Doctors prescribe dapagliflozin (Farxiga) to treat three conditions: type 2 diabetes, heart failure, and chronic kidney disease. Here are answers to some common questions about dapagliflozin.
What Is Dapagliflozin (Farxiga)?
Dapagliflozin (Farxiga) is an oral (taken by mouth) drug used to lower blood sugar in people who have type 2 diabetes.
It’s also prescribed for some people with heart failure, which is when your heart is unable to pump enough blood through your body. It can lower your risk for being hospitalized for or dying from this condition.
Dapagliflozin is also used to help keep chronic, or long-lasting, kidney disease from getting worse, whether or not you have diabetes. In one large study of people with condition, dapagliflozin:
- Reduced the risk of kidney failure, cardiovascular deaths, and being hospitalized for heart failure
- Helped people live longer
It comes as a pill you take daily and is available in 5- and 10-milligram doses.
What Is the Brand Name for Dapagliflozin (Farxiga)?
Dapagfliflozin is sold under the name Farxiga in the U.S. In Canada, it’s called Forxiga. It came onto the market in 2014. No generic version is available.
Some drugs combine dapagliflozin with another diabetes medication in a single pill. Sometimes the combination of two diabetes drugs works better than one.
These combination drugs have different brand names:
- Dapagliflozin and metformin (Xigduo)
- Dapagliflozin and saxagliptin (Qtern)
- Dapagliflozin, saxagliptin, and metformin (Qternmet XR)
How Does Dapagliflozin (Farxiga) Work?
Dapagliflozin belongs to a class of medications called sodium-glucose cotransporter 2 (SGLT2) inhibitors. Other SGLT2 inhibitors are:
- Ertugliflozin (Steglatro)
- Canagliflozin (Invokana)
- Empagliflozin (Jardiance)
SGLT2 inhibitors block the action of a protein in your kidneys known as SGLT2. This keeps your kidneys from reabsorbing glucose and sodium from your bloodstream. The extra sugar leaves your body in your urine. Lower blood sugar is the result.
Good blood sugar control not only helps you feel better, but helps prevent serious complications of type 2 diabetes such as heart disease, kidney disease, and vision problems.
SGLT2 inhibitors were first approved for type 2 diabetes, but studies found that they also worked to treat chronic kidney disease and heart failure.
Researchers are still studying exactly how they do this. But diabetes, heart disease, and kidney disease are all related. High blood sugar can harm your kidneys. And when your kidneys don’t work as they should, your heart must work harder to pump blood to them.
Who Should Take Dapagliflozin (Farxiga)?
Dapagliflozin may be a good option if you have type 2 diabetes but can’t take metformin, the treatment of choice for many people with diabetes. You may not respond well to metformin if you’re over 80 or have kidney or liver problems.
Your doctor might also prescribe dapagliflozin if other medicines haven’t helped to lower your blood sugar.
This drug may not be right for people who have:
- Low blood pressure
- Ever had liver disease
- Frequent urinary tract infections
- Sugar or ketones (chemicals from your liver) in their urine
- Surgery coming up
It’s not approved to treat type 1 diabetes. And we don’t know if it’s safe when you’re pregnant or breastfeeding. Tell your doctor if you’re pregnant, nursing, or if you plan to be.
You shouldn’t take this drug if you:
- Have an allergic reaction to any of its ingredients
- Have serious kidney damage or end-stage kidney disease
- Are on dialysis
How Should I Take Dapagliflozin (Farxiga)?
Swallow the tablet once a day with a glass of water. It doesn’t matter when you take it, but try to take it at about the same time every day. You don’t have to take it with food.
If you miss a dose, take your pill as soon as you remember. But if it’s almost time for the next dose, don’t worry about taking the missed dose. Just take your next one as scheduled. Don’t take two doses back to back.
Ask your doctor if you take dapagliflozin along with another medication, like metformin (in that case, you should take it when you eat or just after).
When you take dapagliflozin, it’s important to follow a healthy diet and get regular exercise as your doctor recommends.
How Long Does Dapagliflozin (Farxiga) Take to Work?
Dapagliflozin begins working to reduce blood sugar in about 2 hours. Sometimes, it takes about a week to see the full effects. You may not feel any difference, but that doesn’t mean it’s not working.
It can take a month or two to see improvements if you take it for heart failure.
Dapagliflozin doesn’t stay in your body long. If you take a 10-milligram dose, half of it will no longer be in your blood about 13 hours later.
Does Dapagliflozin (Farxiga) Cause Weight Loss?
A clinical study found people lost about 7 pounds when they took dapagliflozin with metformin XR. Those taking dapagliflozin alone lost about 6 pounds. On metformin XR (without dapagliflozin), participants lost about 3 pounds.
You lose weight because, along with the glucose, you pee out the calories that glucose contains. Peeing more makes you lose water weight, too. Also, when your blood sugar and insulin levels go down, this can raise levels of glucagon, a hormone linked to weight loss.
Research indicates that dapagliflozin and other SGLT2 inhibitors could help people lose weight even if they don’t have diabetes. One analysis found these drugs helped adults with obesity but without diabetes lose about 3 pounds. But the FDA hasn’t approved dapagliflozin to treat obesity.
Does Dapagliflozin (Farxiga) Improve Ejection Fraction?
Ejection fraction is a measure of how well your heart pumps blood to the rest of your body. When you have heart failure, your doctor will do tests to measure your ejection fraction. The higher the number, the better your heart is working. In healthy hearts, ejection fraction is 50% to 70%.
Researchers looked at how well dapagliflozin worked in a study involving more than 6,200 people with heart failure and an ejection fraction of more than 40%. One group took 10 milligrams of dapagliflozin a day. Another group took a placebo, a pill that didn’t contain any medicine.
Heart failure got worse in 11.8% of the people on dapagliflozin but 14.5% in the others. People taking dapagliflozin were also less likely to die from heart failure during the study. The results were similar in those with an ejection fraction of 60% or more.
What Are the Side Effects of Dapagliflozin (Farxiga)?
The most common side effects of this drug include:
- Stuffy nose
- Sore throat
- Urinary tract infections
- Peeing more often or in larger amounts than usual
You might also have:
- Dizziness
- Back pain
- Skin rash
- Thrush, a type of yeast infection
- Low blood pressure
Dapagliflozin can also cause other side effects, some of which could be serious. They include:
Dehydration. One potentially serious side effect is dehydration, which is when your body gets too low on fluid. You’re at a higher risk for this if you:
- Take medicine to lower your blood pressure
- Are over 65
- Are on a low-salt diet
- Have kidney problems
Ask your doctor how much water and other fluids you should be drinking each day.
Vaginal or penile yeast infections. Symptoms of a yeast infection in the vagina include:
- Odor
- Discharge
- Itching
Symptoms of a yeast infection in the penis may include
- Itching
- Redness
- Swelling
- Discharge
- Skin pain in the area around your penis
Low blood sugar. You may be more prone to low blood sugar, or hypoglycemia, if you take dapagliflozin. Symptoms of hypoglycemia include:
- Feeling dizzy
- Shaking
- Sweating
- Fast heartbeat
Your risk for hypoglycemia goes up if you take other diabetes drugs like sulfonylurea or insulin. You can carry fruit juice or candy with you to help you quickly recover if you have an episode of hypoglycemia.
Bacterial infection. A rare bacterial infection called necrotizing fasciitis or Fournier’s gangrene can happen to people who take dapagliflozin. It damages tissues around your anus and genitals. Symptoms include:
- Fever
- Weakness or tiredness
- Pain or redness in the genital area
Kidney problems. Dapagliflozin can help people with chronic kidney disease. But there have also been reports that it could raise your risk for sudden kidney damage.
If you have any existing kidney issues, make sure your doctor knows about them. Seek immediate medical help if you have signs of kidney injury like:
- Peeing a lot less
- Swelling in your legs or feet
Ketoacidosis. When your body doesn't make enough insulin to let your cells use blood sugar for energy, your liver starts to break down fat for fuel. This process produces acids called ketones. Ketones can build up in your bloodstream and put your body into a potentially dangerous state called ketoacidosis.
At-home testing can detect high ketone levels in your pee. Symptoms of ketoacidosis include:
- Vomiting
- Nausea
- Stomach pain
- Difficulty breathing
Contact your doctor right away if:
- You throw up continuously.
- Your blood sugar won’t come down.
- Testing shows you have moderate or high ketone levels.
Get emergency help if your blood sugar is above 300 milligrams per deciliter or 16.7 millimoles per liter in more than one test, or if you have several of these symptoms:
- Peeing often
- Nausea
- Vomiting
- Fatigue
- Excessive thirst
- Trouble breathing
- Confusion
- Breath that smells fruity
How Much Does Dapagliflozin (Farxiga) Cost?
The list price for a 30-day supply of Farxiga is $548.83. But how much you’ll actually pay depends on whether you have prescription insurance coverage and what type.
If you have employer or individual private insurance, the average out-of-pocket cost is $23.24 per month. If you have Medicare Part D, the average out-of-pocket cost is $44.23 monthly. If you have Medicaid, you may pay under $1 a month or nothing at all.
Farxiga’s manufacturer offers a savings card, which may cover all or some of the costs. But it has restrictions. For instance, you can’t use it if you have a state or federal prescription insurance program like Medicare or Medicaid.
