Farxiga is a brand-name prescription medication. It’s approved for different uses in adults with type 2 diabetes or heart failure.

In people with type 2 diabetes, it’s approved to:

  • improve blood sugar levels when used along with improved diet and exercise
  • reduce the risk of hospitalization for heart failure in people with heart disease or risk factors for heart disease

In people with heart failure with or without type 2 diabetes, it’s approved to:

  • reduce the risk of either hospitalization for heart failure or cardiovascular death* in people with reduced ejection fraction (EF)

It’s important to note that Farxiga isn’t approved to treat type 1 diabetes. And the drug also shouldn’t be used to treat a condition called diabetic ketoacidosis (DKA). (DKA is a life threatening condition that’s related to diabetes.)

* Cardiovascular death is death that’s related to a heart or blood vessel problem.

† With reduced EF, your heart isn’t able to pump out as much blood to the rest of your body as usual.

Drug details

Farxiga can be used by itself or along with other diabetes and heart failure medications.

Farxiga comes as a tablet you take by mouth once daily. It contains the active drug dapagliflozin. And it belongs to a class of medications called sodium-glucose co-transporter 2 (SGLT2) inhibitors.

Effectiveness

In clinical studies, Farxiga decreased fasting blood sugar* levels in people with type 2 diabetes by up to 28.8 milligrams per deciliter (mg/dL). And the drug lowered their hemoglobin A1c (A1C) level by up to 0.9% after 24 weeks of treatment.

About 44% to 51% of people in the studies who took Farxiga for 24 weeks reached their goal A1C of less than 7%.

To learn about Farxiga’s effectiveness for its other approved uses, see the “Farxiga uses” section on below.

* Fasting blood sugar is measured after you’ve fasted for a certain period of time. The American Diabetes Association (ADA) recommends a fasting blood sugar level of 80 mg/dL to 130 mg/dL for most adults.

† A1C is a measurement that shows your average blood sugar levels over the past 2 to 3 months. The ADA recommends an A1C goal of less than 7% for most adults.

Farxiga is only available as a brand-name drug. It contains the drug dapagliflozin, which isn’t currently available in generic form.

Farxiga can cause mild or serious side effects. The following list contains some of the key side effects that may occur while taking Farxiga. This list doesn’t include all possible side effects.

For more information on the possible side effects of Farxiga, or tips on how to deal with a troubling side effect, talk with your doctor or pharmacist.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs it has approved. If you would like to report to the FDA a side effect you’ve had with Farxiga, you can do so through MedWatch.

More common side effects

The more common side effects of Farxiga can include:

  • vaginal yeast infection
  • respiratory infections, such as the common cold or the flu
  • urinary tract infection
  • increased urination
  • genital infection in men
  • back pain
  • nausea
  • increased cholesterol levels

Some of these side effects may go away within a few days or a couple of weeks. If they’re severe or don’t go away, talk to your doctor or pharmacist.

* This is a partial list of mild side effects from Farxiga. To learn about other mild side effects, talk with your doctor or pharmacist, or visit Farxiga’s medication guide.

Serious side effects

Serious side effects from Farxiga aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency.

Serious side effects and their symptoms can include the following:

  • Dehydration (low fluid level) and low blood pressure. Symptoms can include:
    • dizziness
    • feeling faint
    • lightheadedness
    • weakness, especially when you stand up
  • Low blood sugar level (hypoglycemia). Symptoms can include:
    • drowsiness
    • headache
    • confusion
    • weakness
    • hunger
    • irritability
    • sweating
    • feeling jittery
    • fast heartbeat
  • Severe allergic reaction.*
  • Kidney damage.*
  • Serious urinary tract infections (UTIs).*
  • Ketoacidosis.*
  • Fournier’s gangrene (necrotizing fasciitis of the perineum).*

* For information about these serious side effects of Farxiga, see the “Side effect details” section just below.

Side effect details

You may wonder how often certain side effects occur with this drug, or whether certain side effects pertain to it.Here’s some detail on several of the side effects this drug may or may not cause.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Farxiga. In clinical studies, 0.3% of people who took Farxiga had an allergic reaction to it.

Symptoms of a mild allergic reaction can include:

  • skin rash
  • itchiness
  • flushing (warmth and redness in your skin)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your tongue, mouth, or throat
  • trouble breathing

Call your doctor right away if you have a severe allergic reaction to Farxiga. But call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency.

Weight loss

A beneficial side effect of Farxiga is weight loss. In clinical studies, people taking Farxiga lost up to about 7 pounds (3 kilograms) over 24 weeks of treatment.

Farxiga should only be used according to your doctor’s prescription. You shouldn’t use Farxiga without your doctor’s guidance.

Bladder cancer

There may be a connection between Farxiga and bladder cancer, but it’s not certain.

In clinical studies, more people taking Farxiga had bladder cancer compared to people taking a placebo.

In 22 studies, 6,045 people took Farxiga and 10 had bladder cancer. In the 3,512 people who took a placebo or a comparison drug, one person had bladder cancer. (A placebo is a treatment with no active drug.)

However, according to the Food and Drug Administration (FDA), there isn’t enough information to know if Farxiga was the cause of bladder cancer in these cases.

Back pain

In clinical studies, back pain occurred in up to 4% of people taking Farxiga. This side effect may go away with continued used of the drug. If you have back pain that doesn’t go away or becomes severe, talk with your doctor.

Kidney damage

Farxiga can increase your risk of kidney damage. Symptoms of kidney damage can include:

  • reduced urination
  • swelling in your legs or ankles
  • confusion

This side effect didn’t occur in clinical tests of Farxiga, but later reports have mentioned it.

Kidney problems are more likely to occur if you’re dehydrated, have kidney or heart problems, or are over the age of 65 years. They’re also more likely if you take other medications that affect your kidneys.

Before you start taking Farxiga, your doctor will test how well your kidneys are working. If you have kidney problems, you may not be able to take Farxiga.

Your doctor may also test your kidney function from time to time during your treatment with Farxiga. If they detect any problems with your kidneys, they may stop your treatment with the drug.

Yeast infection

Farxiga can increase your risk of genital yeast infection. In clinical studies, yeast infection occurred in up to about 8% of women and about 3% of men taking Farxiga.

Genital yeast infection in men can cause a rash or redness on the penis. This condition is called balanitis or balanoposthitis, depending on what part of the penis is affected.

If you take Farxiga and get a rash or redness on your genitals, talk with your doctor. They may prescribe a medication to treat the infection.

Urinary tract infection (UTI)

Farxiga can increase your risk of urinary tract infection (UTI). In clinical studies, UTI occurred in up to about 6% of people taking the drug.

Symptoms of UTI can include:

  • burning sensation when urinating
  • the need to urinate more often
  • the need to urinate right away
  • pain in the lower part of your abdomen (belly)
  • blood in your urine

If you think you might have a UTI, call your doctor. They can check to see if you have a UTI, and they’ll recommend treatment if needed.

Ketoacidosis

Although uncommon, some people who take Farxiga can develop a serious condition called diabetic ketoacidosis.

This condition occurs when the cells of your body aren’t getting the glucose they need for energy. Instead, your body uses fat for energy, which can cause high levels of chemicals in your blood called ketones. Also, your blood can become too acidic. In severe cases, this condition can cause coma or death.

The first symptoms of ketoacidosis typically include:

  • thirst and dry mouth
  • urinating more often than usual
  • high blood sugar levels
  • high levels of ketones in your urine

Later symptoms may include:

  • nausea and vomiting
  • pain in your abdomen (belly)
  • weakness or fatigue (lack of energy)
  • fruity-smelling breath
  • trouble breathing
  • confusion

If you have any of these symptoms, call your doctor right away. If your symptoms are severe, call 911 or go to the nearest emergency room.

Fournier’s gangrene

While it hasn’t occurred in clinical studies of Farxiga, a condition called Fournier’s gangrene has been reported in people using Farxiga and other drugs in its class.

Also called necrotizing fasciitis of the perineum, it’s an infection of the area between the genitals and the rectum. This condition is rare but can be life threatening, and it can affect both men and women.

Symptoms of Fournier’s gangrene can include:

  • pain, tenderness, swelling, or reddening in the genital or rectal area
  • fever
  • malaise (overall feeling of discomfort)

Fournier’s gangrene requires immediate care, which could include medication, hospitalization, or surgery. If you’re taking Farxiga and have symptoms of this condition, call your doctor right away.

Typically, your doctor will start you on a low dosage of Farxiga and may increase it to reach the dosage that’s right for you. Their goal will be the smallest dosage that provides the desired effect.

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to suit your needs.

Drug forms and strengths

Farxiga comes as a tablet you take by mouth. It’s available in two strengths: 5 milligrams (mg) and 10 mg.

Dosage for type 2 diabetes

The typical starting dosage of Farxiga for type 2 diabetes is 5 mg once daily. This dose is taken in the morning.

If this dosage of Farxiga doesn’t lower your blood sugar levels enough (and it also doesn’t cause troubling side effects), your doctor may increase your dosage to 10 mg once daily.

The maximum dosage of Farxiga for type 2 diabetes is 10 mg once daily.

The dosage to reduce the risk of hospitalization for heart failure in people with type 2 diabetes and heart disease or risk factors for heart disease is 10 mg once daily.

Dosage for heart failure

Farxiga is approved to lower the risk of certain complications of heart failure in adults who don’t have type 2 diabetes. (For more information about this, see the section below called “Farxiga uses.”) The typical dosage for this use is 10 mg once daily.

What if I miss a dose?

If you miss a dose, take it as soon as you remember. If it’s almost time for your next dose, just take that one dose. Don’t try to catch up by taking two doses at once. This can cause dangerous side effects.

Will I need to use this drug long term?

Farxiga is meant to be used as a long-term treatment. If you and your doctor determine that Farxiga is safe and effective for you, you’ll likely take it long term.

Do I need to take this drug with food?

Farxiga can be taken with or without food.

The Food and Drug Administration (FDA) approves prescription drugs such as Farxiga to treat certain conditions. Farxiga may also be used off-label for other conditions. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.

Below, we describe Farxiga’s approved uses. But it’s important to note that Farxiga isn’t approved to treat type 1 diabetes. And the drug also shouldn’t be used to treat diabetic ketoacidosis (DKA), which is a life threatening condition that’s related to diabetes.

Farxiga for type 2 diabetes

Farxiga is FDA-approved for use in adults with type 2 diabetes to:

  • improve blood sugar levels when used along with improved diet and exercise
  • reduce the risk of hospitalization for heart failure in people with either heart disease or risk factors* for heart disease

Diabetes is a chronic (long-lasting) condition. With diabetes, the level of sugar (glucose) in your bloodstream builds up. Normally, a hormone called insulin helps to move glucose from your bloodstream into your cells. (Once inside your cells, glucose is used to make energy.)

But with type 2 diabetes, your body’s cells don’t respond to insulin as well as they should. And in the later stages of diabetes, your body also might not make enough insulin.

Having type 2 diabetes that’s not managed can cause your blood glucose level to be high all the time. And this can cause several symptoms that may lead to serious complications, such as heart failure.

* Some examples of risk factors for heart disease include being of an older age, having high cholesterol or high blood pressure, and smoking.

How type 2 diabetes and heart failure are connected

Many of the risk factors and changes in bodily functions are the same for both type 2 diabetes and heart failure. So both of these conditions can be a risk factor for the other.

For example, having too much sugar and insulin in your bloodstream also causes fatty buildup and inflammation in your blood vessels. This weakens your heart and can lead to heart failure. On the other hand, having heart failure is linked to metabolic problems (problems with your body’s ability to process energy). And this can lead to uncontrolled blood sugar and diabetes.

In clinical studies, people with type 2 diabetes were two to four times more likely to develop heart failure. They also had a 50% higher risk of hospitalization than someone without diabetes.

If you have heart failure without diabetes, you have up to a 60% risk of developing insulin resistance. (With insulin resistance, your body’s insulin isn’t working as it should to move glucose from your bloodstream into your cells.)

Because of the link between type 2 diabetes and heart failure, drugs like Farxiga can help improve both conditions.

Effectiveness for glucose control in type 2 diabetes

A large number of clinical trials have been performed on Farxiga in people with type 2 diabetes. In some studies, different doses of Farxiga alone were compared with a placebo (treatment with no active drug).

In other studies, combinations of Farxiga and other diabetes drugs were compared with a placebo or different diabetes drug. These other diabetes drugs include metformin, glipizide, glimepiride, glyburide, pioglitazone, sitagliptin, exenatide, and insulin.

One clinical study compared treatment with Farxiga alone to that of a placebo in people with newly diagnosed type 2 diabetes. After 24 weeks of treatment:

  • people taking Farxiga 5 mg had their fasting blood sugar* levels decreased by 24.1 mg/dL and their hemoglobin A1c (A1C) level was lowered by 0.8%.
  • people taking Farxiga 10 mg had their fasting blood sugar levels decreased by 28.8 mg/dL and their A1C level lowered by 0.9%.
  • people taking the placebo had their fasting blood sugar levels decreased by 4.1 mg/dL and their A1C level lowered by 0.2%.

About 44% to 51% of people in this study who took Farxiga for 24 weeks reached their goal A1C of less than 7%. In the placebo group, only about 32% of people reached their goal.

Other clinical studies looked at treatment with Farxiga in combination with other diabetes drugs in people with type 2 diabetes. The studies showed that the people had similar or better results as people taking Farxiga alone.

* Fasting blood sugar is measured after you’ve fasted for a certain period of time. The American Diabetes Association (ADA) recommends a fasting blood sugar level of 80 mg/dL to 130 mg/dL for most adults.

† A1C is a measurement that shows your average blood sugar levels over the past 2 to 3 months. The ADA recommends an A1C goal of less than 7% for most adults.

Effectiveness for reducing hospitalization risk from heart failure in type 2 diabetes

In a clinical study, people taking Farxiga had a 27% lower rate of hospitalization due to heart failure than did people taking a placebo. (A placebo is a treatment with no active drug.) People in this study had type 2 diabetes. And they were followed for about 4 years.

Farxiga for heart failure

Farxiga is approved for use in adults with heart failure who don’t have type 2 diabetes. For this use, the drug is given to people with reduced ejection fraction (EF)* to reduce the risk of either:

  • hospitalization for heart failure, or
  • death that’s related to a heart or blood vessel problem [LP2]

* With reduced EF, your heart isn’t able to pump out as much blood to the rest of your body as usual.

With heart failure, your heart isn’t working as well to pump blood throughout your body. Without enough blood flow, your body can’t function normally. Typical symptoms of heart failure can include:

  • shortness of breath
  • tiredness
  • edema (swelling) in your legs, ankles, and feet

Effectiveness for reducing death in heart failure

In a clinical study, people taking Farxiga had an 18% lower rate of death due to heart or blood vessel problems compared with people taking a placebo. (A placebo is a treatment with no active drug). People in this study were followed for 18 months.

Effectiveness for reducing hospitalization risk of heart failure

In the same clinical study as above, people taking Farxiga had a 30% lower likelihood of being hospitalized for heart failure compared with people taking a placebo.

Other possible uses for Farxiga

The FDA hasn’t approved other uses for Farxiga. However, the drug may be used off-label for certain purposes. Off-label use is when a drug is approved for one purpose but is prescribed for a different purpose.

Farxiga for type 1 diabetes

Farxiga is approved to treat type 2 diabetes. But it’s not approved to treat type 1 diabetes. In one clinical study, Farxiga reduced blood sugar levels, hemoglobin A1c (HbA1c),* and total daily insulin doses in people with type 1 diabetes. However, right now there’s not enough information available on the safety and effectiveness of using Farxiga in people with type 1 diabetes. So the use of Farxiga for type 1 diabetes isn’t recommended.

* A1C is a measurement that shows your average blood sugar levels over the past 2 to 3 months. The American Diabetes Association (ADA) recommends an A1C goal of less than 7% for most adults.

Farxiga for weight loss

Many people with diabetes who take Farxiga lose weight, which is a beneficial side effect. Your doctor may recommend Farxiga for you if you have type 2 diabetes and are also overweight.

But keep in mind that Farxiga hasn’t been studied or approved as an aid to weight loss. You should only take Farxiga as prescribed by your doctor.

While Farxiga isn’t approved as a weight-loss medication, weight loss is a beneficial side effect of the drug.

In clinical studies, people taking Farxiga lost up to about 7 pounds (3 kilograms) over 24 weeks of treatment. Because of this side effect, your doctor may recommend Farxiga if you have type 2 diabetes and are also overweight.

It’s thought that Farxiga causes weight loss because it sends extra glucose (sugar) from your blood into your urine. That means the calories from the glucose leave your body in your urine, which may lead to weight loss.

Note: Farxiga should only be used according to your doctor’s prescription. You shouldn’t use Farxiga for weight loss or any other purpose without your doctor’s guidance.

Farxiga can be used by itself or along with other diabetes and heart failure medications.

Farxiga and other diabetes medications

Farxiga can be used alone or along with other diabetes medications to treat type 2 diabetes. If a single drug, such as Farxiga, doesn’t lower your blood sugar or hemoglobin A1c (HbA1c)* levels enough, your doctor may prescribe two or more diabetes drugs.

Examples of other diabetes drugs that may be used with Farxiga include:

* A1C is a measurement that shows your average blood sugar levels over the past 2 to 3 months. The American Diabetes Association (ADA) recommends an A1C goal of less than 7% for most adults.

Farxiga and metformin

Farxiga and metformin (Glucophage, Glumetza, Riomet) are commonly used together to treat type 2 diabetes. In clinical studies, taking Farxiga plus metformin reduced blood sugar levels, HbA1c, and weight more than when either drug was taken by itself.

Farxiga and Bydureon

Farxiga is sometimes used with Bydureon (exenatide) to treat type 2 diabetes. In one study, taking Farxiga plus Bydureon reduced HbA1c more than when either drug was taken by itself.

Farxiga and glimepiride

Farxiga is sometimes used with glimepiride (Amaryl) to treat type 2 diabetes. In a study, taking Farxiga and glimepiride together reduced fasting blood sugar levels, HbA1c, and weight more than when glimepiride was taken alone.

Farxiga and other heart medications

Farxiga may be taken with other drugs used to treat heart problems. These drugs include:

Avoid drinking too much alcohol while taking Farxiga. Alcohol can change your blood sugar levels and increase your risk of low blood sugar.

If you drink alcohol, talk to your doctor about how much alcohol is safe for you while taking Farxiga.

Farxiga can interact with several other medications. It can also interact with certain supplements as well as certain foods.

Different interactions can cause different effects. For instance, some can interfere with how well a drug works, while others can cause increased side effects.

Farxiga and other medications

Below is a list of medications that can interact with Farxiga. This list doesn’t contain all drugs that may interact with Farxiga.

Before taking Farxiga, be sure to tell your doctor and pharmacist about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Farxiga and drugs that increase the risk of low blood sugar (hypoglycemia)

Taking Farxiga with certain medications can lower your blood sugar levels and increase your risk of hypoglycemia. If you take these medications, you may need to check your blood sugar levels more often. Also, your doctor may need to change the dosage of your diabetes medications.

Examples of these medications include:

Farxiga and drugs that increase blood sugar levels

Taking Farxiga with certain medications can increase your blood sugar levels. This can cancel out some or all of the effects of Farxiga. If you take these medications, you may need to check your blood sugar levels more often. Also, your doctor may need to increase your Farxiga dosage.

Examples of these medications include:

Farxiga and drugs that lower blood pressure

Taking Farxiga with certain medications that decrease blood pressure may cause your blood pressure to become too low. It may also increase your risk of kidney damage.

Examples of these medications include:

Farxiga and herbs and supplements

Taking certain herbs and supplements with Farxiga may increase your risk of low blood sugar levels (hypoglycemia). Examples of these include:

Other drugs are available that can treat your condition. Some may be better suited for you than others. If you’re interested in finding an alternative to Farxiga, talk to your doctor to learn more about other medications that may work well for you.

Alternatives for type 2 diabetes

Some of these alternative medications for type 2 diabetes are in the same class as Farxiga, while others are in different drug classes. Examples of these drugs include:

  • sodium-glucose co-transporter 2 (SGLT2) inhibitors, such as:
    • ertugliflozin (Steglatro)
  • incretin mimetics/glucagon-like peptide-1 (GLP1) receptor agonists, such as:
    • lixisenatide (Adlyxin)
  • metformin (Glucophage, Glumetza, Riomet), which is a biguanide
  • dipeptidyl peptidase-4 (DPP-4) inhibitors, such as:
    • alogliptin (Nesina)
    • linagliptin (Tradjenta)
    • saxagliptin (Onglyza)
  • thiazolidinediones, such as:
    • pioglitazone (Actos)
    • rosiglitazone (Avandia)
  • alpha-glucosidase inhibitors, such as:
    • miglitol (Glyset)
  • sulfonylureas, such as:

Alternatives for heart failure

Examples of other drugs that may be used to reduce the risk of certain complications in people with heart failure include:

You may wonder how Farxiga compares to other medications that are prescribed for similar uses. Below are comparisons between Farxiga and several medications.

Farxiga vs. Jardiance

Farxiga and Jardiance (empagliflozin) are both in the same class of medications: sodium-glucose co-transporter 2 (SGLT2) inhibitors. This means they work in the same way to treat type 2 diabetes.

Uses

Both Farxiga and Jardiance are FDA-approved to improve blood sugar control in adults with type 2 diabetes when used with improved diet and exercise.

Farxiga is also approved to reduce the risk of hospitalization for heart failure in adults with type 2 diabetes. For this use, Farxiga is prescribed for adults who have heart disease or risk factors for heart disease.

In addition, Farxiga is used to reduce the risk of certain complications from heart failure in adults who don’t have type 2 diabetes.

Jardiance is also FDA-approved to reduce the risk of heart disease-related death in people with both type 2 diabetes and heart disease.

Drug forms and administration

Both Farxiga and Jardiance come as tablets that are taken by mouth once daily in the morning.

Side effects and risks

Farxiga and Jardiance have similar effects in the body and therefore cause very similar side effects. Below are examples of these side effects.

More common side effects

More common side effects that can occur with both Farxiga and Jardiance include:

  • vaginal yeast infection
  • respiratory infections such as the common cold or flu
  • urinary tract infection
  • increased urination
  • genital infection in men
  • back pain
  • nausea
  • increased cholesterol levels

Serious side effects

Serious side effects that can occur with both Farxiga and Jardiance include:

  • dehydration (low fluid level) and low blood pressure
  • ketoacidosis (increased ketones in the blood or urine)
  • kidney damage*
  • serious urinary tract infections
  • low blood sugar (hypoglycemia)
  • severe allergic reaction

* Both Farxiga and Jardiance can cause kidney damage. However, an analysis of studies found that the risk of kidney damage may be higher in people who take Farxiga compared to those who take Jardiance.

Effectiveness

The only condition both Farxiga and Jardiance are used to treat is type 2 diabetes. The effectiveness of these drugs in treating this condition hasn’t been directly compared in clinical studies. However, they have been indirectly compared in several analyses of clinical studies.

The effects of Farxiga and Jardiance on hemoglobin A1c (HbA1c) are very similar. But a 2016 analysis of studies found that Jardiance may reduce HbA1c slightly more than Farxiga does. Another 2016 analysis also found that Jardiance may reduce HbA1c a little more than Farxiga does.

The two drugs have also been compared in other areas:

  • Reducing heart risks:One analysis found that Jardiance may reduce the risk of heart failure and dying from heart disease in people who have type 2 diabetes. And an analysis of studies found that Farxiga reduced heart failure symptoms in people with type 2 diabetes whose symptoms were getting worse.
  • Lowering blood pressure:Both Farxiga and Jardiance can reduce blood pressure in people with type 2 diabetes. One analysis found that Jardiance and Farxiga worked about equally well to reduce blood pressure.
  • Causing weight loss: Both Farxiga and Jardiance can also reduce weight in people with type 2 diabetes. In an analysis of studies, the two drugs worked about equally well for weight loss.

Costs

Both Farxiga and Jardiance are available as brand-name drugs. They’re not available in generic forms, which typically cost less than brand-name forms.

Farxiga may cost a little more than Jardiance. The exact price you pay for either drug depends on your insurance plan.

Farxiga vs. Invokana

Farxiga and Invokana (canagliflozin) are both in the same class of medications: sodium-glucose co-transporter 2 (SGLT2) inhibitors. This means they work in the same way to treat type 2 diabetes.

Uses

Both Farxiga and Invokana are FDA-approved to improve blood sugar control in adults with type 2 diabetes when used with improved diet and exercise.

Farxiga is also approved to reduce the risk of hospitalization for heart failure in adults with type 2 diabetes. For this use, Farxiga is prescribed for adults who have heart disease or risk factors for heart disease.

In addition, Farxiga is used to reduce the risk of certain complications from heart failure in adults who don’t have type 2 diabetes.

Invokana is also approved to lower the risk of heart attack and stroke in people with both type 2 diabetes and cardiovascular disease (CVD).

In addition, in people with type 2 diabetes and diabetic nephropathy (a type of kidney disease caused by diabetes) with albuminuria (too much protein in your urine), Invokana is approved to reduce the risk of:

Drug forms and administration

Both Farxiga and Invokana come as tablets that are taken by mouth, once daily in the morning.

Side effects and risks

Farxiga and Invokana have similar effects in the body, and therefore cause very similar side effects. Below are examples of these side effects.

More common side effects

These lists contain some of the more common mild side effects that can occur with each drug, as well as mild side effects that both drugs may share.

  • Can occur with Farxiga:
    • respiratory infections, such as the common cold or flu
    • back pain
  • Can occur with Invokana:
    • thirst
  • Can occur with both Farxiga and Invokana:
    • urinary tract infection
    • increased urination
    • nausea
    • genital infection in men
    • increased cholesterol
    • constipation

Serious side effects

These lists contain examples of serious side effects that can occur with Farxiga or Invokana, as well as serious side effects that both drugs may share

  • Can occur with Farxiga:
    • few unique serious side effects
  • Can occur with Invokana:
    • high potassium levels
    • bone fracture
    • limb amputation*
  • Can occur with both Farxiga and Invokana:
    • kidney damage
    • serious urinary tract infections
    • severe allergic reaction

* Invokana has a boxed warning from the FDA about limb amputation. A boxed warning is the strongest warning the FDA requires. It alerts doctors and patients about drug effects that may be dangerous.

Effectiveness

Both Farxiga and Invokana are used to treat type 2 diabetes and reduce the risk of certain heart-related problems in people with type 2 diabetes. The effectiveness of these drugs in treating type 2 diabetes hasn’t been directly compared in clinical studies. However, they have been indirectly compared in analyses of clinical studies.

The effects of Farxiga and Invokana on hemoglobin A1c (HbA1c) have been found to be similar. But a 2016 analysis of studies found that Invokana may reduce HbA1c more than Farxiga does. Another 2016 analysis also found that Invokana may reduce HbA1c more than Farxiga does.

The two drugs have also been compared in other areas:

  • Lowering blood pressure:Both Farxiga and Invokana can reduce blood pressure in people with type 2 diabetes. One analysis found that Invokana and Farxiga worked about equally well to reduce blood pressure.
  • Causing weight loss: Both Farxiga and Invokana can reduce weight in people with type 2 diabetes. In an analysis of studies, people taking Invokana had slightly more weight loss than people taking Farxiga.
  • Improving heart failure symptoms: Both Farxiga and Invokana can reduce symptoms of worsening heart failure in people with type 2 diabetes. One analysis found that Invokana and Farxiga worked about equally well in reducing heart failure symptoms.

Costs

Both Farxiga and Invokana are available as brand-name drugs. They’re not available in generic forms, which typically cost less than brand-name forms.

Farxiga and Invokana cost about the same amount. The exact price you pay for either drug will depend on your insurance plan.

You should take Farxiga according to your doctor’s instructions.

Timing

Farxiga should be taken in the morning.

Taking Farxiga with food

Farxiga can be taken with or without food.

Can Farxiga be crushed?

The manufacturer of Farxiga hasn’t stated whether it’s safe to crush Farxiga. Therefore, it might be safer to avoid crushing it.

Farxiga helps improve blood sugar levels in people with type 2 diabetes. It also helps lower the risk of complications from heart failure in certain people.

How insulin affects blood sugar

Normally, when you eat food, your body releases a hormone called insulin. Insulin helps transport glucose (sugar) from your bloodstream into the cells of your body. The cells then turn the glucose into energy.

People with type 2 diabetes usually have insulin resistance. This means their body doesn’t respond to insulin the way it should. Over time, people with type 2 diabetes may also stop producing enough insulin.

When your body doesn’t respond to insulin the way it should, or if it doesn’t produce enough insulin, this causes problems.

The cells of your body may not get the glucose they need to work correctly. Also, you may get too much glucose in your blood. This is called high blood sugar (hyperglycemia). Having too much glucose in your blood can damage your body and organs, including your eyes, heart, nerves, and kidneys.

What Farxiga does for diabetes

Farxiga belongs to a class of drugs called sodium-glucose co-transporter 2 (SGLT2) inhibitors. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

Farxiga lowers your blood sugar levels by causing your kidneys to get rid of excess sugar in your blood through your urine.

What Farxiga does for heart failure

Farxiga likely treats symptoms of heart failure in many different ways. Symptoms of heart failure that may be reduced with Farxiga include:

  • chest pain
  • shortness of breath
  • edema (swelling) in your legs, ankles, and feet

The possible ways that Farxiga may work to treat heart failure include:

  • Lowering sodium. Farxiga causes your body to get rid of extra sodium through your urine. Having too much sodium in your body can lead to high blood pressure, which makes your heart work harder than usual. And over time, high blood pressure may make your heart muscle thicken and be unable to pump as well as usual.
  • Reducing edema. Farxiga helps to reduce edema (swelling) in your body. With heart failure, your heart is weakened and can’t pump blood as well as usual. This can lead to fluid buildup, which causes swelling.
  • Increasing the strength of your heart. Farxiga improves your heart’s energy supply by helping your body turn blood sugar into energy. This results in your heart having more strength to pump blood. Well-managed blood sugar levels also reduce stress and inflammation in your blood vessels and heart.
  • Reducing muscle thickening in your heart. Farxiga reduces thickening of the muscle wall in your heart’s left ventricle. (The left ventricle is the main pumping chamber of the heart.) In one type of heart failure, the left ventricle is weakened because its wall is too thick. This causes problems with how well your heart is able to pump blood.

How long does it take to work?

In people with diabetes, Farxiga begins to work to lower blood sugar levels within 30 to 60 minutes of when it’s taken. And it reaches its peak (highest) effect about 2 hours after it’s been taken. When first starting Farxiga, it may take days to weeks to see the drug’s full effects on your blood sugar level.

It’s not known for sure how quickly Farxiga works to lower the risk of certain complications in people with heart failure.

There are limited studies on this drug’s effects on human pregnancies. However, based on animal studies that have shown that kidney problems can occur in a fetus, Farxiga shouldn’t be used during the second and third trimesters of pregnancy.

During the first trimester, Farxiga should only be used if the potential benefit outweighs the potential risks.

If you’re pregnant or planning to become pregnant, talk with your doctor about the risks and benefits of using Farxiga during pregnancy.

It isn’t known if Farxiga passes into breast milk. If you’re planning to breastfeed, you and your doctor should decide together whether you should take this drug or breastfeed.

Here are answers to some frequently asked questions about Farxiga.

Do Farxiga and metformin both cause weight loss?

Yes, both Farxiga and metformin (another drug used to treat diabetes) can cause weight loss. In clinical studies, people taking Farxiga lost up to about 7 pounds (3 kilograms) over 24 weeks of treatment. In clinical studies of metformin, mild weight loss has also occurred, usually from less than 1 pound (0.5 kilograms) up to about 8 pounds (4 kilograms).

When these medications are taken together, people usually lose more weight than when taking these drugs by themselves.

Is Farxiga a diuretic?

No, Farxiga isn’t classified as a diuretic. Farxiga is in a class of medications called sodium-glucose co-transporter 2 (SGLT2) inhibitors.

However, Farxiga has some effects that are similar to the effects of diuretics. For instance, Farxiga can make you urinate more and can cause dehydration, which diuretics can also do. (With dehydration, you have a low fluid level in your body.)

Does Farxiga make you tired?

Tiredness isn’t a side effect that has occurred in studies of Farxiga. However, tiredness is a possible symptom of heart failure, which Farxiga is used to help manage.

However, fatigue (lack of energy) and weakness can be signs of dehydration (low fluid level) and low blood sugar. And these conditions are both possible side effects of Farxiga.

Does Farxiga cause constipation?

Yes, it can. Some people who take Farxiga can have constipation. In clinical studies, this effect occurred in about 2 percent of people who took Farxiga.

Taking too much of this medication can increase your risk of serious side effects.

Overdose symptoms

There is very little information about the symptoms you might have if you take too much Farxiga. Possible symptoms of an overdose might include:

What to do in case of overdose

If you think you’ve taken too much of this drug, call your doctor or seek guidance from the American Association of Poison Control Centers at 800-222-1222 or through their online tool. But if your symptoms are severe, call 911 or go to the nearest emergency room right away.

As with all medications, the cost of Farxiga can vary. To find current prices for Farxiga in your area, check out GoodRx.com.


The cost you find on GoodRx.com is what you may pay without insurance. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

Your insurance plan may require you to get prior authorization before approving coverage for Farxiga. This means that your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug. The insurance company will review the prior authorization request and decide if the drug will be covered.

If you’re not sure if you’ll need to get prior authorization for Farxiga, contact your insurance company.

Financial and insurance assistance

If you need financial support to pay for Farxiga, or if you need help understanding your insurance coverage, help is available.

AstraZeneca, the manufacturer of Farxiga, offers a savings card that may lower the cost of Farxiga. For more information and to find out if you’re eligible for support, visit the program website.

Generic version

Farxiga isn’t available in a generic form. (A generic drug is an exact copy of the active drug in a brand-name medication.) Generics tend to cost less than brand-name drugs.

Before taking Farxiga, talk with your doctor about your health history. Farxiga may not be right for you if you have certain medical conditions. These include:

  • Kidney disease: Farxiga could worsen kidney damage. If your kidney function worsens during your treatment, your doctor may have you stop taking this drug. Don’t take this medication if you have severe kidney disease or if you’re on dialysis. (Dialysis is a process that’s used to remove extra fluids and waste from your blood when your kidneys can’t do it.)
  • High cholesterol: Farxiga may increase your cholesterol levels. If you already have high cholesterol, your doctor will likely monitor your cholesterol levels closely during your treatment with this drug.
  • Risk factors for dehydration: Farxiga may increase your risk of dehydration (low fluid level). This is the case if you’re ages 65 years and older, maintaining a low salt diet, have kidney problems, or are taking drugs to lower your blood pressure. With dehydration, you may feel faint, dizzy, weak, and have low blood pressure, especially when you stand up suddenly. Talk with your doctor about these symptoms. And ask your doctor how much fluid you should drink every day to help avoid dehydration.

When Farxiga is dispensed from the pharmacy, the pharmacist adds an expiration date to the label on the container. This date is typically 1 year from the date the medication was dispensed.

The expiration date helps guarantee that the medication is effective during this time. The current stance of the Food and Drug Administration (FDA) is to avoid using expired medications. However, an FDA study showed that many medications may still be good beyond the expiration date listed on the bottle.

Storage

How long a medication remains good can depend on many factors, including how and where the medication is stored. Farxiga tablets should be stored at a room temperature of 68°F to 77°F (20°C to 25°C).

Disposal

If you no longer need to take Farxiga and have leftover medication, it’s important to dispose of it safely. This helps prevent others, including children and pets, from taking the drug by accident. It also helps keep the drug from harming the environment.

This article provides several useful tips on medication disposal. You can also ask your pharmacist for information on how to dispose of your medication.

The following information is provided for clinicians and other healthcare professionals.

Indications

Farxiga is approved for the following indications in adults:

  • Type 2 diabetes. For this condition, Farxiga is used:
    • in combination with exercise and diet to improve blood glucose management.
    • to lower the risk of hospitalization due to heart failure in adults with type 2 diabetes who have existing cardiovascular disease (CVD) or multiple risk factors for CVD.
  • Heart failure with or without type 2 diabetes. For this condition, Farxiga is indicated to lower the risk of hospitalization and cardiovascular death in adults who have heart failure with reduced ejection fraction (EF).

Farxiga should not be used to treat either type 1 diabetes or diabetic ketoacidosis (DKA).

Mechanism of action

Farxiga blocks the sodium-glucose co-transporter 2 (SGLT2) in the proximal renal tubules. This prevents reabsorption of filtered glucose from the renal tubules. The result is osmotic diuresis due to excess excretion of urinary glucose.

Farxiga also lowers reabsorption of sodium and increases distal tubular sodium delivery. This likely decreases both cardiac preload and afterload, and reduces sympathetic activity, thus attenuating heart failure symptoms.

Pharmacokinetics and metabolism

After oral administration, maximum concentration occurs within 2 hours. Administration with a high-fat meal reduces the maximum concentration by about 50 percent and increases the time to maximum concentration by about an hour. However, this doesn’t have a clinically significant effect, and Farxiga can be taken with or without food.

The oral bioavailability of Farxiga is 78%.

Farxiga is primarily metabolized by UGT1A9. Metabolism via cytochrome P450 enzymes is considered a minor pathway.

The half-life of Farxiga is about 13 hours.

Administration

Farxiga is administered orally. It is available in two strengths: 5 mg and 10 mg.

Contraindications

Farxiga is contraindicated in people who:

  • have a history of a severe hypersensitivity reaction to Farxiga
  • have severe renal impairment with an eGFR of less than 30 mL/minute/1.73 m2
  • are on dialysis

Storage

Farxiga should be stored at a room temperature of 68°F to 77°F (20°C to 25°C).

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.