Farxiga
Farxiga, the brand name for dapagliflozin, is used together with a nutritious diet and exercise plan to lower blood sugar levels in people 10 years and older with Type 2 diabetes. It can also help lower the risk of serious complications, hospitalization, and death in certain adults with heart failure or chronic kidney disease (CKD). Farxiga (dapagliflozin) belongs to the drug class called sodium-glucose cotransporter 2 (SGLT2) inhibitors. It's taken by mouth once a day. Some side effects include yeast infections, urinating more often, and weight loss.
What is Farxiga (dapagliflozin)?
What is Farxiga (dapagliflozin) used for?
- Type 2 diabetes (in addition to diet and exercise) in people age 10 and over
- Lowering the risk of hospitalization for heart failure in adults with Type 2 diabetes and heart disease
- Lowering the risk of hospitalization and death due to heart problems in people with heart failure
- Lowering the risk of worsening kidney problems, hospitalization for heart failure, and death due to heart problems in adults with chronic kidney disease (CKD)
How Farxiga (dapagliflozin) works
Farxiga (dapagliflozin) is a sodium-glucose cotransporter 2 (SGLT2) inhibitor. It blocks the SGLT2 protein in the kidneys. This prevents sugar and sodium (salt) from absorbing back into your body in the kidneys.
- For Type 2 diabetes: Instead of reabsorbing sugar back into the body, the sugar goes into your urine. This helps get rid of extra sugar in your blood and lower your blood sugar levels.
- For heart failure: By preventing your body from reabsorbing sodium, the heart fills with blood easier and pumps blood more easily throughout the body. This lessens stress on the heart.
- For CKD: The way that the medication works helps improve blood flow through the kidneys and lessens stress on the kidneys to help slow the worsening of CKD.
Drug facts
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Side effects of Farxiga (dapagliflozin)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Vaginal yeast infection in females (7-8%)
- Nose and throat infection (6-7%)
- Urinary tract infection (UTI, 4-6%)
Less Common Side Effects
- Back pain
- Pain in arms, legs, hands, or feet
- Urinating more
- Discomfort when urinating
- Genital yeast infection in males
- Nausea
- Constipation
- Flu-like symptoms
- Higher cholesterol levels
Farxiga (dapagliflozin) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- High ketone levels in the blood (ketoacidosis): fruity breath, dry mouth, thirsty, trouble breathing, tiredness, nausea, vomiting, stomach pain
- Severe allergic reaction: swelling in the face, throat, tongue, or mouth; rash; trouble breathing
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The following Farxiga (dapagliflozin) side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Dehydration—increased thirst, dry mouth, feeling faint or lightheaded, headache, dark yellow or brown urine
- Diabetic ketoacidosis (DKA)—increased thirst or amount of urine, dry mouth, fatigue, fruity odor to breath, trouble breathing, stomach pain, nausea, vomiting
- Genital yeast infection—redness, swelling, pain, or itchiness, odor, thick or lumpy discharge
- New pain or tenderness, change in skin color, sores or ulcers, infection of the leg or foot
- Infection or redness, swelling, tenderness, or pain in the genitals, or area from the genitals to the back of the rectum
- Urinary tract infection (UTI)—burning when passing urine, passing frequent small amounts of urine, bloody or cloudy urine, pain in the lower back or sides
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Pros and cons of Farxiga (dapagliflozin)
Pros
- Taken only once daily
- Low risk of causing low blood sugar when taken by itself
- Can take with other diabetes medications
Cons
- Raises risk of yeast infections and urinary tract infections (UTIs)
- Not available as a liquid
- Not recommended during the second and third trimesters of pregnancy
Pharmacist tips for Farxiga (dapagliflozin)
- Take Farxiga (dapagliflozin) by mouth every day with or without food.
- Be sure to drink plenty of fluids because Farxiga (dapagliflozin) can cause dehydration or lower your blood pressure. Let your prescriber know if you feel dizzy.
- Farxiga (dapagliflozin) raises your risk for genital infections, such as yeast infections and UTIs. Contact your care team if you have a fever or pain, swelling, redness, itching, odor, or tenderness of your genitals. Also call your care team if you notice blood in your urine, have pain when you urinate, or feel the urge to urinate more often. These can be signs of a genital infection that should get treated.
- Check your ketone levels and get medical help right away if you notice that you have fruity breath, trouble breathing, nausea, or vomiting or if you start to feel unwell. These are signs of a life-threatening condition called ketoacidosis (high ketone levels in your body).
- Check your blood sugar if you feel confused, shaky, or have a fast heartbeat. It's important to be aware of these signs of low blood sugar (less than 70 mg/dL), know how to get it back up fast, and know when you need to call 911. You might be at risk for having low blood sugar if you're taking other diabetes medications with Farxiga (dapagliflozin) or if you've recently changed your diet, exercise, and drinking habits.
- Tell your prescriber if you plan to have major surgery where you won't be able to eat for a while. Stress on the body, like with surgery, and eating less than usual can raise your risk for serious ketoacidosis. To keep you safe, your prescriber might tell you to stop taking Farxiga (dapagliflozin) for a few days before your surgery and then restart it again when you've recovered enough and are eating normally again.
- Continue to exercise regularly, eat a balanced and nutritious diet, and take your other prescribed medications along with Farxiga (dapagliflozin). Speak with your care team for more tips about how to manage your condition the best you can.
- Farxiga (dapagliflozin) isn't recommended if you're in your second or third trimester of pregnancy or if you're breastfeeding. There's a potential risk of harm to your baby's kidneys. Speak to your prescriber about the risks and benefits of taking Farxiga (dapagliflozin) and about other treatment options.
Common questions about Farxiga (dapagliflozin)
Yes. Farxiga (dapagliflozin) isn't FDA approved for weight loss, but this could be a side effect from the medication. Weight loss might happen because the medication removes extra sugar from your body that could otherwise be turned into fat as stored energy. Some of the weight loss could also be due to losing water weight, since it causes you to urinate more. In studies, people lost an average of around 6 to 7 pounds over 6 months while they were taking Farxiga (dapagliflozin) together with metformin. Keep in mind that how Farxiga (dapagliflozin) affects your weight could be influenced by many factors, such as any other medications you're taking and your lifestyle habits.
Farxiga (dapagliflozin) and Jardiance (empagliflozin) are once-daily oral medications that belong to the same drug class and are used to treat the same conditions. But Farxiga (dapagliflozin) is available in both brand-name and generic versions, whereas Jardiance (empagliflozin) is only available as a brand name. The dosage recommendations for Jardiance (empagliflozin) are also a little different. Follow up with your prescriber to learn more about comparing the two medications.
What happens after you stop taking Farxiga (dapagliflozin) can depend on the reason why you're taking the medication. If you have diabetes and you stop taking Farxiga (dapagliflozin), your diabetes could get worse because your blood sugar could go back up. And if you have heart failure, stopping the medication could put you at risk for hospitalization. Stopping Farxiga (dapagliflozin) can also worsen your kidney health if you have CKD. Don't stop taking Farxiga (dapagliflozin) without speaking to your prescriber first.
Farxiga (dapagliflozin) interacts with some medications, so it's important to review a list of your current medications with your care team. A few examples include taking Farxiga (dapagliflozin) with insulin or some other diabetes medications like glipizide. This drug interaction can put you at risk for having low blood sugar. Taking Farxiga (dapagliflozin) with a diuretic (water pill) can also put you at risk for having a low amount of fluids in your body. And Farxiga (dapagliflozin) can potentially make lithium (Lithobid), a medication for bipolar disorder, work less well. Your pharmacist can help identify interactions with Farxiga (dapagliflozin) and offer guidance on how to manage them.
The manufacturer of Farxiga (dapagliflozin) doesn't suggest a particular time to take the medication. But you might want to consider taking it in the morning. This is because the medication can make you have to urinate more often, which can mean having to get up more at night if you take it later during the day. Whichever time you choose, it might be helpful to pick a time that you can be consistent with. This helps you remember to take Farxiga (dapagliflozin) every day.
It's not recommended to cut Farxiga (dapagliflozin) tablets. The manufacturer doesn't give directions about whether it's okay to cut the tablets in half. But the tablets aren't scored (indented line down the middle), so it would be difficult to split them properly. Talk to your prescriber if you're having trouble swallowing the Farxiga (dapagliflozin) tablets whole.
Diarrhea wasn't reported as a side effect of Farxiga (dapagliflozin) during clinical studies. Be sure to rehydrate with fluids if you have diarrhea. Let your prescriber know if you have bothersome or long-lasting diarrhea while you're taking Farxiga (dapagliflozin). Your prescriber will want to make sure that you don't lose too much fluid from your body. Having too little fluids in your body could cause dizziness, dehydration, and possible kidney damage.
Yes, you can take Farxiga (dapagliflozin) and metformin together. These medications work differently to lower blood sugar in people with Type 2 diabetes. Farxiga (dapagliflozin) works in the kidneys to get rid of extra blood sugar from your body through your urine. On the other hand, metformin works in the liver to lower the amount of sugar that's made and released into your blood. Metformin also lessens the amount of sugar your body absorbs from your diet and helps your body use its natural insulin better. Taking Farxiga (dapagliflozin) and metformin together can help lower your blood sugar more than taking either medication alone. Ask your prescriber if this combination is right for you.
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Risks and warnings for Farxiga (dapagliflozin)
Farxiga (dapagliflozin) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Ketoacidosis
- Risk factors: Diabetes | Sick with a fever | Lowered calorie intake | Ketogenic diet | Dehydration | Pancreatic problems | Alcohol use | Insulin dose reduction or missed insulin doses | Surgery
Farxiga (dapagliflozin) can cause a serious, life-threatening condition called ketoacidosis in people with diabetes. This condition happens when your body makes too many acids called ketones, which makes your blood acidic and can be dangerous. Your risk is higher if you get sick, eat less calories than usual, or have recently had your insulin dose lowered.
Early signs of ketoacidosis include feeling thirstier, having dry mouth, and urinating more often. If you also have fruity breath, stomach pain, nausea, vomiting, or feel very tired, check your ketone levels and seek medical attention right away.
Low fluids in the body (leading to low blood pressure or dehydration)
- Risk factors: 65 years or older | History of kidney problems | Taking loop diuretics (water pills)
Farxiga (dapagliflozin) can cause the amount of fluids in the body to drop. As a result, some people might get dehydrated, and others might have very low blood pressure. Low fluid levels in the body can also affect blood flow to the kidneys and cause kidney injury.
Your risk of having low fluid levels and its complications might be higher if you're 65 years or older, you have a history of kidney problems, or you take certain water pills (e.g., furosemide (Lasix)). To make sure Farxiga (dapagliflozin) is safe for you to take, your prescriber will check your kidney health through blood tests before you start treatment and regularly while you're taking the medication.
Let your care team know if you feel dizzy while you're taking Farxiga (dapagliflozin), since this can be a sign of dehydration or low blood pressure. Also contact your prescriber if you're urinating less than usual, which could mean you're dehydrated as well.
Genital and urinary tract infections
- Risk factors: History of genital yeast infections or urinary tract infections (UTIs)
Farxiga (dapagliflozin) raises your risk of genital infections, including yeast infections and urinary tract infections (UTIs). In some cases, these infections can become serious and might require hospitalization. Contact your prescriber if you have a fever; pain with urination; tenderness, redness, or itching around your genitals; or smelly discharge from your genitals. These can be signs of a genital or urinary tract infection. You might need to take an antibiotic or antifungal to treat an infection.
Low blood sugar (hypoglycemia) when used with other diabetes medications
- Risk factors: Changes in diet and exercise | Drinking alcohol | Taking other diabetes medications
Taking Farxiga (dapagliflozin) together with other diabetes medications, like insulin or glipizide, can put you at risk for dangerously low blood sugar (hypoglycemia). Very low blood sugar can be life-threatening.
Be sure you can recognize symptoms of low blood sugar, including feeling shaky; feeling nervous or confused; sweating; and having fast heartbeat, body chills, low energy, and hunger. Check your blood sugar if you have these symptoms and treat any low blood sugar right away. Talk to your prescriber or pharmacist about your risk for low blood sugar.
Farxiga (dapagliflozin) dosage
Tablet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 5mg | 30 tablets | $288.00 | $9.60 |
| 10mg | 30 tablets | $288.00 | $9.60 |
Typical dosage for Farxiga (dapagliflozin)
- Adults and children 10 years and older with Type 2 diabetes: The typical starting dose is 5 mg by mouth once daily. Your prescriber might raise your dose to 10 mg once daily if you need additional control of your blood sugar levels.
- Adults with heart failure or CKD: The typical dose is 10 mg by mouth once daily.
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