From the Guidelines
Farxiga (dapagliflozin) is a medication primarily used to treat type 2 diabetes, heart failure, and chronic kidney disease, with a recommended dose of 10 mg daily for heart failure and kidney disease, as evidenced by the DAPA-HF trial 1 and DAPA-CKD study 1. The medication belongs to a class of drugs called SGLT2 inhibitors, which work by helping the kidneys remove excess sugar from the bloodstream through urine.
- The typical starting dose is 5 mg once daily, taken in the morning, with or without food, which may be increased to 10 mg daily if needed and tolerated.
- Patients should maintain adequate hydration while taking Farxiga and be aware of potential side effects, including urinary tract infections, genital yeast infections, and rarely, diabetic ketoacidosis.
- The medication should not be used by patients with type 1 diabetes or severe kidney impairment.
- Farxiga works by blocking sodium-glucose cotransporter 2 proteins in the kidneys, preventing glucose reabsorption and promoting its excretion, which lowers blood sugar levels while also providing cardiovascular and renal protective benefits through mechanisms that extend beyond glucose control, as shown in the EMPEROR-Reduced trial 1 and CREDENCE trial 1. Key benefits of Farxiga include:
- Reduced risk of worsening heart failure and cardiovascular death in people with type 2 diabetes and established heart failure, as demonstrated in the DAPA-HF trial 1 and DELIVER trial 1.
- Reduced risk of hospitalization for heart failure and cardiovascular death in people with heart failure and an ejection fraction of 40% or less, as shown in the EMPEROR-Reduced trial 1.
- Reduced risk of kidney disease progression and cardiovascular events in people with chronic kidney disease, as evidenced by the DAPA-CKD study 1 and CREDENCE trial 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
The use of Farxiga (Dapagliflozin) is 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.
- Reduce the risk of cardiovascular death, hospitalization for heart failure, and urgent heart failure visit in adults with heart failure.
- 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.
- Improve glycemic control in adults and pediatric patients aged 10 years and older with type 2 diabetes mellitus as an adjunct to diet and exercise 2
From the Research
Uses of Farxiga (Dapagliflozin)
- Dapagliflozin is indicated for the treatment of type 2 diabetes [ 3 , 4 , 5 ]
- It is used as monotherapy or in combination with other glucose-lowering agents, including insulin, to improve glycemic control [ 3 , 4 ]
- Dapagliflozin has been shown to reduce the risk of cardiovascular death or hospitalization for heart failure [ 3 , 6 ]
- It is also approved to reduce the risk of declining kidney function, kidney failure, cardiovascular death, and hospitalization for heart failure in adults with chronic kidney disease with or without type 2 diabetes [ 7 ]
- Dapagliflozin has been shown to be effective in reducing hospitalizations for heart failure, urgent heart failure visits, and cardiovascular death in patients with heart failure with reduced ejection fraction [ 6 ]
Mechanism of Action
- Dapagliflozin works by inhibiting the sodium-glucose cotransporter-2 (SGLT2) in the renal proximal tubule, increasing urinary glucose excretion and reducing blood glucose levels [ 4 ]
- Its mechanism of action is independent of insulin secretion or action, making it a useful complementary therapy when used in combination with other antihyperglycemic drugs [ 4 ]