Problems stopping Dapagliflozin?

[Musiclover2025]

Hi, has anyone experienced extreme fatigue when stopping dapagliflozin?

My 57 year old, marathon running husband had a silent heart attack last March which wasn’t diagnosed until October following a CMRI by which time he has stage 2 heart failure. He was prescribed Entresto 25mg, Eplerenone 25mg, Clopidagrel 75mg, Aspirin 75mg and Ezetimibe 10mg.

By January he was feeling much more energised and able to walk (not run!) @ 5 miles a day with only the occasional duvet day. His cardiac nurse then started him on Dapagliflozin which made him feel more fatigued again so he stopped taking it after about 3 weeks. Naively we expected that he would return to his January energy levels but it’s nearly 4 weeks since he stopped taking it and he still feels dreadful.

Has anyone experienced anything similar? Might it pass or should we be worried that his heart failure has got worse?

Thanks in advance

[DWizza]

Had you discussed the stoppage with your medical team before stopping? Have you spoken with your pharmacist? They are usually very helpful , mine was very supportive of me changing statins and write to my GP and helped me get a quicker appointment. I would definitely be emailing /calling the consultants secretary and giving a full update and ask for a review of meds.

[Musiclover2025 in reply to DWizza]

Thanks for taking the time to reply. Yes he stopped after talking to his cardiac nurse who said it should be out of his system in 5 - 7 days. We all expected that he’d return to how he was in January as those meds seemed to be OK but it’s now 4 weeks and no real change. I wondered if anyone else had experienced a long tail coming off Dapa. His nurse has booked another ECHO but it’s not until the end of the month. I hate all the uncertainty! Good idea re a meds review too, thank you. Lots of people seem to have really positive results with Dapa so hopefully this is just a blip.

[Catlady56]

Worth getting back to his cardiac team as there must have been a reason for them starting him on Dapagliflozin? I was started on Empagliflozin (similar to Dapa) due to a kidney issue that was spotted in blood tests - but not mentioned to me at the time. I was getting very tired - but not due to the new med and after several months of being on Empagliflozin I was feeling slightly more energetic. As your husband only took the Dapa for three weeks - unless he had an allergic reaction to it, or it just didn't suit him - I would not have expected there to be much change in his condition as both Dapa and Empag take several weeks to "kick in" for heart failure rather than the more instant effect they have for diabetes. His overall heart failure position should probably be re-evaluated due to his change in energy levels just to see what is going on. HF can be a petulant beastie with good days and bad days. I am 69 and have had HF since I was 63 following a pulmonary embolism and on Empag since December 2023

[Musiclover2025 in reply to Catlady56]

It certainly is a petulant beastie! I think we’re only just realising that and it’s a particularly hard adjustment when you’re usually fit, well and consistent, as I’m sure many people here experience. The dapa was for his HF and supposed to make him feel more energised but it seems to have had the opposite effect. Thanks for the advice that it takes several weeks to kick in so it may not be the cause of this dip, I guess that what we’re worried about but the ECHO should shed some light. Thank you for taking the time to reply and share your experience.