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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What are the side effects of Farxiga (dapagliflozin)?
Common Side Effects
- Vaginal yeast infection in females (7-8%)
- Nose and throat infection (6-7%)
- Urinary tract infection (UTI, 4-6%)
Other 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
Serious Side Effects
- 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
Source: DailyMed
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The following 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
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.
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What are the 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 forms
Typical dosing 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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How much does Farxiga (dapagliflozin) cost?
What are alternatives to Farxiga (dapagliflozin)?
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)
Type 2 diabetes
Lowering the risk of major heart events (e.g., heart attack, stroke) in adults with Type 2 diabetes and heart disease
Lowering the risk of hospitalization for heart failure, death due to heart problems, and worsening of kidney problems in certain adults with Type 2 diabetes and diabetic kidney disease
What is the latest news about Farxiga (dapagliflozin)?
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References
Best studies we foundAmerican Diabetes Association. (n.d.). Diabetes & DKA (ketoacidosis).
American Diabetes Association. (n.d.). Signs, symptoms, and treatment for hypoglycemia (low blood glucose).
Anderson, S. L. (2014). Dapagliflozin efficacy and safety: A perspective review. Therapeutic Advances in Drug Safety.
AstraZeneca Pharmaceuticals LP. (2024). Farxiga- dapagliflozin tablet, film coated [package insert]. DailyMed.
Centers for Disease Control and Prevention. (2024). Diabetic ketoacidosis.
Centers for Disease Control and Prevention. (2024). About healthy weight and growth.
Centers for Disease Control and Prevention. (2024). Urinary tract infection basics.
Espinosa, J., et al. (2023). The risks of patient pill splitting: A case report and review. Cureus.
Nakagaito, M., et al. (2024). The impact of the withdrawal of SGLT2 inhibitors on clinical outcomes in patients with heart failure. Journal of Clinical Medicine.
Vallon, V., et al. (2021). Effects of SGLT2 inhibitors on kidney and cardiovascular function. Annual Review of Physiology.
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