How Does Farxiga Work for Chronic Kidney Disease (CKD)?

Chronic kidney disease (CKD) affects about 37 million U.S. adults. The biggest causes of CKD are diabetes and high blood pressure, which damage the kidneys and, over time, negatively affect how they function.

Over the past several years, new CKD treatment options have come to market. One notable example is Farxiga (dapagliflozin), a medication originally approved to treat Type 2 diabetes.

After its initial approval, researchers discovered Farxiga can protect the kidneys of people who have diabetes and those who don’t. Based on these studies, the FDA expanded Farxiga’s approved uses in 2021 to include the treatment of CKD.

What is Farxiga?

Farxiga belongs to a group of medications called sodium-glucose transport protein 2 (SGLT2) inhibitors. It comes as 5 mg and 10 mg tablets that are taken by mouth once a day.

Farxiga has a few FDA-approved uses:

• To help lower blood glucose (sugar) levels in adults with Type 2 diabetes, in combination with a diabetes-friendly diet and regular exercise

• To slow the worsening of kidney function and lower the risk of hospitalization and death associated with CKD

• To lower the risk of hospitalization due to heart failure for people who have Type 2 diabetes and heart disease (or other heart-related risks)

• To lower the risk of complications, hospitalization, and death due to heart failure

Promotion disclosure

Manufacturer exclusive discount

Farxiga

Avg retail price

$695.50(Save 58.59%)

GoodRx discount

$288.00

See all discounts

How it works

Use GoodRx to find medications, pharmacies, and discounts.

GoodRx discounts can help you pay less for your prescription.

Bring your free coupon or savings card to the pharmacy.

How does Farxiga work?

Farxiga works by helping your kidneys get rid of extra glucose (sugar) and sodium in your blood. The excess then comes out in your urine.

Farxiga blocks a protein called SGLT2. This protein normally helps reabsorb glucose and sodium from your kidneys back into your bloodstream. By blocking SGLT2, Farxiga’s mechanism of action helps lower blood glucose levels and reduce the amount of stress on your kidneys.

How does Farxiga treat CKD?

It’s thought that Farxiga helps treat CKD by reducing the amount of stress on your kidneys. In a large clinical trial, Farxiga was found to help prevent kidney function from getting worse for people with CKD. The study also found it reduced the risk of heart problems linked to CKD and reduced the need for dialysis.

When you have CKD, your kidneys can’t filter out waste and extra fluid from your body as well as they should. This can cause a buildup of toxins and other harmful substances in your blood, which can damage your kidneys even further.

For example, when people have CKD, their kidneys have trouble properly balancing sodium, an electrolyte, in the blood. And too much sodium in the blood long term can raise the risk of serious complications, such as heart disease.

By blocking the SGLT2 protein, Farxiga helps lower the amount of glucose and sodium in your blood. This takes stress off the kidneys, helping them to work better. Some experts believe Farxiga and other SGLT2 inhibitors may also help prevent damage to the kidneys by lowering the pressure in the blood vessels in and around these organs, relieving even more strain and stress from them.

Is Farxiga safe for people with all stages of kidney disease?

No, Farxiga isn’t safe for people with all stages of kidney disease.

If you have end-stage kidney disease (ESKD) or are receiving dialysis, you should not take Farxiga. ESKD (also called kidney failure) occurs when a person’s eGFR (a marker of kidney function) is less than 15 mL/min. Farxiga hasn’t been well studied for safety or effectiveness in people who have this stage of kidney disease.

Is there an eGFR cut off for Farxiga?

The eGFR cutoff for starting treatment with Farxiga is 25 mL/min. This means your eGFR should be higher than this when you first begin taking it. There is concern that if your eGFR is too low, Farxiga could cause a sudden loss of fluid that could damage your kidney.

However, if you start taking Farxiga and your eGFR drops below 25 mL/min later on, you can keep taking it. In this instance, the benefits of continuing the medication outweigh the risks of potential kidney damage that may happen with a low eGFR.

What are some risks and side effects of Farxiga?

Many people tolerate Farxiga well overall. But there are some risks and side effects you should be aware of before taking it. Common side effects include:

• Yeast infections around the genitals (more common for women)

• Urinary tract infections (UTIs)

• Cold-like symptoms

• Urinating more often than usual

Since more frequent urination is a common side effect, it’s possible to become dehydrated as a result of taking Farxiga. This is more likely to happen if you also take diuretics (“water pills”).

Very rarely, Farxiga can cause a serious problem called ketoacidosis in people who have diabetes. This life-threatening situation is caused by dangerously low insulin levels and leads to a buildup of acid in the body. Ketoacidosis is more common in people with Type 1 diabetes, which is why you shouldn’t take Farxiga if you have this form of diabetes.

What are the dosages of Farxiga as a treatment for CKD?

Before you start taking Farxiga, your healthcare provider will check your kidney function. As described above, if your eGFR is too low, you may not be able to start taking it. This type of dose decision is known as renal dosing.

Farxiga’s renal dosing schedule is as follows:

• eGFR of 25 mL/min or greater: Take 10 mg by mouth once a day.

• eGFR of less than 25 mL/min: It’s not recommended to start Farxiga. But you can continue to take 10 mg once a day if you’re already taking it.

• End-stage kidney disease or receiving dialysis: Farxiga isn’t recommended.

Who shouldn’t take Farxiga?

There are some people who shouldn’t take Farxiga. Before you start taking it, make sure your healthcare provider knows if you:

• Are currently receiving dialysis

• Have Type 1 diabetes

• Are pregnant or breastfeeding

• Are allergic to any of the ingredients of Farxiga

• If you have polycystic kidney disease, a genetic disease that causes cysts to grow on the kidneys

How to save on Farxiga

There are ways to save on Farxiga, which is only available as a brand-name medication. GoodRx can help you navigate between copay savings cards and patient assistance programs to save money on your prescription:

• Save with a copay savings card. If you have commercial insurance, you may be eligible to pay as little as $0 a month for Farxiga using a savings card from the manufacturer.

• Save with patient assistance programs. If you’re uninsured or underinsured, you may be eligible for Farxiga’s patient assistance program, which offers the medication free of cost.

Why trust our experts?

Written by:

Timothy Aungst, PharmD

Timothy Aungst, PharmD, has worked in pharmacy practice for the past decade with different roles and responsibilities. He has served as an associate professor of pharmacy practice for almost a decade, a clinical pharmacist in outpatient cardiology management, and now in home healthcare.

Edited by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

Reviewed by:

Joshua Murdock, PharmD, BCBBS

Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.

Our editorial standards

Meet our experts