpose, it’s not unusual for a doctor to prescribe both Farxiga and insulin.

Examples of insulin medications are:

What could happen

Insulin drugs can cause low blood sugar as a side effect.

Farxiga didn’t cause blood sugar to drop below the normal range when used on its own in studies. But because it does lower blood sugar levels, taking it together with insulin increases the risk of the blood sugar dropping too low.

What you can do

If your doctor prescribes Farxiga with insulin for managing your diabetes, they may prescribe a lower insulin dosage than usual. They may also suggest you monitor your blood sugar level more frequently.

Be sure to follow your doctor’s directions for checking your blood sugar level. You’ll also want to learn about low blood sugar symptoms and have an action plan if these symptoms occur.

Should you experience this side effect, your doctor may try lowering your insulin dosage. Or they may suggest that you stop treatment with insulin and explore other treatment options.

Interaction with sulfonylureas

Farxiga may interact with sulfonylurea medications. Farxiga and sulfonylureas are both prescribed to manage high blood sugar levels caused by type 2 diabetes. In some cases, a doctor may prescribe these medications together.

Examples of sulfonylurea medications are:

What could happen

Sulfonylureas can cause low blood sugar as a side effect. Because Farxiga works by lowering blood sugar, taking it with a sulfonylurea may raise your risk of low blood sugar.

What you can do

If your doctor prescribes Farxiga and a sulfonylurea drug, they may prescribe a lower dosage of the sulfonylurea. They may also suggest you monitor your blood sugar level more often.

Be sure to follow your doctor’s directions for checking your blood sugar. You’ll also want to learn about low blood sugar symptoms and have an action plan if these symptoms occur.

Let your doctor know if you’ve experienced an episode of low blood sugar during treatment. If so, they may lower your sulfonylurea dosage or suggest a different combination of medications.

Interaction with lithium

Farxiga can interact with the drug lithium (Lithibid). Lithium is a mood stabilizer and is prescribed as treatment for bipolar disorder and other mood disorders.

What could happen

If taken together, Farxiga could lower the level of lithium in your body. At a lower level, lithium may not work as effectively to manage your condition.

What you can do

If you’re taking lithium, your doctor will order regularly scheduled blood tests to check lithium levels. These tests are more frequent when:

• you first start taking lithium
• anytime your lithium dosage is changed
• if you start a medication that interacts with lithium
• if you change the dosage of a medication that interacts with lithium

Since Farxiga interacts with lithium, your doctor will likely check your lithium blood levels more frequently when you first start taking Farxiga and anytime your Farxiga dosage changes. By checking lithium blood levels, your doctor will be able to determine the right dosage of lithium for you.

Farxiga may have other interactions. They could occur with supplements, foods, vaccines, or even lab tests. See below for details. Note that the information below does not include all other possible interactions with Farxiga.

Does Farxiga interact with supplements?

Before you start taking Farxiga, talk with your doctor and pharmacist about any supplements, herbs, and vitamins you take. Sharing this information with them may help you avoid possible interactions.

If you have questions about interactions that may affect you, talk with your doctor or pharmacist.

Farxiga interactions with herbs

Farxiga may interact with garlic supplements. This is because garlic supplements may lower blood sugar levels. Taking Farxiga with a garlic supplement may cause your blood sugar level to drop too low.

If you take a garlic supplement while taking Farxiga, your doctor may recommend that you check your blood sugar level more frequently. Depending on your blood sugar level, they may lower your Farxiga dosage.

Farxiga interactions with vitamins and minerals

Farxiga may interact with the mineral supplement chromium. Some studies suggest that chromium may improve blood sugar level management in people with type 2 diabetes. Taking Farxiga with chromium may cause your blood sugar level to drop too low.

If you take a chromium supplement while taking Farxiga, your doctor may have you check your blood sugar level more frequently. Depending on your blood sugar level, they may lower your Farxiga dosage.

Does Farxiga interact with food?

There are currently no reports of Farxiga interacting with food. If you have questions about eating certain foods during your treatment with Farxiga, talk with your doctor.

Does Farxiga interact with vaccines?

There are currently no reports of Farxiga interacting with vaccines. If you have questions about receiving vaccines during your treatment with Farxiga, talk with your doctor.

Does Farxiga interact with lab tests?

Farxiga may interact with certain lab tests. Specifically, it may interact with certain tests used to monitor how well your diabetes is being managed. These are:

• 1,5-anhydroglucitol (GlycoMark) – a test used to estimate your average blood sugar levels after meals over the past 1–2 weeks
• urine glucose – a test that measures the amount of glucose (sugar) in your urine

If you’re prescribed Farxiga, your doctor will recommend different tests to gather this information.

Does Farxiga interact with cannabis or CBD?

There are currently no reports of Farxiga interacting with cannabis (commonly called marijuana) or cannabis products such as cannabidiol (CBD). But as with any drug or supplement, talk with your doctor before using cannabis with Farxiga.

Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.

Certain medical conditions or other health factors may raise the risk of interactions with Farxiga. Before taking Farxiga, talk with your doctor about your health history. They’ll determine whether Farxiga is right for you.

Health conditions or other factors that might interact with Farxiga include:

Genital yeast infections. Be sure to let your doctor know if you’ve had a vaginal yeast infection or penile yeast infection in the past. Taking Farxiga increases your risk of having a yeast infection. Your doctor will educate you on the symptoms to watch out for, your treatment options, and when to call for a medical appointment.

Liver problem. It’s not known whether Farxiga is safe or effective in people with severe liver problems, such as liver cirrhosis. Be sure to let your doctor know if you have a liver condition before you start taking Farxiga. Your doctor can evaluate the severity of your condition and determine whether it’s safe for you to take Farxiga.

Pancreatitis. If you have pancreatitis or have had it in the past, you may be at higher risk of developing ketoacidosis, a rare but serious side effect of Farxiga. Your doctor will determine whether Farxiga is safe for you to take based on your health history.

Planned surgery. While taking Farxiga, it’s important to let your doctor know if you have surgery planned. Your doctor may have you temporarily stop taking Farxiga before surgery to lower the risk of developing ketoacidosis.

Type 1 diabetes. People with type 1 diabetes should not take Farxiga. For managing high blood sugar, Farxiga is prescribed only to adults with type 2 diabetes. If you have type 1 diabetes, your doctor can review appropriate treatments for your condition with you.

Frequent urinary tract infection (UTI). Some people have had severe UTIs during their treatment with Farxiga. Let your doctor know if you have frequent or chronic UTIs. If you develop UTI symptoms while taking Farxiga, you should make an appointment to see your doctor.

Pregnancy. Using Farxiga during the second and third pregnancy trimesters is not recommended. However, it’s important to manage your health during pregnancy. Talk with your doctor about the best treatment plan for you if you’re pregnant or can become pregnant.

Breastfeeding. Breastfeeding while taking Farxiga isn’t recommended. If you’re breastfeeding or plan to breastfeed, ask your doctor about other treatment options for you.

Allergic reaction. If you’ve had an allergic reaction to Farxiga or any of its ingredients, your doctor will likely not prescribe Farxiga. This is because taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better choices for you.

Find answers to some frequently asked questions about Farxiga and possible interactions.

Can you take Farxiga and metformin together?

Yes, if your doctor prescribes both medications, you can take Farxiga and metformin together. These medications aren’t known to interact. In fact, a combination drug called Xigduo is available that contains the active ingredients of both drugs.

Studies have shown that taking Farxiga and metformin together is effective for managing blood sugar levels in people with type 2 diabetes. Low blood sugar levels weren’t reported as a problem by people taking both medications.

Talk with your doctor or pharmacist if you have additional questions about using Farxiga with other medications for type 2 diabetes.

How much water should you drink when taking Farxiga?

You should drink enough water to stay hydrated. How much water you need to drink depends on a number of factors including:

• your sex and age
• the climate where you live
• how much you exercise
• health conditions you have
• medications you take

Farxiga can cause dehydration, so it’s important to pay attention to your fluid intake.

Dehydration raises the risk of low blood pressure as one of Farxiga’s side effects. Some people taking Farxiga have had kidney injury after becoming dehydrated. Symptoms of dehydration to watch for include feeling dizzy, lightheaded, or weak, particularly while standing up.

Consider your individual factors and talk with your doctor about how much you should drink each day.

Taking certain steps can help you avoid interactions with Farxiga. Before starting treatment, talk with your doctor and pharmacist. Things to discuss with them include:

• Whether you drink alcohol or use cannabis.
• Other medications you take, as well as any vitamins, supplements, and herbs. Your doctor or pharmacist can help you fill out a medication list.
• What to do if you start taking a new drug during your Farxiga treatment.

It’s also important to understand Farxiga’s label and other paperwork that may come with the drug. Colored stickers that describe interactions may be on the label. And the paperwork (sometimes called the patient package insert or medication guide) may have other details about interactions. (If you did not get paperwork with Farxiga, ask your pharmacist to print a copy for you.)

If you have trouble reading or understanding this information, your doctor or pharmacist can help.

Taking Farxiga exactly as prescribed can also help prevent interactions.

If you still have questions about Farxiga and its possible interactions, talk with your doctor.

Questions you may want to ask your doctor include:

• Does my Farxiga dosage affect my risk for interactions?
• If I change my diet while taking Farxiga, do I need to let you know?
• Do my health conditions increase my risk of interactions?
• Will spacing out my diabetes medications throughout the day help to avoid interactions with Farxiga?

To learn more about Farxiga, see these articles:

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Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.