From the Guidelines
Farxiga (dapagliflozin) is an SGLT2 inhibitor medication primarily used to treat type 2 diabetes, heart failure, and chronic kidney disease, with a typical starting dose of 5 mg once daily, which may be increased to 10 mg daily if needed and tolerated, as supported by the most recent evidence from the DAPA-HF trial 1.
Key Uses of Farxiga
- Treatment of type 2 diabetes
- Reduction of heart failure hospitalizations and mortality
- Renal protection by slowing kidney function decline
Mechanism of Action
Farxiga works by preventing glucose reabsorption in the kidneys, causing excess sugar to be eliminated through urine, which helps lower blood sugar levels.
Important Considerations
- Patients should maintain adequate hydration while taking Farxiga and temporarily stop it during periods of reduced oral intake or illness that may cause dehydration.
- Those with type 1 diabetes should not use Farxiga due to increased risk of diabetic ketoacidosis.
- Regular kidney function monitoring is recommended while on this medication.
Side Effects
- Common side effects include genital yeast infections, urinary tract infections, and increased urination.
Recent Evidence
The DAPA-HF trial demonstrated that dapagliflozin reduced the risk of worsening heart failure or cardiovascular death in patients with heart failure with reduced ejection fraction, regardless of the presence or absence of type 2 diabetes 1. The EMPEROR-Reduced trial also showed that empagliflozin reduced the composite endpoint of cardiovascular death or hospitalization for worsening heart failure in patients with heart failure with reduced ejection fraction 1.
Dosage and Administration
The recommended starting dose of Farxiga 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, as supported by the evidence from the DAPA-HF trial 1.
Clinical Guidelines
The use of SGLT2 inhibitors, including Farxiga, is recommended in patients with type 2 diabetes and established heart failure with reduced ejection fraction to reduce the risk of worsening heart failure and cardiovascular death, as stated in the 2024 standards of care in diabetes 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 kidney disease progression and cardiovascular events in adults with chronic kidney disease
- Reduce the risk of cardiovascular death and hospitalization for heart failure in adults with heart failure
- Reduce the risk of hospitalization for heart failure in adults with type 2 diabetes and 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 a sodium-glucose cotransporter-2 (SGLT-2) inhibitor used in the management of patients with type 2 diabetes 3, 4, 5, 6, 7
- It is also approved for the treatment of chronic kidney disease, heart failure with reduced ejection fraction, and heart failure with preserved ejection fraction 4
- Dapagliflozin works by inhibiting the reabsorption of glucose in the kidney, increasing urinary glucose excretion and reducing blood glucose levels 5, 6
Benefits of Dapagliflozin
- Effective in reducing glycosylated haemoglobin, fasting plasma glucose levels, and body weight 3, 5, 6, 7 *-desktop and possibly renoprotective properties 3
- Reduced risk of cardiovascular death or hospitalization for heart failure 3
- Favorable tolerability profile with a low risk of hypoglycemia 3, 5, 6, 7