What is the equivalent dose of Farxiga (dapagliflozin) to Jardiance (empagliflozin) 10mg?

Equivalent Dose of Farxiga to Jardiance 10mg

The equivalent dose of Farxiga (dapagliflozin) to Jardiance (empagliflozin) 10mg is 10mg of dapagliflozin taken once daily.

Dosing Equivalence and Clinical Evidence

Farxiga (dapagliflozin) and Jardiance (empagliflozin) are both SGLT2 inhibitors with similar mechanisms of action but different dosing strategies:

• Empagliflozin (Jardiance) is typically prescribed at 10mg or 25mg once daily 1
• Dapagliflozin (Farxiga) is typically prescribed at 10mg once daily 1

The standard therapeutic dose of dapagliflozin is 10mg once daily, which provides comparable clinical effects to empagliflozin 10mg once daily in terms of glycemic control and cardiorenal benefits 1.

Pharmacokinetic Considerations

Research has shown that dapagliflozin's pharmacokinetic profile supports once-daily dosing at 10mg:

• A study comparing dapagliflozin 10mg once daily versus 5mg twice daily found similar area under the curve (AUC) and average concentration at steady state, supporting the 10mg once-daily regimen 2
• The 10mg once-daily dose of dapagliflozin achieves optimal inhibition of renal glucose reabsorption over a 24-hour period 2

Clinical Efficacy Comparison

When comparing the two medications:

• Both dapagliflozin 10mg and empagliflozin 10mg have demonstrated significant reductions in HbA1c, with some studies suggesting empagliflozin may have slightly greater efficacy (HbA1c reduction of -1.7±0.9% for empagliflozin 25mg vs -1.2±1.4% for dapagliflozin 10mg) 3
• Both medications have proven cardiovascular and renal benefits in patients with type 2 diabetes 1

Safety Profile Differences

There are some differences in the safety profiles that may be relevant when switching between these medications:

• Dapagliflozin has been associated with slightly higher rates of genital mycotic infections (5.7% for 5mg dose, 4.8% for 10mg dose) compared to placebo (0.9%) 4
• Some comparative studies suggest empagliflozin may have lower rates of urinary and genital infections (2.34% and 3.1% respectively) compared to dapagliflozin (7.08% and 8.66%) 3

Renal Function Considerations

When switching between these medications, renal function is an important consideration:

• Dapagliflozin 10mg can be used with eGFR ≥25 mL/min/1.73m² and can be continued at lower eGFR levels for cardiovascular and renal benefits 1
• Empagliflozin 10mg is not recommended for use when eGFR <45 mL/min/1.73m² according to the ADA/KDIGO consensus 1

Practical Switching Recommendations

When switching from Jardiance 10mg to Farxiga:

1. Prescribe Farxiga 10mg once daily
2. Monitor for fluid balance changes, as both medications have diuretic effects 5
3. Ensure adequate hydration (2-3 liters daily) to prevent dehydration 5
4. If the patient is on diuretics, consider reducing the diuretic dose to minimize volume depletion risk 5
5. Monitor for genital mycotic infections, which may be slightly more common with dapagliflozin 4, 3

Special Considerations

• Both medications have demonstrated benefits in heart failure with reduced ejection fraction (HFrEF), with dapagliflozin showing a 26% reduction in the composite of worsening heart failure or cardiovascular death 6
• For patients with heart failure, both medications are included in standard heart failure treatment protocols, with dapagliflozin 10mg and empagliflozin 10mg both being recommended doses 1

In summary, when switching from Jardiance 10mg to Farxiga, the appropriate equivalent dose is Farxiga 10mg once daily, with attention to the slight differences in side effect profiles and renal dosing considerations.