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Medication · sglt2 inhibitor

Supplements and Dapagliflozin.

Every documented pair, every citation. Below: 4 documented pairs grouped by mechanism.

Dapagliflozin, sold under the brand names Forxiga, Farxiga, is a sodium-glucose cotransporter 2 (SGLT2) inhibitor: it lowers blood glucose by increasing urinary glucose excretion.

Dapagliflozin is an SGLT2 inhibitor. The full name is sodium glucose cotransporter 2. The class lowers blood glucose by increasing urinary glucose excretion. It also carries a separate cardiovascular and renal benefit shown in DAPA-HF, EMPA-REG, and the CKD trials, leading to expanded indication in heart failure and CKD even without diabetes. The supplement surface is small because SGLT2 inhibitors are minimally CYP metabolised. The clinically important issues are urinary tract and genital fungal infections (since glucose in the urine creates favourable conditions), volume depletion in heat or illness (the diuretic effect adds to dehydration risk), and the rare diabetic ketoacidosis presentation including the unusual "euglycaemic" form. Cranberry supplementation often comes up for UTI prevention. The Cochrane evidence supports modest efficacy in recurrent UTI in women. SGLT2 inhibitors tend to RAISE serum magnesium slightly, which is a class effect confirmed in meta-analyses (PMID 35582188, PMID 27628105) and the opposite of what is often assumed. They have even been studied in refractory hypomagnesaemia. Routine magnesium supplementation is not indicated simply because someone takes this drug.

Below are the 4 documented pairs we have explicitly assessed against Dapagliflozin in the Distil database: 4 amber. The pairs cluster around 2 mechanisms: Reduced glucose control and Additive glucose lowering. Every call is cited to either a clinical reference (PMID) or the British National Formulary. Anything not on this list is either still to be assessed or beyond our database scope. The checker beneath surfaces assessments by supplement, and the missing-item form at the bottom of the page routes any uncatalogued supplement into our next curation pass.

Documented interactions

Last reviewed 14 June 2026. Each interaction below lists the evidence its assessment drew on: some rest on studies of the exact pair, others on mechanism evidence, where a citation may support one part of the reasoning rather than the exact combination. The evidence line on each entry says which.

Reduced glucose control

Amber Does Melatonin interact with ?

Melatonin can blunt the body's insulin response and raise blood sugar after eating, which works against the blood-sugar control that dapagliflozin is helping with. The effect is strongest when melatonin and food are taken close together, so if you take dapagliflozin it is best to keep melatonin well away from your evening meal and to mention it to your prescriber if your blood sugar is being monitored.

Evidence: Based on an established mechanism, with no direct study of this exact combination yet.

PMID 35015083 · PMID 33220095 · BNF: Melatonin · BNF: Dapagliflozin

Reviewer-flagged: awaiting clinical-reviewer sign-off.

Additive glucose lowering

Amber Does Berberine interact with ?

Berberine lowers blood sugar, and dapagliflozin does too. It is worth monitoring your glucose when you start berberine and letting your GP know; the combination is usually well tolerated because dapagliflozin rarely causes low blood sugar on its own.

Evidence: Based on an established mechanism, with no direct study of this exact combination yet.

PMID 25498346 · PMID 36467075 · BNF: Dapagliflozin

Reviewer-flagged: awaiting clinical-reviewer sign-off.

Amber Does Garlic Extract interact with ?

Garlic supplements may lower blood sugar a little on their own. Dapagliflozin also lowers blood sugar but rarely pushes it too low on its own, so the combination is generally manageable. Monitor your glucose when you start a garlic supplement or change the dose.

Evidence: Limited human data, based on case reports and a known mechanism.

PMID 26693740 · PMID 38892625 · BNF: Dapagliflozin

Reviewer-flagged: awaiting clinical-reviewer sign-off.

Amber Does Pine Bark Extract interact with ?

Pine bark extract (pycnogenol) may lower blood sugar a little on its own. Dapagliflozin also lowers blood sugar but rarely pushes it too low on its own, so the combination is generally manageable. Monitor your glucose when you start pine bark extract or change the dose.

Evidence: Limited human data, based on case reports and a known mechanism.

PMID 19083426 · PMID 33610726 · PMID 32990945 · BNF: Dapagliflozin

Reviewer-flagged: awaiting clinical-reviewer sign-off.

What this list does not say. Pairs not flagged here are not implicitly safe. They are either not yet in our database, or fall outside our inclusion scope (food-supplement interactions only; for drug-drug interactions, the BNF is authoritative). Use the checker below to surface any supplement, and submit a missing item if you take something we have not catalogued.

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