From the Guidelines
The recommended dose of Farxiga (dapagliflozin) is 10 mg PO daily. This dose is based on the 2020 expert consensus decision pathway on novel therapies for cardiovascular risk reduction in patients with type 2 diabetes, as reported in the Journal of the American College of Cardiology 1. According to this study, the recommended dose of dapagliflozin for improving glycemic control in adults with type 2 diabetes, as well as reducing the risk of hospitalization for heart failure in adults with type 2 diabetes and established cardiovascular disease or multiple cardiovascular risk factors, is 10 mg PO daily.
Key Considerations
- The dose of Farxiga should not be titrated for cardiovascular or renal risk reduction, as there is no evidence of a graded dose response regarding these effects 1.
- However, dose increases may provide further glucose reduction benefits if indicated.
- Farxiga should not be used in patients with severe renal impairment (eGFR less than 30 mL/min/1.73 m²) or end-stage renal disease, and its use is not recommended for glycemic control in patients with eGFR less than 45 mL/min/1.73 m² 1.
- Patients should be advised to stay well-hydrated while taking Farxiga to reduce the risk of dehydration and hypotension.
Mechanism of Action
Farxiga works by inhibiting sodium-glucose cotransporter 2 (SGLT2) in the kidneys, which increases glucose excretion in urine and lowers blood glucose levels. This mechanism also provides cardiovascular and renal benefits beyond glucose control, making it beneficial for many patients with type 2 diabetes, especially those with cardiovascular disease or chronic kidney disease.
Monitoring and Adverse Effects
- Adverse effects to monitor include genital fungal infections, urinary tract infections, and euglycemic diabetic ketoacidosis 1.
- Patients with prior amputation, severe peripheral neuropathy, severe peripheral vascular disease, or active diabetic foot ulcers or soft tissue infections should use Farxiga with caution 1.
From the FDA Drug Label
2.2 Recommended Dosage for Glycemic Control in Adults and Pediatric Patients Aged 10 Years and Older with Type 2 Diabetes Mellitus In adults and pediatric patients aged 10 years and older with type 2 diabetes mellitus, the recommended starting dosage of DAPAGLIFLOZIN TABLETS is 5 mg orally once daily to improve glycemic control For additional glycemic control, the dosage can be increased to 10 mg orally once daily.
2.3 Recommended Dosage for Other Indications in Adults The recommended dosage of DAPAGLIFLOZIN TABLETS is 10 mg orally once daily in adults for the following indications: • To reduce the risk of sustained eGFR decline, end stage kidney disease (ESKD), cardiovascular (CV) death, and hospitalization for heart failure (hHF) in patients with chronic kidney disease at risk of progression • To reduce the risk of CV death, hHF, and urgent heart failure visit in patients with heart failure. • To reduce the risk of hHF in patients with type 2 diabetes mellitus and either established CV disease or multiple CV risk factors
The recommended dosage of Farxiga (dapagliflozin) is:
- 5 mg orally once daily as the starting dose for adults and pediatric patients aged 10 years and older with type 2 diabetes mellitus, with the option to increase to 10 mg orally once daily for additional glycemic control.
- 10 mg orally once daily for adults with other indications, including chronic kidney disease, heart failure, and type 2 diabetes mellitus with established cardiovascular disease or multiple cardiovascular risk factors 2.
From the Research
Dosage of Farxiga
The dosage of Farxiga (dapagliflozin) is not explicitly stated in the provided studies. However, the following information can be gathered:
- Dapagliflozin is approved for use as monotherapy or as add-on combination therapy for type 2 diabetes, with a recommended dosage of 10mg once daily 3.
- In the DAPA ACT HF-TIMI 68 trial, patients hospitalized for acute heart failure are randomized to receive either dapagliflozin 10mg daily or placebo 4.
- The studies do not provide information on the dosage of Farxiga for specific patient populations or conditions, such as heart failure with reduced ejection fraction or type 2 diabetes with established cardiovascular disease.
Key Findings
- Dapagliflozin has been shown to be effective in reducing the risk of cardiovascular death or hospitalization for heart failure in patients with type 2 diabetes 3, 5.
- The medication has also been found to improve cardiac and renal function, and reduce the risk of major adverse cardiovascular events in patients with heart failure with reduced ejection fraction and type 2 diabetes 6.
- Dapagliflozin has been compared to other SGLT-2 inhibitors, such as empagliflozin and canagliflozin, in terms of cost-effectiveness and clinical outcomes 7.
Safety and Efficacy
- Dapagliflozin has been found to be generally well-tolerated, with a low risk of hypoglycemia and a higher risk of genital infections and diabetic ketoacidosis compared to placebo 3, 5.
- The medication has been shown to be effective in reducing the risk of cardiovascular death or hospitalization for heart failure, and improving cardiac and renal function in patients with heart failure with reduced ejection fraction and type 2 diabetes 6.