What is Xiduo?

Xigduo XR is an extended-release oral diabetes drug containing a combination of dapagliflozin propaned and metformin. It’s also known as dapagliflozin propaned-metformin, dapagliflozin propanediol-metformin, dapagliflozin-metformin HCl, or simply dapagliflozin-metformin. These ingredients work together to control blood sugar in patients with type 2 diabetes. Xigduo does not treat type 1 diabetes.

Dapagliflozin Propanediol

Dapagliflozin is categorized as a sodium-glucose cotransporter 2 (SGLT2) inhibitor, which means it prevents your kidneys from absorbing as much glucose from your body. Typically, the kidneys filter the blood, removing waste products and sending other compounds (such as glucose) back into circulation. Glucose and sodium are transported together into a portion of the kidneys that handles this waste filtration and reabsorption. Glucose usually diffuses back into the bloodstream through kidney capillaries. This reabsorbed glucose is included in blood glucose levels.

An SGLT2 such as dapagliflozin prevents sodium and glucose from being transported into the region of the kidneys that manages reabsorption. This prevents glucose from re-entering the bloodstream. Instead, the glucose is treated as a waste product. It leaves the body in urine. Dapagliflozin reduces blood glucose by increasing glycosuria, or the amount of glucose in the blood. Glycosuria is often a symptom of untreated type 2 diabetes. However, it is also a strategy for reducing blood sugar in patients under a doctor’s care. Dapagliflozin is also sold as the brand name drug Farxiga.


Metformin is the first-line treatment for patients with type 2 diabetes because it encourages increased insulin responsivity. Insulin is a hormone the liver normally releases when the blood contains high levels of glucose. Insulin acts on cells throughout the body, instructing them to absorb glucose and either use it for immediate energy to to store it for use later. However, type 2 diabetes is characterized by insulin resistance. Patients with type 2 diabetes do not exhibit the standard response to insulin. Their cells are less likely to absorb glucose even in the presence of insulin.

Metformin treats high blood glucose by reducing the amount of glucose made in the liver, reducing the amount of sugar absorbed from food during digestion, and reducing the amount of stored energy that’s transformed into glucose. Metformin is also known by the brand names Glucophage, Fortamet, and Riomet.

Metformin also comes in a generic tablets.

How Does Xigduo Work?

By combining dapagliflozin propanediol and metformin, Xigduo lowers blood sugar through several avenues. It prevents the kidneys from reabsorbing glucose, allowing the glucose to instead leave the body in urine. It reduces the amount of glucose absorbed during digestion. It also prevents the liver from making as much glucose and from triggering glucose to be produced from stored energy.

Xigduo Precautions and Warnings

Don’t use Xigduo if you’re allergic to dapagliflozin, metformin, or any of the medicine’s inactive ingredients. Tell your medical team about all your allergies and any negative reactions to other diabetes medicines to make sure Xigduo is a good fit for you.

It can be hard to control your blood sugar when you are ill, dehydrated, recovering from injury or illness, or dealing with other physical stress. Don’t use heavy machinery or drive until you know how Xigduo will affect you. Consider carrying glucose tablets or gels in case of dangerously low blood sugar. Your doctor may recommend monitoring your glucose levels while taking Xigduo.

Xigduo can impact the menstrual cycle including making it more likely to conceive. This medication may not be safe during pregnancy or breastfeeding. Talk with your doctors, including your child’s pediatrician if relevant, to determine the best way to manage your blood sugar if you’re pregnant, nursing, or trying to get pregnant.

Don’t use Xigduo if you have type 1 diabetes. Type 1 and type 2 diabetes are different conditions and Xigduo will not treat type 1 diabetes. In fact, it could make type 1 diabetes symptoms worse.

Xigduo changes how your liver and kidneys work. These organs play important roles in your metabolism, immune system, and waste filtration. Xigduo can therefore make other conditions worse. Tell your doctor if you have current or previous problems with any of these conditions:

  • Breathing trouble (asthma, COPD, etc.)
  • Liver, kidney, or pancreatic disease
  • Genital or anal infections
  • Alcohol abuse
  • Dehydration
  • Blood problems

Xigduo Side Effects

Xigduo can cause side effects, especially when you are new to the medication. These side effects often subside over time. Tell your doctor if any of these effects are unmanageable, get worse, or don’t go away.

Common Side Effects

Common side effects of Xigduo include the following:

  • Diarrhea, nausea, or vomiting
  • Headache
  • Runny nose
  • Sore throat

Serious Side Effects

You should also seek medical help if you experience any of these serious side effects:

  • Urinary tract infection
  • Changes in the amount of urine
  • Swelling in the legs, ankles, or feet
  • Genital or anal infections
  • Unusually high or low blood sugar
  • Symptoms of an allergic reaction (facial or throat swelling, hives, rash, trouble breathing)

Lactic Acidosis

Some of these symptoms can be caused by lactic acidosis, a rare but serious condition that can cause heart or liver failure. Call your doctor immediately if you experience digestive trouble that goes away and then returns since this could be a sign of lactic acidosis. Other lactic acidosis symptoms include:

  • Extreme tiredness or fatigue
  • Blue skin, lips, or nails
  • Chills
  • Muscle pain
  • Abdominal/stomach pain and digestive upset

Drug Interactions with Xigduo

Xigduo can change how your body metabolizes other drugs. This includes other prescriptions as well as over-the-counter medicine, herbs, vitamins, supplements, alcohol, cannabis, and other recreational substances. Drinking alcohol increases your risk of dehydration, blood sugar swings, and lactic acidosis. Talk to your doctor about whether you should drink while taking Xigduo.

Tell your doctor about all your medicines and drug use to find the safest way to treat your blood sugar.

Xigduo commonly interacts with the following types of medicine:

  • Beta-blockers
  • Other diabetes medications
  • Other medications that impact your blood sugar
  • Diuretics or water pills
  • Non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin or ibuprofen
  • Some heart medications

Strengths and Dosages of Xigduo

Xigduo is available in a range of strengths. Your doctor may start you on a low dose and gradually increase it based on your results.

Dapagliflozin PropanediolMetformin

The standard highest dosage is dapagliflozin 10mg, metformin 2000mg a day. Xigduo XR is taken orally, once a day.

Cost of Xigduo in America

A 30-day prescription for maximum-dose Xigduo (dapagliflozin 10mg, metformin 2000mg) is around $575. Patients may pay a lower out-of-pocket cost with insurance coverage, discount programs, coupons, and patient assistance programs. Generic dapagliflozin-metformin usually costs less as well.

Why is Xigduo so Expensive?

Xigduo is a name brand medication. These drugs often cost more because they’re sold by the original manufacturer who held the original patent. Original manufacturers usually set higher prices in an attempt to recoup their initial investment in the drug. The generic version of dapagliflozin-metformin typically costs less than the name brand version.

Alternatives to Xigduo

Yes, these combination diabetes drugs work similarly to Xigduo:

Xigduo FAQs

What is Xigduo XR?

Xigduo XR is an oral type 2 diabetes drug containing dapagliflozin and metformin. It helps reduce blood sugar levels. Xigduo is only for type 2 diabetes. It does not treat type 1 diabetes.

How does Xigduo work?

Xigduo lowers blood sugar in several ways. It keeps your body from absorbing as much glucose from the food you eat. It prevents your body from making as much glucose. It also increases the amount of glucose that leaves the body as a waste product in the urine.

How long does it take for Xigduo to start working?

Xigduo starts working almost as soon as you take it. Results will first be noticeable about two hours after your first dose. You may not see the best results for several weeks, though. Keep taking your medicine even if the results seem minor at first.

How long does Xigduo stay in your system?

The metformin in Xigduo can stay in your body for around four days after your last dose.

What do I need to know about when to take Xigduo?

Take Xigduo according to your doctor’s instructions. Most people take Xigduo in the morning. You can take it with or without food according to your preferences. If you realize you missed a dose at least 12 hours before it’s type for your next pill, take the missing dose then. Don’t take two doses within 12 hours even if you skipped one before that.

Is there propane in Xigduo?

Xigduo contains dapagliflozin propanediol, also known as dapagliflozin propaned. This substance does contain an (S)-propane-1,2-diol molecule. However, this is a different chemical than the natural gas propane. Xigduo does not contain propane gas.

IMPORTANT NOTE: The information provided here is for educational purposes only and is not intended to serve as medical advice, diagnosis, or treatment recommendations. It should not be taken as an endorsement of any specific medication or treatment. Individual health conditions and responses to treatment can vary greatly; therefore, this information should not be seen as a guarantee of safety, suitability, or effectiveness for any particular individual. Always consult with a healthcare professional for personalized medical advice and before making any decisions regarding your health or treatment plans.

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