Maximum Dose of Farxiga (Dapagliflozin)
The maximum recommended dose of Farxiga (dapagliflozin) is 10 mg once daily. 1
Dosing by Indication
The dosing of Farxiga varies based on the clinical indication:
For Glycemic Control in Type 2 Diabetes
- Starting dose: 5 mg once daily
- Maximum dose: 10 mg once daily (if additional glycemic control is needed) 1
- This applies to both adults and pediatric patients aged 10 years and older 1
For Heart Failure, CKD, and Cardiovascular Risk Reduction
- Standard dose: 10 mg once daily 1
- This single dose is used for:
- Reducing risk of sustained eGFR decline, end-stage kidney disease, CV death, and hospitalization for heart failure in adults with CKD at risk of progression
- Reducing risk of CV death, hospitalization for heart failure, and urgent heart failure visits in adults with heart failure
- Reducing risk of hospitalization for heart failure in adults with type 2 diabetes and established CVD or multiple CV risk factors 1
Key Dosing Considerations
The 10 mg dose represents both the maximum approved dose and the dose tested in cardiovascular and renal outcomes trials 2, 3, 2. Multiple high-quality guidelines consistently confirm this maximum:
- The 2022 ADA/KDIGO consensus report specifies dapagliflozin 10 mg daily as the standard dose for CKD and heart failure indications 3
- The 2022 Mayo Clinic guideline confirms the dosing range of 5-10 mg with 10 mg as the maximum 2
- FDA labeling explicitly states 10 mg as the maximum approved daily dose 1
Important Clinical Caveat
Higher doses do not provide additional clinical benefit. The cardiovascular and renal protective effects observed in major trials (DAPA-HF, DAPA-CKD, DECLARE-TIMI 58) were achieved with the 10 mg dose 3. There is no evidence supporting doses above 10 mg, and the glucose-lowering efficacy does not meaningfully improve beyond this dose 3.
Renal Function Adjustments
For glycemic control in type 2 diabetes:
- eGFR ≥45 mL/min/1.73 m²: No dose adjustment needed
- eGFR <45 mL/min/1.73 m²: Not recommended for glycemic control (ineffective due to mechanism of action) 1
For heart failure and CKD indications:
- eGFR ≥25 mL/min/1.73 m²: Use standard 10 mg dose
- eGFR <25 mL/min/1.73 m²: Initiation not recommended, but may continue 10 mg if already on treatment 2, 3, 1
The maximum dose remains 10 mg once daily regardless of renal function—dose reduction is not required, but initiation thresholds vary by indication 3, 1.