Equivalent Dose of Jardiance from Farxiga 5mg
The equivalent dose of Jardiance (empagliflozin) for a patient currently taking Farxiga (dapagliflozin) 5mg is 10mg daily. 1
Dosing Equivalence Rationale
- The standard therapeutic dose of empagliflozin is 10mg daily, which provides comparable glycemic control to dapagliflozin 10mg daily 2, 1
- Since the patient is on dapagliflozin 5mg (half of the standard 10mg dose), clinical judgment would suggest maintaining the standard 10mg dose of empagliflozin, as this is the recommended starting dose for most patients 1
- Comparative studies have shown that empagliflozin 25mg provides greater HbA1c reduction than dapagliflozin 10mg, suggesting that empagliflozin may be more potent at equivalent doses 3, 4
Clinical Considerations for SGLT2 Inhibitor Dosing
- Both medications belong to the SGLT2 inhibitor class and share similar mechanisms of action, reducing renal glucose reabsorption and promoting urinary glucose excretion 5, 6
- Empagliflozin 10mg daily is the standard dose recommended for both glycemic control and cardiovascular benefits 2, 1
- Dapagliflozin is typically prescribed at 5-10mg daily, with 10mg being the most common therapeutic dose 5, 6
Renal Function Considerations
- For patients with eGFR ≥25 ml/min/1.73 m², dapagliflozin can be initiated at 10mg daily 2
- For patients with eGFR ≥20 ml/min/1.73 m², empagliflozin can be initiated at 10mg daily 2, 1
- If the patient has significant renal impairment (eGFR <45 ml/min/1.73 m²), empagliflozin is not recommended for glycemic control but may still be used for cardiovascular benefits 2, 1
Comparative Efficacy
- In head-to-head studies, empagliflozin 25mg showed greater reductions in HbA1c (-1.7% vs -1.1%) and body weight (-4.5kg vs -1.0kg) compared to dapagliflozin 10mg over a 3-year period 4
- At standard doses, empagliflozin 10mg and dapagliflozin 10mg have similar efficacy profiles for glycemic control, though empagliflozin may offer slightly better cardiometabolic benefits 3
Clinical Implications
- When switching between SGLT2 inhibitors, monitor for changes in glycemic control as individual responses may vary 1
- Both medications have demonstrated cardiovascular benefits, with dapagliflozin showing a 26% reduction in the composite endpoint of cardiovascular death or hospitalization for heart failure 2, 6
- Consider reducing concurrent diuretic doses when initiating either SGLT2 inhibitor due to potential volume depletion 1
Monitoring Recommendations
- Monitor renal function after switching medications, particularly in patients with pre-existing renal impairment 2, 1
- Watch for genital mycotic infections and urinary tract infections, which are class effects of SGLT2 inhibitors 1
- Assess for signs of diabetic ketoacidosis, especially during illness or reduced oral intake 1
By following these guidelines, the transition from Farxiga 5mg to Jardiance 10mg should provide comparable or potentially improved glycemic control and cardiometabolic benefits.