Farxiga (Dapagliflozin) Tablets

Farxiga (generic name: dapagliflozin) is a prescription oral medication manufactured by AstraZeneca. It belongs to the sodium-glucose co-transporter 2 (SGLT2) inhibitor class of drugs, mirroring the mechanism and profile of medications like Jardiance.

1. Approved Uses (Indications)

Farxiga is prescribed for adults (and in some cases, children) to manage three primary chronic health conditions:

• Type 2 Diabetes: Used alongside diet and exercise to lower blood sugar levels in adults and children aged 10 and older. It is also indicated to reduce the risk of hospitalization for heart failure in adults with type 2 diabetes who have established cardiovascular disease or multiple cardiovascular risk factors.

• Heart Failure: Approved for adults to reduce the risk of cardiovascular death, hospitalization for heart failure, and urgent heart failure visits. It is effective regardless of whether the patient has diabetes.

• Chronic Kidney Disease (CKD): Prescribed to adults at risk of disease progression to reduce the risk of sustained kidney function decline (eGFR decline), end-stage kidney disease (ESKD), cardiovascular death, and heart failure hospitalizations.

Note: Farxiga is not indicated for the treatment of type 1 diabetes.

2. How it Works (Mechanism of Action)

Farxiga works directly on the kidneys by blocking the SGLT2 proteins. Because these proteins are responsible for reabsorbing sugar from the kidney filters back into the blood, blocking them allows the kidneys to excrete excess glucose through the urine.

This process also shifts fluid and sodium out of the body. The resulting drop in blood pressure and intravascular volume alleviates stress on both the heart and the kidneys, providing organ protection that extends beyond blood sugar management.

3. Dosage and Appearance

• Form: Film-coated oral tablets.

• Strengths & Appearance:

  • 5 mg: Yellow, round, biconvex tablets engraved with “5” on one side and “1427” on the reverse.

  • 10 mg: Yellow, biconvex, diamond-shaped tablets engraved with “10” on one side and “1428” on the reverse.

• Administration: Taken once daily, typically in the morning, with or without food.

  • For type 2 diabetes, the standard starting dose is 5 mg, which can be increased to 10 mg if extra glycemic control is needed.

  • For heart failure and chronic kidney disease, the standard therapeutic dose is 10 mg once daily from the start.

4. Key Side Effects & Warnings

Excreting sugar and fluids through the urinary system yields specific side-effect profiles:

• Common: Vaginal yeast infections, yeast infections of the penis (balanitis), and urinary tract infections (UTIs). Nasopharyngitis (common cold symptoms) and increased urination are also common.

• Volume Depletion (Dehydration): The fluid-flushing effect can cause low blood pressure (hypotension), dizziness, or lightheadedness, particularly in elderly patients or those taking blood pressure medications like diuretics.

• Serious Warnings:

  • Diabetic Ketoacidosis (DKA): A rare, critical condition where the blood becomes highly acidic. DKA associated with SGLT2 inhibitors can present with normal or only moderately elevated blood sugar levels (euglycemic DKA). Farxiga is typically paused at least 3 days before scheduled surgeries to lower this risk.

  • Fournier’s Gangrene: A rare but life-threatening bacterial infection targeting tissues under the skin in the perineal and genital areas.

  • Hypoglycemia: Low blood sugar risk increases significantly if Farxiga is combined with insulin or insulin-stimulating medications like sulfonylureas.