What is Farxiga used for?
Farxiga (dapagliflozin) is a prescription sodium-glucose cotransporter 2 (SGLT2) inhibitor that is manufactured by AstraZeneca. It is approved by the U.S. Food and Drug Administration (FDA):
- In combination with diet and exercise to improve blood glucose control in adults with T2DM.
- To reduce the risk of hospitalization for heart failure in adults with T2DM and either established cardiovascular disease or multiple cardiovascular risk factors.
- To reduce the risk of cardiovascular death (heart attack, stroke) and hospitalization for heart failure in adults with heart failure with reduced ejection fraction (NYHA class II-IV).
- To reduce the risk of sustained estimated glomerular filtration rate (eGFR) decline, end-stage kidney disease, cardiovascular death, and hospitalization for heart failure in adults with chronic kidney disease (CKD) at risk of progression.
How does Farxiga work?
Farxiga is an inhibitor of the sodium-glucose co-transporter-2 (SGLT2) found in your kidneys. By inhibiting SGLT2, Farxiga reduces renal reabsorption of filtered glucose back into your bloodstream and thereby promotes urinary glucose excretion. Farxiga also lowers sodium reabsorption and both preload and afterload of your heart, which makes it easier for it to pump blood throughout your body.
What are the most commonly prescribed doses of Farxiga?
How to take Farxiga
- Take Farxiga exactly as your healthcare provider prescribes it to you. Do not change your Farxiga dose without talking to your healthcare provider.
- Read the Full Prescribing Information and Medication Guide provided by your pharmacist before you start taking Farxiga and with each refill.
- Farxiga is taken by mouth once a day, with or without food.
- Stick to your prescribed diet and exercise program while taking Farxiga.
- Farxiga can cause your urine to test positive for glucose.
- You may receive certain blood tests to measure your blood sugar and HbA1c levels before you start Farxiga and during your treatment.
- If you miss a dose, take it immediately. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra doses of Farxiga to make up for a missed dose.
- If you take too much Farxiga, call your healthcare provider or go to the nearest emergency room right away.
Farxiga is contraindicated if you:
- Have a history of serious hypersensitivity reaction to Farxiga or any of its inactive ingredients.
- Are a dialysis patient.
- Watch for signs and symptoms of metabolic acidosis or ketoacidosis (nausea, vomiting, abdominal pain, or trouble breathing). Farxiga should be discontinued and ketoacidosis treatment started as soon as it’s diagnosed.
- Farxiga can increase your risk of dehydration and volume depletion. Your doctor should check your kidney function before starting Farxiga if you have kidney disease, are elderly, or are on loop diuretics. Notify your doctor of any signs and symptoms of kidney problems or volume depletion during Farxiga therapy (decreased urination, dry mouth, excessive thirst, increased heart rate, dizziness, fainting).
- Monitor for signs and symptoms of urosepsis and pyelonephritis (urinary tract infections) and treat if indicated.
- The dose of the insulin secretagogue or insulin may need to be reduced when you start Farxiga to reduce your risk of hypoglycemia (low blood sugar).
- Farxiga increases the risk of a life-threatening genital infection (Fournier’s Gangrene) in both males and females. You should be treated immediately if you have symptoms such as pain, tenderness, redness, and swelling, in the genital or perineal area along with fever and tiredness.
- You should be monitored and treated for genital mycotic infections (yeast infections) while taking Farxiga.
- Before you start Farxiga, tell your doctor if you have pancreatitis (swelling of the pancreas) or have had surgery on your pancreas.
- Serious allergic reactions have occurred while taking Farxiga. You should discontinue Farxiga immediately and seek medical advice if an allergic reaction occurs.
- Based on animal studies showing adverse effects on the kidney, Farxiga is not recommended during the second or third trimesters of pregnancy.
- It is not known if Farxiga is found in human breast milk or how it would affect the breastfed infant if it is present. However, because of the possibility of serious adverse events in breastfed infants, the use of Farxiga is not recommended while breastfeeding.
Farxiga drug interactions
Taking Farxiga with other medications can interact and change how those work. It may also increase the frequency and severity of certain side effects. Make sure your doctor is aware of all the medications you take, including prescription drugs, over-the-counter medications, vitamins, and herbal supplements. Some major drug interactions of Farxiga include:
- Diuretics – Causes increased urine frequency and volume, which can lead to volume depletion or hypotension (low blood pressure).
- Insulin secretagogues (sulfonylurea) or insulin – Increases your risk of hypoglycemia (low blood sugar).
Side effects of Farxiga
Some common side effects of Farxiga may include:
- Urinary tract infections (UTI)
- Female genital mycotic infections (yeast infection)
- Common cold symptoms
- Back pain
- Increased urination
- Weight loss
Farxiga can cause serious side effects, including:
- Ketoacidosis (increased ketones in your blood or urine)
- Volume depletion
- Fournier’s Gangrene
- Increased risk of hypoglycemia when used along with insulin secretagogues or insulin
- Serious allergic reactions
You can report any side effects you experience to the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
If Farxiga is not right for you, there are several other type 2 diabetes medications that your healthcare professional can prescribe. Some alternative FDA-approved treatment options include:
Is Farxiga better than Glucophage (metformin)?
Farxiga belongs to a class of medications called SGLT2 inhibitors. It reduces the reabsorption of glucose back into your bloodstream and increases glucose excretion through your urine.
Metformin is classified as a biguanide. It works by making it easier for your cells to take in and use sugar. It also reduces the amount of sugar you absorb from food and decreases the production of sugar in your liver. Metformin is considered the first choice of treatment for patients with type 2 diabetes. Farxiga is usually used as add-on therapy or if you have failed other diabetes medications. Farxiga may also protect against kidney and heart disease complications.
There are no studies that directly compare their effectiveness. However, metformin has been shown to decrease HbA1c levels by as much as 2% while Farxiga lowers it by 1%.
Price is a big difference between Farxiga and metformin. Metformin is relatively inexpensive and costs around $8 for a month’s supply of #60, 500mg tablets. Farxiga is much more expensive, costing around $550 for a month’s supply of #30, 10mg tablets.
Does Farxiga work in heart failure patients if they don’t have type 2 diabetes?
Yes, clinical trials have shown that Farxiga works for patients with heart failure, with or without type 2 diabetes.
How does Farxiga help with heart failure?
Farxiga helps with heart failure by reducing sodium reabsorption and increasing sodium excretion. This reduces the load on your heart, making it easier to circulate blood throughout your body.
Will I lose weight with Farxiga?
Farxiga is not indicated for weight loss but you may lose some weight while taking it. In clinical studies, patients taking Farxiga lost up to 7 pounds (3kg) after 6 months of treatment.
How long does Farxiga stay in the system?
Based on a half-life of almost 13 hours following a single oral dose of Farxiga 10mg, it will remain in the bloodstream for a little over 2.5 days.
How do I store Farxiga?
Farxiga should be stored at room temperature between 68°F to 77°F (20°C to 25°C) away from light and moisture.
How long does it take for Farxiga to start working?
Your blood glucose levels should start to decline within the first week of starting Farxiga.
Will I have labs monitored while taking Farxiga?
Your doctor may run blood and urine tests to check your liver and kidney function, blood sugar level, hemoglobin A1c level, cholesterol level, and for the presence of ketones before you start Farxiga and while you are taking it.
Is there a generic for Farxiga?
Currently, there is not a generic for Farxiga available on the market. However, you can still save on brand-name drugs like Farxiga with the help of NiceRx.