Farxiga

Jul 23, 2022

Generic name:  dapagliflozin  [ DAP-a-gli-FLOE-zin ]
Drug class:  SGLT-2 inhibitors

What is Farxiga?

Farxiga is an oral diabetes medicine that helps control blood sugar levels. Dapagliflozin works by helping the kidneys get rid of glucose from your bloodstream.

Farxiga is used together with diet and exercise to improve blood sugar control in adults with type 2  diabetes mellitus . This medicine is not for treating  type 1 diabetes .

Farxiga is also used to lower the risk of death from  heart attack , stroke, or heart failure in adults with type 2 diabetes who also have heart disease.

Farxiga is also used to lower the risk of needing to be in the hospital for  heart failure  in adults with  type 2 diabetes  who also have heart disease.

Farxiga is also used to lower the risk of further worsening of kidney disease, end-stage kidney disease (ESKD), death due to cardiovascular disease, and hospitalization for heart failure in adults with  chronic kidney disease .

Warnings

You should not use Farxiga if you have  diabetic ketoacidosis , severe kidney disease, or if you are on dialysis.

Tell your doctor if you are sick with  vomiting  or  diarrhea , or if you eat or drink less than usual.

Taking Farxiga can make you dehydrated, which could cause you to feel weak or dizzy (especially when you stand up).

Farxiga can cause serious infections in the penis or vagina. Get medical help right away if you have burning, itching, odor, discharge, pain, tenderness, redness or swelling of the genital or rectal area, fever, or if you don’t feel well.

Some people taking this medicine have had bladder cancer, but it is not clear if dapagliflozin was the actual cause.

Before taking this medicine

You should not use Farxiga if you are allergic to dapagliflozin, or if you have:

  • severe kidney disease (or if you are on dialysis); or
  • diabetic ketoacidosis  (call your doctor for treatment).

To make sure Farxiga is safe for you, tell your doctor if you have ever had:

  • polycystic kidney disease ;
  • liver disease ;
  • bladder infections or other urination problems;
  • problems with your pancreas, including surgery;
  • alcoholism , or if you currently drink large amounts of alcohol; or
  • if you are on a low salt diet.

Follow your doctor’s instructions about using Farxiga if you are pregnant or you become pregnant. Controlling diabetes is very important during pregnancy.

You should not use dapagliflozin during the second or third trimester of pregnancy.

Do not breastfeed.

Farxiga is not approved for use by anyone younger than 18 years old.

How should I take Farxiga?

Take Farxiga exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose.

You may take Farxiga with or without food.

Your blood sugar will need to be checked often, and you may also need to test the level of ketones in your urine. Dapagliflozin can cause life-threatening ketoacidosis (too much acid in the blood). Even if your blood sugar is normal, contact your doctor if a urine test shows that you have high ketones in the urine.

Blood sugar can be affected by  stress , illness, surgery, exercise, alcohol use, or skipping meals.

Low blood sugar  (hypoglycemia) can make you feel very hungry, dizzy, irritable, or shaky. To quickly treat  hypoglycemia , eat or drink hard candy, crackers, raisins, fruit juice, or non-diet soda. Your doctor may prescribe  glucagon  injection in case of severe hypoglycemia.

You may get dehydrated during prolonged illness. Call your doctor if you are sick with vomiting or diarrhea, or if you eat or drink less than usual.

This medicine can affect the results of certain medical tests. Tell any doctor who treats you that you are using Farxiga.

Your treatment may also include diet, exercise, weight control, and special medical care.

Store at room temperature away from moisture and heat.

Farxiga dosing information

Usual Adult Dose for Diabetes Type 2:

To improve glycemic control:
Initial dose: 5 mg orally once a day
-May increase to 10 mg orally once a day for additional glycemic control if lower dose has been tolerated
Maximum dose: 10 mg/day

To reduce the risk of hospitalization for heart failure: 10 mg orally once a day

Comments:
-Correct volume depletion prior to initiating therapy.
-Ensure adequate renal function (eGFR greater than 45 mL/min/1.73 m2) as glycemic efficacy is dependent on adequate renal function.
-If used in combination with  insulin  or an  insulin  secretagogue, a lower dose of insulin or the insulin secretagogue should be considered to reduce the risk of hypoglycemia.

Uses:
-As an adjunct to diet and exercise to improve glycemic control in patients with type 2 diabetes mellitus.
-To reduce the risk of hospitalization for heart failure in patients with type 2 diabetes mellitus and established cardiovascular disease (CVD) or multiple cardiovascular (CV) risk factors.

Usual Adult Dose for Heart Failure with Reduced Ejection Fraction:

10 mg orally once a day

Comments:
-Correct volume depletion prior to initiating therapy.
-This drug is not recommended for patients with type 1 diabetes mellitus.

Use: To reduce the risk of cardiovascular death and hospitalization for heart failure in adults with heart failure (NYHA class II-IV) with reduced ejection fraction.

Usual Adult Dose for Chronic Kidney Disease:

10 mg orally once a day

Comments:
-Correct volume depletion prior to initiating therapy.
-This drug is not recommended in patients with polycystic kidney disease or patients requiring, or with a recent history of immunosuppressive therapy for kidney disease, as it is not expected to be effective.
-This drug is not recommended for patients with type 1 diabetes mellitus.

Use: To reduce the risk of sustained eGFR decline, end-stage kidney disease, cardiovascular death, and
hospitalization for heart failure in adults with  chronic kidney disease  at risk of progression.

Detailed Farxiga dosage information

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking Farxiga?

Avoid drinking alcohol.

Farxiga Farxiga and alcohol  (more detail)

Avoid getting up too fast from a sitting or lying position, or you may feel dizzy.

Farxiga side effects

Get emergency medical help if you have signs of an allergic reaction to Farxiga:  hives ; difficult breathing; swelling of your face, lips, tongue, or throat.

Seek medical attention right away if you have signs of a genital infection (penis or vagina): burning, itching, odor, discharge, pain, tenderness, redness or swelling of the genital or rectal area, fever, not feeling well. These symptoms may get worse quickly.

Call your doctor at once if you have:

  • dehydration –  dizziness , confusion, feeling very thirsty, less urination;
  • kidney problems – little or no urination, swelling in your feet or ankles, feeling tired or short of breath;
  • ketoacidosis (too much acid in the blood) –  nausea , vomiting, stomach pain, confusion, unusual drowsiness, or trouble breathing; or
  • signs of a  bladder infection –pain or burning when you urinate, increased urination, blood in your urine, fever, pain in your pelvis or back.

Some side effects may be more likely to occur in older adults.

Common Farxiga side effects may include:

  • genital yeast infection;
  • urinating more than usual; or
  • sore throat  and runny or stuffy nose.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Farxiga side effects  (more detail)

What other drugs will affect Farxiga?

Other drugs may increase or decrease the effects of Farxiga on lowering your blood sugar. Tell your doctor about all your current medicines and any you start or stop using, especially:

  • insulin  or other oral diabetes medicines; or
  • a diuretic or “water pill.”

This list is not complete. Other drugs may interact with dapagliflozin, including prescription and over-the-counter medicines,  vitamins , and  herbal products . Not all possible drug interactions are listed here.

source :: https://www.drugs.com/farxiga.html