What Is Farxiga?

Farxiga (generic name dapagliflozin) is a prescription medication used to help manage certain chronic conditions. It belongs to the class of drugs known as SGLT2 inhibitors (sodium-glucose co-transporter 2 inhibitors). Farxiga works by helping your kidneys remove excess glucose (sugar) from your bloodstream through your urine.

Approved Uses of Farxiga

• Type 2 diabetes mellitus
  • Helps lower blood sugar when diet and exercise alone aren’t enough
  • Often used with other glucose-lowering medicines
• Heart failure with reduced ejection fraction (HFrEF)
  • Reduces risk of hospitalization for heart failure
  • Can improve symptoms like shortness of breath and fatigue
• Chronic kidney disease (CKD)
  • Slows kidney function decline
  • May delay need for dialysis

How Farxiga Works

• Inhibits the SGLT2 protein in the kidney’s proximal tubules
• Prevents reabsorption of filtered glucose
• Increases urinary glucose excretion
• Lowers blood glucose levels, which in turn:
  • Reduces blood pressure mildly
  • Promotes weight loss through calorie loss in urine

Benefits of Farxiga

1. Blood Sugar Control
   • A1C reduction of about 0.5–1.0% when added to standard care (McKeage & Perry, 2019)
2. Heart Protection
   • Decreases risk of heart failure hospitalization by ~30% in HFrEF patients
   • Improves cardiovascular outcomes regardless of diabetes status
3. Kidney Protection
   • Lowers risk of kidney disease progression in type 2 diabetes and CKD
   • Delays onset of dialysis or kidney transplant

Dosage and Administration

• Standard starting dose: 10 mg once daily, in the morning, with or without food
• For type 2 diabetes, lower doses (5 mg) may be considered in older adults or those with moderate kidney impairment
• Swallow tablets whole; do not crush or chew

Always follow your doctor’s instructions exactly. Do not adjust your dose or stop Farxiga without consulting your healthcare provider.

Potential Side Effects

Common side effects (occur in 2–10% of patients):

• Urinary tract infections (UTIs)
• Genital yeast infections in men and women
• Increased urination
• Thirst

Less common but serious side effects:

• Dehydration, leading to low blood pressure, dizziness or fainting
• Diabetic ketoacidosis (DKA), a rare but serious condition even with near-normal blood sugar
• Acute kidney injury
• Fournier’s gangrene (necrotizing infection around the genitals)

If you experience severe abdominal pain, trouble breathing, rapid heartbeat, or persistent vomiting, seek medical attention immediately.

Warnings and Precautions

• Kidney Function: Farxiga is less effective if your estimated glomerular filtration rate (eGFR) is below 45 mL/min/1.73 m². In severe kidney impairment, doctors may withhold the drug.
• Liver Disease: Patients with decompensated cirrhosis (advanced liver disease with fluid buildup) were excluded from major trials. According to EASL guidelines, medications affecting fluid balance should be used cautiously in these cases. Always inform your doctor about any history of liver problems.
• Blood Pressure: Can cause a modest drop in blood pressure. If you’re on diuretics or have low baseline blood pressure, monitor yourself for dizziness.
• Electrolyte Imbalances: Monitor sodium and potassium levels, especially if you take diuretics.

Who Should Avoid Farxiga

• Type 1 diabetes (high risk of DKA)
• History of severe genital infections or recurring UTIs
• Severe kidney impairment (eGFR < 30 mL/min/1.73 m²)
• Hypersensitivity to dapagliflozin or any component of the tablet
• Patients at high risk for volume depletion (e.g., on high-dose diuretics, elderly)

Drug Interactions

• Diuretics (water pills): Increased risk of dehydration and low blood pressure
• Insulin or insulin secretagogues (e.g., sulfonylureas): Increased risk of hypoglycemia; dose adjustments may be needed
• Other antihypertensives: Monitor for additive blood pressure–lowering effects

Always provide your doctor or pharmacist with a list of all prescription medications, over-the-counter drugs, and supplements you take.

Monitoring While on Farxiga

• Blood sugar (self-monitoring and A1C every 3–6 months)
• Kidney function tests (serum creatinine, eGFR) periodically
• Blood pressure checks
• Signs of infection (especially genital and urinary)
• Symptoms of dehydration (dizziness, lightheadedness, dark urine)

Lifestyle Tips to Enhance Farxiga’s Effects

• Stick to a balanced diet low in simple sugars and refined carbs
• Aim for at least 150 minutes of moderate exercise weekly
• Maintain adequate hydration, especially in hot weather or during exercise
• Limit alcohol, as it can increase dehydration and hypoglycemia risk

When to Seek Medical Help

• Signs of serious infection: fever, unusual genital pain or swelling
• Symptoms of DKA: nausea, vomiting, abdominal pain, rapid breathing, confusion
• Severe dizziness, fainting spells
• Sudden decrease in urine output or dark-colored urine

You might also consider doing a free, online symptom check for to see if you need to seek care.

Final Thoughts

Farxiga offers significant benefits for blood sugar control, heart failure management, and kidney protection. However, it’s not right for everyone. Discuss your full medical history—including kidney or liver disease—and all medications you take with your doctor before starting Farxiga. If you experience any serious or life-threatening symptoms, seek immediate medical attention.

Speak to a doctor before making any changes to your treatment plan or if you have concerns about Farxiga’s risks versus benefits. Your healthcare provider can help tailor therapy to your individual needs.