What is the effect of combining Baxdrostat with Dapagliflozin (Forxiga) in patients with Chronic Kidney Disease (CKD)?

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Last updated: March 2, 2025View editorial policy

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From the Guidelines

The combination of Baxdrostat and Dapagliflozin (Forxiga) in patients with Chronic Kidney Disease (CKD) may be beneficial in reducing the risk of kidney function decline, end-stage kidney disease, and cardiovascular death, but its use should be approached with caution due to potential increased risk of electrolyte abnormalities and hypotension.

Mechanism of Action

Baxdrostat is an investigational aldosterone synthase inhibitor that reduces blood pressure by blocking aldosterone production, while dapagliflozin is an approved SGLT2 inhibitor with proven benefits in CKD, as shown in the DAPA-CKD study 1. Dapagliflozin's glucose-independent kidney protection and Baxdrostat's potential to address resistant hypertension and reduce aldosterone-mediated kidney damage provide a theoretical basis for their complementary use.

Dosage and Administration

Dapagliflozin is typically prescribed at 10mg once daily for CKD patients with eGFR ≥25 mL/min/1.73m², as it reduces the risk of kidney function decline, end-stage kidney disease, and cardiovascular death 1. However, Baxdrostat is still in clinical trials and doesn't have an approved dosage for CKD yet.

Potential Benefits and Risks

The combination of Baxdrostat and Dapagliflozin may offer additional benefits in reducing kidney damage and cardiovascular risk, as suggested by the results of the DAPA-CKD study 1 and other trials examining the effects of SGLT2 inhibitors in CKD patients. However, patients should be aware that this combination might increase the risk of electrolyte abnormalities, particularly hypokalemia, and hypotension. Close monitoring of blood pressure, kidney function, and electrolytes would be essential if these medications were used together once Baxdrostat receives regulatory approval.

Key Considerations

  • The use of Baxdrostat and Dapagliflozin in combination should be individualized and based on a thorough assessment of the patient's kidney function, blood pressure, and overall health status.
  • Patients should be closely monitored for potential adverse effects, including electrolyte abnormalities and hypotension.
  • The benefits and risks of this combination should be carefully weighed, taking into account the latest evidence from clinical trials and the patient's specific needs and circumstances.

From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

Effect of Combining Baxdrostat with Dapagliflozin in Patients with CKD

  • There are no research papers to assist in answering this question as the provided studies do not mention Baxdrostat.
  • However, the studies do discuss the effects of Dapagliflozin (Forxiga) and other SGLT2 inhibitors on patients with Chronic Kidney Disease (CKD) 2, 3, 4, 5, 6.
  • Dapagliflozin has been shown to reduce cardiovascular and major renal events in patients with CKD 2, 3.
  • SGLT2 inhibitors, including Dapagliflozin, have been found to slow the decline of kidney function and reduce the incidence of serious kidney events in patients with CKD 3, 4, 5, 6.
  • The combination of SGLT2 inhibitors with other therapies, such as angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, may provide additional benefits for patients with CKD 4, 5.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

An update on dapagliflozin for chronic kidney disease.

Drugs of today (Barcelona, Spain : 1998), 2022

Research

Class effects of SGLT2 inhibitors on cardiorenal outcomes.

Cardiovascular diabetology, 2019

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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