What is Forxiga (dapagliflozin) used for?

Forxiga (Dapagliflozin): Therapeutic Uses and Benefits

Forxiga (dapagliflozin) is primarily used to treat type 2 diabetes, reduce cardiovascular risk, manage heart failure (regardless of ejection fraction), and slow chronic kidney disease progression. 1, 2

Main Therapeutic Uses

• Type 2 diabetes management: Approved as monotherapy (when metformin is not tolerated) or as add-on therapy with other glucose-lowering agents, including insulin, to improve glycemic control 3

• Heart failure treatment: Recommended for patients with heart failure with reduced ejection fraction (HFrEF) and preserved ejection fraction (HFpEF), regardless of diabetes status, to reduce:

  • Cardiovascular death
  • Hospitalization for heart failure
  • Urgent heart failure visits 2, 4

• Chronic kidney disease management: Used to reduce the risk of:

  • Further worsening of kidney disease
  • End-stage kidney disease
  • Death due to cardiovascular disease
  • Hospitalization for heart failure 1, 4

Cardiovascular Benefits

• Reduces hospitalization for heart failure by 27% in patients with type 2 diabetes with established cardiovascular disease or multiple risk factors 2

• Provides 26% reduction in the composite of worsening heart failure or cardiovascular death in patients with HFrEF, regardless of diabetes status 4

• Demonstrates 18% reduction in the composite of worsening heart failure or cardiovascular death in patients with HFpEF 2

Mechanism of Action

• Inhibits sodium-glucose cotransporter-2 (SGLT2) in the kidneys, reducing renal glucose reabsorption and increasing urinary glucose excretion 3, 5

• Cardiovascular and renal benefits appear independent of glucose-lowering effects, as benefits are seen in patients with and without diabetes 2, 6

Dosing

• Standard dose is 10 mg once daily for all approved indications 2, 1

Safety Considerations

• Common adverse effects:

  • Genital fungal infections (especially in women)
  • Urinary tract infections
  • Volume depletion 1, 2

• Serious but rare adverse effects:

  • Diabetic ketoacidosis (can occur even with normal blood glucose levels)
  • Sudden kidney injury 1

• Precautions:

  • Discontinue at least 3 days before planned surgery to prevent postoperative ketoacidosis 2
  • Assess volume status before initiation and correct volume depletion if present 2
  • Consider reducing diuretic dose if patient is at risk for volume depletion 2
  • Not recommended in patients with moderate to severe kidney problems for glucose control 1

Clinical Evidence Supporting Use

• The DAPA-HF trial showed significant benefits in heart failure patients regardless of diabetes status 6, 4

• The DECLARE-TIMI 58 trial demonstrated cardiovascular safety and reduced hospitalization for heart failure in type 2 diabetes patients 6, 2

• The DELIVER trial confirmed benefits in heart failure with preserved ejection fraction 6, 2

• The DAPA-CKD study showed significant reductions in kidney disease progression 4

Advantages Over Other Diabetes Medications

• Low risk of hypoglycemia when used as monotherapy 3, 7
• Associated with weight reduction 3, 5
• Provides blood pressure reduction 3
• Complementary mechanism of action when combined with other antidiabetic drugs 5, 7

Forxiga represents an important treatment option across multiple conditions with proven benefits for reducing mortality, hospitalization for heart failure, and disease progression in both diabetes and non-diabetes populations.