Weight Loss and Side Effects of Forxiga and Olmetec

Rapid weight loss

Hello doctor, on March 30th, my physician prescribed me Forxiga 10mg for weight loss.
On April 5th, I returned for a check-up due to discomfort near my heart, and an ECG showed normal results, but my blood pressure was 155/101.
The doctor asked if I wanted to try a blood pressure medication (Olmetec 20mg).
On the day I took it (at 5 PM), I felt dizzy.
By Thursday morning (April 7th) at 11 AM, I started experiencing tingling in my head, followed by numbness and coldness in my hands and feet, along with dizziness.
A friend called an ambulance, and after examination at the hospital, it was determined to be a side effect.
On Friday (April 8th), during my follow-up visit, the doctor advised me to stop the medication, with the last dose taken on Thursday at 5 PM.
On Saturday (April 9th), I stopped taking Forxiga, but then I began to feel a heavy dizziness in the back of my head.
On the nights of April 10th and 11th, I had trouble sleeping and felt a pulsating sensation in the back of my head.
By April 12th, my sleep improved, but I still experienced heaviness and occasional dizziness in the back of my head in the mornings.
The doctor mentioned it could be due to mental stress, and sometimes my scalp feels tingly and tight.
Now, I also feel like I have a cold, and every night around 10 PM, I feel fatigued and dizzy.
As for my weight, I measured 118 kg on March 5th, and 109 kg on April 11th.
My friend suggested that the tingling in my hands and feet on April 7th might be due to low blood sugar.
Before the ambulance arrived, I ate a fruit bar, and my blood sugar was measured at 5.8 in the ambulance.
On April 24th, my weight was 105.7 kg.
I would like to ask the doctor what issues my body might be experiencing.
Recently, my food intake has been quite low because I am a bit afraid of dying, so I don't eat much, and I walk briskly for thirty minutes every day.
Thank you.

Alvin, 40~49 year old female. Ask Date: 2016/04/24

Dr. Huang Yaoxuan reply Internal Medicine

1.
Do you know what Forxiga 10mg is (what it does)? Are there any precautions to take when using this medication? It is a new type of antidiabetic medication (approved by the FDA in the United States), which lowers blood sugar levels and can also lead to weight loss.
Some physicians use it for weight management; you can refer to the medication's package insert for more information, available at "http://www.fda.gov.tw/MLMS/ShowFile.aspx?LicId=52026476&Seq=001&Type=9".
In simple terms, it causes the absorption of glucose to be excreted in urine (this is the drug's mechanism of action, which does not occur in healthy individuals), thereby lowering blood sugar levels.
It can also cause an "osmotic" diuretic effect, which may lead to dehydration and result in orthostatic hypotension and low blood pressure.
Additionally, the increased glucose in urine can raise the risk of infections (urinary tract infections).
The reduction in blood sugar may lead to decreased insulin secretion, potentially resulting in almost no insulin production, which can cause ketoacidosis.
In summary, this medication lowers blood sugar, blood pressure, and weight, increases the risk of urinary tract infections, and occasionally leads to ketoacidosis.
Therefore, it is important to monitor changes in blood pressure, blood sugar, and weight (ideally measuring blood pressure, blood sugar, and weight daily at home).
Based on your description, it may be suspected that your symptoms are related to hypoglycemia.
The half-life of this medication is approximately 13 hours, and typically, a drug can be considered eliminated from the body after about five half-lives (with some exceptions).
Thus, Forxiga would likely have diminished effects about three days after discontinuation (stopping on 4/9 and feeling better around 4/12).
2.
Recommendations: (1) I am not sure of your height (BMI?).
If you are overweight or obese (metabolic syndrome), it is advisable to consult an endocrinologist for follow-up.
(2) If possible, measure your blood pressure daily; if it is elevated (systolic/diastolic > 135/85 mmHg), seek follow-up with a cardiologist or nephrologist for management.
I suspect your blood pressure may be elevated.
(3) Weight loss is not just about intentionally "eating less" or relying on medication; a balanced diet, regular and normal routines, along with appropriate exercise, are essential for maintaining good health.

Reply Date: 2016/04/24

More Info

It sounds like you've been experiencing a challenging time with your health, particularly with the medications Forxiga (Dapagliflozin) and Olmetec (Olmesartan). Let's break down the potential effects of these medications and your symptoms to provide a clearer understanding.

Forxiga (Dapagliflozin) is primarily used to manage type 2 diabetes but has also been noted for its weight loss effects. It works by preventing glucose reabsorption in the kidneys, leading to increased glucose excretion in urine. This mechanism can lead to weight loss, but it can also cause side effects such as dehydration, urinary tract infections, and, in some cases, dizziness or lightheadedness, especially if you are not drinking enough fluids.

Olmetec (Olmesartan) is an antihypertensive medication used to treat high blood pressure. It can cause side effects like dizziness, especially when you first start taking it or if your dose is increased. The dizziness you experienced after taking Olmetec could be due to a drop in blood pressure, especially if you were already feeling unwell or dehydrated.

Your symptoms of head heaviness, tingling in your extremities, and feeling faint could be attributed to several factors:
1. Medication Side Effects: Both medications can cause dizziness and other neurological symptoms. The combination of these medications may have compounded these effects, especially if your blood pressure dropped significantly.

2. Dehydration: Forxiga can lead to increased urination, which may cause dehydration if fluid intake is not adequate. Dehydration can lead to symptoms like dizziness, headaches, and fatigue.

3. Blood Sugar Levels: Although your blood sugar reading was normal at 5.8 mmol/L, fluctuations in blood sugar levels can occur, especially if your food intake has decreased significantly. Low blood sugar can cause symptoms such as dizziness, confusion, and tingling in the extremities.

4. Anxiety and Stress: You mentioned feeling anxious and having a fear of death, which can exacerbate physical symptoms. Anxiety can lead to hyperventilation, which may cause tingling and numbness in the hands and feet.

5. Weight Loss: The weight loss you experienced (from 118 kg to 105.7 kg) in a short period could also contribute to your symptoms. Rapid weight loss can sometimes lead to electrolyte imbalances, which can affect how your body functions.

Given your symptoms and the medications you are taking, it is crucial to follow up with your healthcare provider. They may want to monitor your blood pressure and blood sugar levels more closely and assess whether any adjustments to your medications are necessary. Additionally, they might recommend strategies to manage anxiety and improve your overall well-being.

In the meantime, ensure you are staying hydrated, eating balanced meals, and engaging in light physical activity as tolerated. If you continue to experience concerning symptoms, such as persistent dizziness, tingling, or any new symptoms, seek medical attention promptly.

Remember, managing medications and health conditions can be complex, and it's essential to work closely with your healthcare provider to find the best approach for your individual needs.

Similar Q&A

Are There Side Effects of the Weight Loss Drug Naltrexone?

Is there any side effects of the weight loss medication known as Naltrexone? I am 152 cm tall, weigh 51 kg, and have a body fat percentage of 35. I love eating starchy foods; is it suitable for me?

Dr. Lin Shunliang reply Pharmacology
Hello Ms. Hsiao-Hui: The common side effects of Normetec include decreased appetite, constipation, dry mouth, and insomnia. Occasionally, there may be side effects such as palpitations and hypertension. Based on your information, it should be safe for you to take; however, please...

Essential Information on Weight Loss Medications and Health Risks

I visited Yang's Professional Medical Weight Loss Clinic and experienced symptoms of dizziness and hearing loss while using weight loss medication. I only have the medication package and no prescription label, which makes it difficult to check the medication information. Rec...

Dr. Huang Mingde reply Family Medicine
Thank you for your consultation. If you are using weight loss medications at a weight loss center without any available consultation channels and the medications have no warning labels, you should definitely stop using them. Generally, weight loss medications often include PPA or...

Understanding Foamy Urine: Causes and Concerns After Rapid Weight Loss

Hello Dr. Wu, I previously experienced rapid weight loss due to taking Forxiga, dropping from 116 kg to 109 kg between March 30 and April 11. I stopped the medication on April 8. I was concerned about potential kidney issues, so I had blood tests done on April 18. On April 25, I ...

Dr. Wu Jiyu reply Internal Medicine
Hello, 1. First, it is essential to understand the dosage of Forxiga you are using and whether you are combining it with other weight loss medications or treatments. A weight loss of nearly seven kilograms in less than two weeks is considered too rapid and may pose potential ha...

Understanding Side Effects of Doxycycline and Acne Medications

Due to acne, the doctor prescribed Doxycycline, Voren, and OUCEMIN, one of each. I have been taking them for five weeks, and it seems like I am gaining weight. Could you please tell me what side effects these medications might have? Thank you.

Dr. Hou Fangmin reply Pharmacology
Hello: I apologize for the late response regarding the medications you inquired about. Here are the details: Doxymycin: This is an antibiotic. Side effects include: 1. Occasionally elevated liver function tests such as S-GOT and S-GPT. 2. Rarely, thrombocytopenia, neutropenia, a...