What is Farxiga used for?

In this article:

• Type 2 diabetes
• Chronic heart failure
• Chronic kidney disease
• Off-label uses of Farxiga
• Side effects
• Warnings
• Interactions
• Expert takeaway

In this article

• Type 2 diabetes
• Chronic heart failure
• Chronic kidney disease
• Off-label uses of Farxiga
• Side effects
• Warnings
• Interactions
• Expert takeaway

Farxiga (brand name for dapagliflozin) was first approved by the Food and Drug Administration (FDA) in 2014. Various clinical trials have shown that it is generally effective and safe for Type 2 diabetes, congestive heart failure (CHF), and chronic kidney disease. It’s an oral tablet that’s often taken once a day in the morning. Use this guide to better understand how Farxiga is effective in lowering blood sugar, reducing the risk of cardiovascular death, and slowing kidney disease progression.

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Farxiga for Type 2 diabetes

Farxiga is approved to help control blood sugar levels in adults and children aged 10 years and older with Type 2 diabetes. It can be an effective part of a diabetes management plan when combined with diet and exercise.

• How it works: Farxiga is a sodium-glucose cotransporter 2 (SGLT2) inhibitors, which reduce blood sugar levels by telling the kidneys to eliminate sugar into the urine. 
• How it’s taken: Although it can be used alone to treat Type 2 diabetes, it’s typically prescribed with metformin or other diabetes medications to boost blood sugar control. Metformin and lifestyle changes, including diet and exercise, are generally the first-line options for Type 2 diabetes. 
• Who it’s prescribed to: Farxiga may be especially useful for people with Type 2 diabetes and heart disease or chronic kidney disease. 
• Other benefits: Unless combined with insulin or sulfonylureas like glipizide or glimepiride, Farxiga does not cause blood sugar levels to drop too low, making it a safer pick.

Farxiga for congestive heart failure

Farxiga is approved for treating congestive heart failure (CHF). It reduces the risk of hospitalization, urgent heart failure visits, and death in adults with CHF.

• How it works: By helping the kidneys eliminate more sugar, salt, and water, Farxiga may reduce stress on the heart. This allows it to pump blood more effectively and may help prevent the progression of heart failure.
• Who it’s prescribed to: Farxiga may also be prescribed to reduce the risk of hospitalization for CHF in adults with Type 2 diabetes who have either heart disease or multiple risk factors for heart disease, such as obesity and high blood pressure. In essence, even without a pre-existing history of CHF, the drug is a proactive way to prevent CHF hospital admissions for those at high risk for the condition.
• Other benefits: Clinical studies have now shown that Farxiga is beneficial for patients with heart failure from a weakened heart squeeze (reduced ejection fraction) and when heart squeeze is normal (preserved ejection fraction). 

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Farxiga for chronic kidney disease

In patients with chronic kidney disease, Farxiga reduces the risk of worsening kidney function, cardiovascular death, end-stage kidney disease, and hospital visits for heart failure in adults with chronic kidney disease.

• How it works: Farxiga lowers blood sugar by blocking glucose reabsorption in the kidneys, which also lowers blood pressure and reduces strain on kidney filtration units.
• Who it’s prescribed for: Farxiga is used when there is a significant likelihood of chronic kidney disease progression. Factors that indicate a person may be at high risk include reduced kidney function, protein in the urine, high blood pressure, or a history of heart problems.
• Other benefits: Farxiga is effective at reducing the risk of progression to kidney failure in patients with and without diabetes, including those with severe renal disease.

RELATED: How does Farxiga help kidneys?

Off-label uses of Farxiga

Healthcare providers may prescribe Farxiga for uses that have not been approved by the FDA.

Type 1 diabetes

Farxiga has been studied for Type 1 diabetes and may improve blood sugar control. However, it significantly increases the risk of diabetic ketoacidosis (DKA), a serious and potentially life-threatening condition. Studies like the DEPICT-2 trial have found that Farxiga is linked to a reduction in HbA1c and body weight in adults with Type 1 diabetes. These results suggest potential benefits for those who struggle to control their blood sugar levels through insulin alone. However, the study, along with others, also found that Farxiga may increase the risk of DKA. Due to the risk of DKA, Farxiga is not approved for Type 1 diabetes and is rarely used off-label.

Weight loss

Farxiga is not approved to promote weight loss either. However, clinical studies show promising results for using Farxiga in weight management plans, perhaps by causing sugar elimination from the body. A study of obese adults without diabetes found that a combination of Farxiga and another diabetes medication called exenatide, a GLP-1 agonist, led to an average weight loss of around 9 pounds after 24 weeks. The treatment also reduced the risk of prediabetes and lowered systolic blood pressure.

When considering off-label medication use, patients and healthcare providers should weigh the potential benefits against possible risks. Regular doctor visits may be needed to ensure the medication is being used safely and effectively.

Farxiga side effects, warnings, and interactions

Farxiga has a range of different side effects, warnings, and interactions. Although it’s generally considered safe and effective, it’s helpful to be aware of the potential risks of taking this medication. 

Common side effects

When people take Farxiga, they might experience side effects, some of which are more common than others. Not everyone will encounter these issues, and their occurrence doesn’t mean that Farxiga isn’t an appropriate medication for managing certain health conditions. Common side effects of Farxiga include:

• Changes in urination, including an increased need to urinate and to urinate in larger amounts.
• Common cold symptoms, including sore throat and stuffy or runny nose.
• Genital yeast infections in both men and women, with symptoms that include itching, burning, redness, and unusual discharge.
• Urinary tract infections (UTIs), which can be serious. Because Farxiga increases blood sugar levels in urine, making it easier for bacteria to grow in the urinary tract.

Changes in urination and common cold symptoms are typically mild and manageable. In many cases, these side effects subside over time. However, UTIs generally require medical guidance and antibiotics. UTIs may rarely become severe and frequent.

This is not an exhaustive list of the possible side effects patients may experience while on Farxiga. Consult a healthcare provider for medical advice if you notice any side effects or have concerns about this medication.

Warnings

Farxiga is associated with potentially serious side effects. These serious side effects may include:

• Diabetic ketoacidosis: Farxiga may increase the risk of developing DKA, a serious condition where the body produces high levels of blood acids called ketones. DKA symptoms may include excessive thirst, frequent urination, nausea, vomiting, abdominal pain, confusion, and fruity-scented breath.
• Dehydration: Taking Farxiga can lead to dehydration due to increased urination. Symptoms of dehydration include dry mouth, extreme thirst, dark yellow urine, fatigue, dizziness, and confusion. It’s important to stay hydrated while on this medication. Consult your healthcare provider to understand your specific hydration goals and limits, especially in the setting of CHF or kidney problems.
• Low blood sugar (hypoglycemia): Farxiga can potentially lower blood sugar levels when combined with other antidiabetic medications. Symptoms of hypoglycemia may include sweating, shaking, weakness, hunger, confusion, and dizziness. 
• Fournier’s gangrene: Although rare, Fournier’s gangrene is a severe infection of the genital area that may occur with Farxiga use. Symptoms include sudden severe pain in the genital or anal area, swelling, redness, and fever.
• Allergic reactions: Some individuals may experience allergic reactions to Farxiga, including rash, itching, swelling (especially of the face, tongue, or throat), severe dizziness, and trouble breathing. Seek immediate medical help if any allergic reaction is suspected.

RELATED: What happens if you stop taking Farxiga?

Interactions

Farxiga may interact with other medications, potentially leading to harmful effects or reducing the effectiveness of either drug. For example, combining Farxiga with insulin or insulin secretagogues may lead to hypoglycemia due to the additive effects of lowering blood sugar levels. Monitor blood sugar levels closely and consult a healthcare provider to adjust dosages when combining Farxiga with insulin or insulin secretagogues (sulfonylureas and meglitinides).

Drugs that may interact with Farxiga include:

• Insulin
• Repaglinide 
• Glimepiride 
• Glyburide 
• Glucotrol XL (glipizide extended-release) and glipizide regular-release
• Nateglinide

Consult a healthcare provider before combining Farxiga with any other medication, and discuss all drugs and supplements you’re currently taking to avoid harmful interactions. Review the prescribing information and medication guide for more information on Farxiga’s potential risks and interactions.

RELATED: What can I take instead of Farxiga?

Expert takeaway

“SGLT2 inhibitors, like Farxiga, are being prescribed in earnest by primary care providers and specialists in diabetes, heart, and kidney care. These three health conditions often occur together, so having a drug that provides important benefits to them all is clearly appealing,” says Chad Shaffer, MD, a member of the SingleCare Medical Board.