How long does Farxiga stay in your system?

In this article:

• How long does Farxiga stay in your system?
• What affects the duration?
• Side effects & risks
• How long do the side effects last?
• Accumulation and longevity
• Alternatives

In this article

• How long does Farxiga stay in your system?
• What affects the duration?
• Side effects & risks
• How long do the side effects last?
• Accumulation and longevity
• Alternatives

Farxiga is the brand name of dapagliflozin. It is a prescription drug used to treat Type 2 diabetes mellitus, along with exercise and dietary approaches, in adults and children who are 10 years or older. It belongs to the class of drugs called sodium-glucose co-transporter-2 inhibitors (SGLT2 inhibitors), which are prescribed alone or in combination with other diabetes medications like Glucophage (metformin) to manage blood sugar levels. Farxiga is also FDA approved for a certain type of heart failure.

Farxiga works by blocking the kidneys’ sodium-glucose cotransporter, which prevents glucose reabsorption into the blood. It causes the kidneys to remove excess glucose through urine, thereby lowering glucose levels in the blood. Farxiga usually starts working about two hours after taking a dose, but it may stay in your system for up to three days.

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How long does Farxiga stay in your system?

“Farxiga stays in the body for about two to three days after stopping the medication,” says Erika Gray, Pharm.D., Founder & Chief Medical Officer at ToolBox Genomics. It takes about 13 hours for half of it to be metabolized (called half-life). It takes about four to five half-lives for a medication to be fully metabolized, and for Farxiga, multiplying by 13 hours equals about two to three days.

After you take Farxiga, the medication reaches its peak in the blood approximately two hours after administration. Yet, to improve the conditions it treats, the medication must reach a steady state in the body. For the management of blood sugar, it may take two to three months to see the full clinical effect of Farxiga. For the management of heart disease, the peak effect can take approximately two to four weeks.

If you discontinue Farxiga, a blood or urine test can detect whether Farxiga is present in your system. However, this is not a routine test, and most regular clinics cannot conduct it. “Tests that are more common but can be indicators of Farxiga’s effect include blood glucose testing, urine glucose testing, and hemoglobin A1c (HbA1c),” Dr. Gray adds. “These show that the drug is causing sugar to leave in the urine and that blood sugar level is being lowered in effect.”

Factors that influence how long Farxiga stays in your system

Certain factors may influence the duration of time that Farxiga remains in your body.

Protein levels in your blood

After you take Farxiga, it travels through your bloodstream. Most of it, about 9 out of every 10 parts, attaches to proteins in your blood. The rest stays “free,” which means it can move into your body’s tissues to do its job.

The part that’s attached to proteins isn’t active right away, but it acts like a storage supply that releases the medicine slowly over time. This helps the effects of Farxiga last longer. If someone has lower protein levels in their blood (for example, due to illness or malnutrition), the medicine might behave a little differently—possibly working more strongly or clearing out of the body faster.

Kidney health

The kidney plays an important role in the elimination of Farxiga. “If your kidneys do not work as well, the medicine can stay in your system for longer,” Dr. Gray says, adding that Farxiga requires properly functioning kidneys to effectively lower blood sugar. If your kidney function is low, less sugar is removed through your urine, weakening the blood-sugar-lowering effect. 

Liver health

Your liver helps break down Farxiga before it leaves your body through the kidneys. If your liver isn’t working well, the medicine can build up and stay in your system longer than usual.

That doesn’t mean the medicine will be more effective. It just means there’s a higher chance of side effects. So if you have liver problems, your healthcare team may monitor you more closely to make sure the medication stays safe.

Side effects and risks of Farxiga

Common side effects of Farxiga include the urgent need to urinate more often (including at night), passing larger-than-usual amounts of urine, and penile or vaginal yeast infections. 

Other side effects of Farxiga may include:

• Sore throat
• Runny or stuffy nose
• Pain in the arm or legs
• Constipation
• Vaginal odor or itching
• Foul-smelling discharge, redness, or swelling of the penis
• Tiredness and weakness

Sometimes, serious side effects may occur. If you experience symptoms of a yeast infection or the following, it’s important to contact your healthcare provider immediately:

• Symptoms of urinary tract infections
• Dehydration, which may cause dark urine, dry mouth, lightheadedness, and dizziness
• Fever and back pain
• Symptoms of diabetic ketoacidosis, such as nausea and vomiting, abdominal pain, and difficulty breathing
• Symptoms of low blood sugar (hypoglycemia)
• Allergic reaction, which presents with symptoms like itching, rashes, hives, and swelling (especially of the throat, tongue, face, lips, eyes, or mouth)
  

Farxiga may not be ideal for everyone with Type 2 diabetes, and there may be drug interactions with some other medications. For instance, there is a risk of low blood sugar when it is combined with other diabetes medications like insulin or a sulfonylurea like Glucotrol (glipizide), Diamicron (gliclazide), and Amaryl (glimepiride).

It is best not to drink alcohol while on this medication, as alcohol can also cause changes in blood sugar. Although there is no evidence of Farxiga interacting with caffeine, it is advisable to consume coffee in moderation (or avoid it altogether) while taking Farxiga, as caffeinated beverages are considered risk factors for dehydration.

You may be at a higher risk of dehydration while on this medication if you are 65 years old, are on a low-sodium diet, have kidney conditions, or take hypertension medications. It is important to stand up slowly to avoid lightheadedness. 

How long does it take for side effects to go away after stopping Farxiga?

Farxiga is prescribed to be taken daily. “The starting dose is usually 5 mg by mouth daily, with a maximum dosage of 10 mg by mouth daily,” says Stacy Bruce, Pharm.D., BCPS, a pharmacist at UAB Medicine. 

You may experience side effects when you start using this medication. However, Dr. Bruce says the side effects of Farxiga often improve after your body gets used to taking the medication. If you discontinue the medication, it may take a few days to a few weeks for the side effects to resolve, while some side effects may take longer.

Important considerations and when to talk to your healthcare provider

Your healthcare provider will assess you to determine if Farxiga is the best treatment for you. This medication may not be ideal for:

• People with type 1 diabetes (T1D)
• People with Type 2 diabetes who have moderate to severe kidney problems
• People who have recently received immunosuppressive medications for treating kidney disease
• People with some genetic forms of polycystic kidney disease

Before you get on Farxiga, let your healthcare provider know if:

• You are pregnant or plan to become pregnant 
• You are breastfeeding
• You have had a history of diabetic ketoacidosis
• You follow a special diet, such as a ketogenic or low-sodium diet

Tell your healthcare team about any medical conditions and medications you are taking.

Don’t discontinue Farxiga without consulting your healthcare provider. “While there are no true withdrawal effects from stopping Farxiga, discontinuing the medication suddenly can cause your underlying medical condition (e.g., Type 2 diabetes, heart failure, or chronic kidney disease) to become worse,” Dr. Bruce says.

If you miss a dose of Farxiga, take it as soon as you remember. However, if it’s nearly time for the next dose, skip the one you missed and take the medicine at the next regularly scheduled time. 

Farxiga alternatives

If you feel Farxiga isn’t working for you or simply want to switch to a different medication, seek medical advice first. Your provider will discuss alternatives and their pros and cons with you.

The alternative options to Farxiga would depend on factors like your symptoms and the condition you are treating. They include:

• Other SGLT2 Inhibitors: These medications are typically used to manage blood sugar but may also lower blood pressure and body weight and improve heart function. In addition to Farxiga, Jardiance (empagliflozin) and Inpefa (sotagliflozin) are also approved for treating heart failure. 
• Glucagon-like peptide-1 receptor agonists (GLP-1 agonists): These medications enhance the secretion of insulin, the hormone that allows glucose to move from the bloodstream into the cells (lowering blood glucose levels). They also reduce appetite and generally improve glycemic control. GLP-1 agonists that may serve as alternatives to Farxiga include Ozempic (semaglutide) and Mounjaro (tirzepatide).
• Diuretics: Also called water pills, these are medications that help the kidneys remove excess water and salt through urine. By reducing fluid buildup in different parts of the body, they help reduce the heart’s workload and lower blood pressure. They are sometimes prescribed for heart failure and include Bumex (bumetanide) and Lasix (furosemide) 
• Angiotensin-converting enzyme (ACE) inhibitors: ACE inhibitors like Accupril (quinapril) and Lotensin (benazepril) act on blood vessels, widening them to lower blood pressure. They also offer protection to kidney health and are typically prescribed for the treatment of Type 2 diabetes.

Metformin and Victoza (liraglutide) are also common diabetes medicines your healthcare provider may prescribe in place of Farxiga. Making lifestyle and dietary modifications, like exercising more regularly and eating a low-calorie diet, can also help with diabetes management and improve overall well-being.