Minimum Dose for Farxiga (Dapagliflozin)
The minimum approved dose of Farxiga is 5 mg once daily, which is the recommended starting dose for glycemic control in adults and pediatric patients aged 10 years and older with type 2 diabetes mellitus. 1
Dosing by Indication
For Glycemic Control (Type 2 Diabetes)
- Starting dose: 5 mg once daily
- May increase to 10 mg once daily if additional glycemic control is needed
- This applies to both adults and pediatric patients ≥10 years old 1
Important renal consideration for glycemic control: Farxiga is not recommended for improving glycemic control in patients with eGFR <45 mL/min/1.73 m² as it is likely ineffective based on its mechanism of action 2, 1.
For Cardiovascular and Renal Protection
- Fixed dose: 10 mg once daily for all the following indications 1:
- Chronic kidney disease at risk of progression
- Heart failure (to reduce CV death, hospitalization, urgent visits)
- Type 2 diabetes with established CVD or multiple CV risk factors (to reduce hospitalization for heart failure)
There is no 5 mg option for these indications - the evidence-based dose tested in cardiovascular and renal outcomes trials was 10 mg daily 3, 4.
Key Clinical Considerations
Renal dosing for non-glycemic indications: The 10 mg dose can be initiated in patients with eGFR ≥25 mL/min/1.73 m². If eGFR falls below 25 mL/min/1.73 m² during treatment, patients may continue the 10 mg dose for cardio-renal protection 3, 1.
No dose titration needed for CV/renal benefits: Because there is no graded dose-response for cardiovascular and renal effects, the lowest dose tested in outcomes trials (10 mg) should be used without further titration 4.
Common pitfall: Do not start at 5 mg for heart failure or CKD indications thinking you can "start low and go slow" - the evidence supports 10 mg as the therapeutic dose for these conditions 2, 5.