From the Guidelines
Farxiga (dapagliflozin) is an SGLT2 inhibitor used to improve glycemic control in adults with type 2 diabetes mellitus, with a recommended starting dose of 10 mg once daily, as indicated in the most recent study 1.
Key Points
- The medication works by preventing glucose reabsorption in the kidneys, causing excess glucose to be excreted in the urine, which lowers blood glucose levels.
- Beyond glycemic control, Farxiga offers cardiovascular benefits, including reducing the risk of hospitalization for heart failure and cardiovascular death, as demonstrated in several studies 1.
- Renal function should be assessed before starting treatment, as Farxiga is not recommended for patients with severe renal impairment (eGFR less than 45 mL/min/1.73 m²) 1.
- Common side effects include genital mycotic infections, urinary tract infections, and increased urination.
- Patients should be monitored for signs of diabetic ketoacidosis, hypotension, and hypoglycemia, especially when used with insulin or insulin secretagogues 1.
- Adequate hydration is important while taking this medication to reduce the risk of volume depletion.
Dosage and Administration
- The recommended dose of Farxiga is 10 mg once daily, taken in the morning with or without food.
- No dose titration is needed for cardiovascular or renal risk reduction, but dose increases may provide further glucose reduction benefits if indicated 1.
Special Considerations
- Farxiga is contraindicated in patients with a history of serious hypersensitivity reaction to the drug, pregnancy, or breastfeeding 1.
- The medication should be used with caution in patients with prior amputation, severe peripheral neuropathy, severe peripheral vascular disease, or active diabetic foot ulcers or soft tissue infections 1.
From the FDA Drug Label
DAPAGLIFLOZIN TABLETS are indicated: • To reduce the risk of sustained eGFR decline, end-stage kidney disease, cardiovascular death, and hospitalization for heart failure in adults with chronic kidney disease at risk of progression • To reduce the risk of cardiovascular death, hospitalization for heart failure, and urgent heart failure visit in adults with heart failure. • To reduce the risk of hospitalization for heart failure in adults with type 2 diabetes mellitus and either established cardiovascular disease or multiple cardiovascular risk factors • As an adjunct to diet and exercise to improve glycemic control in adults and pediatric patients aged 10 years and older with type 2 diabetes mellitus.
Farxiga (dapagliflozin) is used for:
- Reducing the risk of hospitalization for heart failure in adults with type 2 diabetes mellitus and either established cardiovascular disease or multiple cardiovascular risk factors
- Improving glycemic control in adults and pediatric patients aged 10 years and older with type 2 diabetes mellitus
- The recommended starting dosage of Farxiga for glycemic control in adults and pediatric patients aged 10 years and older with type 2 diabetes mellitus is 5 mg orally once daily, which can be increased to 10 mg orally once daily for additional glycemic control 2
From the Research
Use of Farxiga
- Farxiga (dapagliflozin) is a sodium-glucose cotransporter-2 inhibitor used in the treatment of type 2 diabetes mellitus 3, 4, 5.
- It is indicated for use as monotherapy in patients who are intolerant of metformin, and as add-on combination therapy with other glucose-lowering agents, including insulin, when diet and exercise alone do not provide adequate glycaemic control 3.
- Dapagliflozin has been shown to provide effective glycaemic control, reduce body weight and blood pressure, and have a low risk of hypoglycaemia 3, 4, 5.
Dosing of Farxiga
- The recommended dose of dapagliflozin is 5 or 10 mg once daily, with or without food 4, 5.
- Dapagliflozin can be used as monotherapy or in combination with other antidiabetic drugs, including metformin, glimepiride, pioglitazone, or insulin-based therapy 4.
- The efficacy and safety of dapagliflozin have been established in numerous clinical trials, with extensions of these trials showing that the effects are maintained over longer-term follow-up periods of up to 2 years 4, 5.
Benefits and Risks
- Dapagliflozin has been shown to reduce the rate of cardiovascular death or hospitalization for heart failure, and possibly reduce the progression of renal disease relative to placebo in patients with established atherosclerotic cardiovascular disease or multiple risk factors for cardiovascular disease 3.
- The most common adverse events associated with dapagliflozin are genital mycotic infections, particularly in women, and urinary tract infections 4, 5.
- Dapagliflozin is not recommended in patients with moderate or severe renal impairment 5.