Key takeaways:
Farxiga (dapagliflozin) is a diabetes medication that’s also FDA approved to treat chronic kidney disease (CKD). Because of how it works, Farxiga can provide kidney protection for people who have diabetes and those who don’t.
Farxiga’s mechanism of action — meaning, how the medication works — helps slow the progression of CKD. Farxiga removes extra sodium and glucose (sugar) from the blood. This takes stress off the kidneys, which can keep them working better longer.
Farxiga’s dose is based on a kidney function test called eGFR. The recommended eGFR cutoff for starting treatment with Farxiga is 25 mL/min or higher. This means you shouldn’t start taking Farxiga if your eGFR is lower than this.
There are several ways to save on Farxiga. GoodRx can help you access a 30-day supply of Farxiga at an exclusive cash price of $288. A manufacturer savings card and patient assistance program are also available.
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Chronic kidney disease (CKD) affects about 1 in 7 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.
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What is Farxiga?
Farxiga belongs to a group of medications called sodium-glucose cotransporter-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 (blood sugar) levels for people ages 10 and older 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 for adults
To lower the risk of hospitalization due to heart failure for adults 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 for adults
How does Farxiga work?
Farxiga works by helping your kidneys get rid of extra sugar and sodium in your blood. The excess then comes out in your urine.
Farxiga blocks a protein called SGLT2. This protein normally helps your kidneys reabsorb sugar and sodium back into your bloodstream. By blocking SGLT2, Farxiga’s mechanism of action helps lower blood sugar levels and take stress off 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 sugar 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.
What to expect: Learn more about notable Farxiga (dapagliflozin) side effects — from nausea to yeast infections — and how to manage them.
Medications to avoid: Pharmacists discuss how to prevent and manage Farxiga interactions.
Does Farxiga cause weight loss? Get the answer to this and other frequently asked questions about Farxiga.
Is Farxiga safe for people with all stages of kidney disease?
How safe Farxiga is for those living with kidney disease depends on why you’re taking the medication.
If you’re prescribed Farxiga for heart or kidney protection, you may not be able to start the medication if your kidney function is too low. But if your kidney function dropped after you started taking it, it’s generally OK to continue (more details on this next).
If you have diabetes and you’re only taking Farxiga to help lower blood sugar, you shouldn’t take it if you have stage 3b, stage 4, or stage 5 CKD. Your kidney specialist can tell you what stage of kidney disease you have. They should also monitor your eGFR (a marker of kidney function) before and during treatment with Farxiga. They’ll let you know if it’s safe for you to keep taking it.
Is there an eGFR cut off for Farxiga?
The eGFR cutoff for starting treatment with Farxiga for heart or kidney protection 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.
The eGFR cutoff for Farxiga when used only for diabetes is 45 mL/min. Farxiga doesn’t lower blood sugar as well when your eGFR drops below this level.
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)
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 prescriber should check your kidney function. As described above, if your eGFR is too low, you may not be able to start taking it.
Farxiga dosages for CKD depend on what your eGFR is before you start taking it:
eGFR of 25 mL/min or greater: Take 10 mg by mouth once a day in the morning.
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.
Who shouldn’t take Farxiga?
There are some people who shouldn’t take Farxiga. Before you start taking it, make sure your prescriber knows if you:
Have Type 1 diabetes
Are pregnant or breastfeeding
Are allergic to any of the active or inactive 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 available as a brand-name medication and authorized generic. GoodRx can help you navigate between GoodRx coupons, copay savings cards, and patient assistance programs to save money on your prescription.
Save with GoodRx. Anyone with a valid prescription, regardless of insurance status, can use GoodRx to purchase a 30-day supply of Farxiga at an exclusive cash price of $288. GoodRx can also help you save over 45% off the retail cost of the generic version.
Save with a copay savings card. If you have commercial insurance, you may be eligible to pay as little as $0 per month for Farxiga by 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 charge.
Frequently asked questions
If you’re taking Farxiga for Type 2 diabetes, you should notice a reduction in your hemoglobin A1C (your average blood sugar over the past 3 months) within 3 to 6 months. For CKD, Farxiga’s benefits are noticeable within about 1 year of treatment. And for heart failure, Farxiga should be fully working about 2 to 4 weeks after starting it.
For some people, Farxiga may cause modest weight loss. Studies found that people lost an average of 4 lbs to 6 lbs while taking SGLT2 inhibitors such as Farxiga. And when paired with metformin, a common diabetes medication, people lost about 10 lbs. But keep in mind not everyone loses weight while taking Farxiga.
Discuss your weight-loss goals with your prescriber. There are some medications, such as Ozempic (semaglutide), that are approved for some of the same health conditions as Farxiga and typically lead to more significant weight loss.
If you’re taking Farxiga for Type 2 diabetes, you should notice a reduction in your hemoglobin A1C (your average blood sugar over the past 3 months) within 3 to 6 months. For CKD, Farxiga’s benefits are noticeable within about 1 year of treatment. And for heart failure, Farxiga should be fully working about 2 to 4 weeks after starting it.
For some people, Farxiga may cause modest weight loss. Studies found that people lost an average of 4 lbs to 6 lbs while taking SGLT2 inhibitors such as Farxiga. And when paired with metformin, a common diabetes medication, people lost about 10 lbs. But keep in mind not everyone loses weight while taking Farxiga.
Discuss your weight-loss goals with your prescriber. There are some medications, such as Ozempic (semaglutide), that are approved for some of the same health conditions as Farxiga and typically lead to more significant weight loss.
The bottom line
Farxiga (dapagliflozin) is an oral diabetes medication that can also treat chronic kidney disease (CKD) in adults. It can help prevent kidney function from worsening and lower the risk of heart-related complications.
Farxiga primarily works by removing extra glucose (sugar) and sodium from the blood. But it may also lower the pressure in the blood vessels in and around the kidneys. These actions help take stress off the kidneys.
Discuss the risks and benefits of Farxiga as a treatment for CKD with your healthcare team to learn more.
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References
Cherney, D. Z. I., et al. (2013). Renal hemodynamic effect of sodium-glucose cotransporter 2 inhibition in patients with type 1 diabetes mellitus. Circulation.
Chertow, G. M., et al. (2021). Effects of dapagliflozin in stage 4 chronic kidney disease. Journal of the American Society of Nephrology.
Heerspink, H. J. L., et al. (2020). Dapagliflozin in patients with chronic kidney disease. The New England Journal of Medicine.
National Kidney Foundation. (n.d.). Stages of chronic kidney disease (CKD).
National Kidney Foundation. (2022). Estimated glomerular filtration rate (eGFR).
National Kidney Foundation. (2024). Kidney disease: Fact sheet.
Padda, I. S., et al. (2025). Sodium-glucose transport protein 2 (SGLT2) inhibitors. StatPearls.
Perkovic, V., et al. (2019). Canagliflozin and renal outcomes in type 2 diabetes and nephropathy. The New England Journal of Medicine.
Prasco Laboratories. (2024). Dapagliflozin- dapagliflozin tablet, film coated [package insert].
Wilding, J., et al. (2016). Glycated hemoglobin, body weight and blood pressure in type 2 diabetes patients initiating dapagliflozin treatment in primary care: A retrospective study. Diabetes Therapy.
