Who Can Take Farxiga
Farxiga is approved to treat 3 conditions: type 2 diabetes, heart failure and CKD.
When it comes to CKD, it works for people with or without diabetes. Farxiga is meant to slow the progression of chronic kidney disease and help prevent end-stage kidney disease, says James J. ODonnell, PhD. Hes an assistant professor at Rosalind Franklin University of Medicine and Science in North Chicago.
Farxiga isnt recommended for those with severe CKD who are on dialysis. Nor is it recommended for those with polycystic kidney disease or those who need or have recently undergone immunosuppressive therapy for kidney disease, says ODonnell.
Being told you have CKD can be overwhelming. But having this knowledge puts you in the drivers seat to take action. Thankfully there are more tools than ever at your disposal to halt CKD in its tracks.
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What Was Farxiga Previously Approved For
Originally, all SGLT2 Inhibitors, including Farxiga, were approved to help treat type 2 diabetes. However, during studies in the mid-2010s, researchers found that SGLT2 Inhibitors could also help lower the risk of heart and kidney problems in those with diabetes. Since then, some of the SGLT2 inhibitors have also been FDA-approved to lower the risk of death due to heart-related problems and treat CKD, but people taking them must also have type 2 diabetes.
This is where Farxiga has stood out from the crowd. Since May 2020, it has earned two FDA approvals that others in this class of medication have not. Currently, Farxiga is the only SGLT2 inhibitor that is approved to treat heart failure and CKD in people with or without diabetes. Because people without diabetes can also use Farxiga for these conditions, more people may be able to benefit from it compared to the other SGLT2 inhibitors at this time.
Type 2 Diabetes Mellitus
Improve glycemic control
- Indicated as an adjunct to diet and exercise to improve glycemic control with type 2 diabetes mellitus
- Initial: 5 mg PO qDay in AM
- May increase to 10 mg qDay in patients tolerating 5 mg/day who require additional glycemic control
Reduce risk of hospitalization for heart failure
- Indicated to reduce hospitalization risk for heart failure in adults with T2DM and established cardiovascular disease or multiple CV risk factors
- 10 mg PO qDay in AM
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How Can I Prevent It
Diabetic kidney disease can be prevented by keeping blood glucose in your target range. Research has shown that tight blood glucose control reduces the risk of microalbuminuria by one third. In people who already had microalbuminuria, the risk of progressing to macroalbuminuria was cut in half. Other studies have suggested that tight control can reverse microalbuminuria.
Farxiga Shows Potential To Protect Millions Of People With Chronic Kidney Disease
SGLT-2 inhibitor Farxiga shows impressive results from its latest clinical trial: it slows the loss of kidney function and reduces the risk of death in people with chronic kidney disease, with or without type 2 diabetes
In amazing news, Farxiga is found to be a very effective treatment for chronic kidney disease. Farxiga is an SGLT-2 inhibitor drug commonly used to lower glucose in people with type 2 diabetes. In a recent clinical trial , Farxiga was used to treat people who had chronic kidney disease, with or without type 2 diabetes. The trial found that Farxiga slows the worsening of kidney function and is now the first medicine to significantly reduce the risk of death for people with chronic kidney disease.
Chronic kidney disease is a serious health complication in which the kidneys cannot properly filter the fluids that normally pass through them. Chronic kidney disease affects about 37 million people in the United States and according to the American Kidney Fund, diabetes is the primary cause of chronic kidney disease. Read diaTribes article on chronic kidney disease and view our infographic on diabetes and kidney disease to learn how to support the health of your kidneys.
Farxiga has been in the news several times now for its positive results and protective benefits:
To learn more SGLT-2 inhibitors, including their pros and cons, click here.
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What To Tell Your Doctor
Before starting Farxiga, tell your doctor if you:
- Have a history of kidney, pancreas, or liver problems
- Have type 1 diabetes or have had diabetic ketoacidosis in the past
- Are planning to have surgery in the near future
- Have recently changed your diet or are planning to change your diet
- Have a history of urinary tract infections or urinary issues
- Drink alcohol often or binge drink
- Are pregnant or may become pregnant
- Are breastfeeding or plan to breastfeed
- Are taking any other medications, vitamins, or supplements
Read the prescribing information to learn more about Farxiga.1
The Molecular Actions Of Dapagliflozin
Dapagliflozin is a potent selective reversible inhibitor of SGLT2 in the kidney. The selectivity of dapagliflozin for SGLT2 is at least 1200-fold greater than that for SGLT1 . SGLT2 is exclusively expressed in the proximal tubule of the kidney . In contrast, SGLT1, with which SGLT2 shares 59% identity, is also expressed in the brain, the heart, and in the intestinal epithelium, where it is involved in water and glucose uptake. Indeed, it has been estimated that almost half the daily uptake of water from the small intestine occurs via SGLT1 dependent pathways . Moreover, SGLT1 also serves as the intestinal glucose sensor for glucose-induced incretin secretion , a key component in glycaemic control. These characteristics potentially make SGLT1 a less acceptable clinical target, and selectivity for SGLT2 a desirable property.
There are no clear data that dapagliflozin has actions beyond inhibition of SGLT2 and the induction of glycosuria. Its parent compound, the plant-derived dihydrochalcone phlorizin has been associated with actions on other targets including histone deacetylase, the sodium iodide symporter, as well as antioxidant activities . However, these may reflect its other actions on SGLT1 or other receptors.
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Farxiga For Weight Loss
While Farxiga isnt 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 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.
Its thought that Farxiga causes weight loss because it sends extra glucose 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 doctors prescription. You shouldnt use Farxiga for weight loss or any other purpose without your doctors guidance.
Farxiga can be used by itself or along with other diabetes and heart failure medications.
What Should I Tell My Health Care Provider Before Taking Qtern Or Farxiga
Before you take QTERN or FARXIGA, tell your health care provider:
- all of your medical conditions, including problems with your kidneys, liver, bladder, heart or pancreas
- if you have had, or have risk factors for, ketoacidosis
- if you are pregnant, or plan to become pregnant.QTERN or FARXIGA may harm your unborn baby
- if you are breastfeeding or plan to breastfeed. It is unknown if QTERN or FARXIGA passes into your breast milk. Breastfeeding is not recommended while taking QTERN
- about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements
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What Other Drugs Could Interact With This Medication
There may be an interaction between dapagliflozin and any of the following:
- alpha lipoic acid
- atypical antipsychotics
- buserelin
- other diabetes medications
- disopyramide
- diuretics
- estrogens
- everolimus
- hepatitis C antivirals
- HIV protease inhibitors
- hydroxychloroquine
- inhaled corticosteroids
- lanreotide
- monoamine oxidase inhibitors
- oral corticosteroids
- pasireotide
- progestins
- quinine
- quinolone antibiotics
- selective serotonin reuptake inhibitors
- sirolimus
- sulfonamide antibiotics
- sunitinib
- triptorelin
- vorinostat
If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:
- stop taking one of the medications,
- change one of the medications to another,
- change how you are taking one or both of the medications, or
- leave everything as is.
An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.
Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter , and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.
What Stages Of Ckd Is Farxiga Approved To Treat
Currently Farxiga is not approved for a specific stage of CKD, but rather to help prevent your CKD from getting worse and to help lower the risk of developing ESRD. In the clinical trial that earned this medication its CKD approval, Farxiga was studied in people with moderate kidney damage and an eGFR between 25 mL/min and 75 mL/min. Because of this, people whose eGFR is below 25 mL/min should not take Farxiga unless they started taking it when their eGFR was higher.
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Can Farxiga Cause Hair Loss
No, Farxiga should not cause hair loss. This was not a side effect reported in studies of people taking Farxiga.
But its possible that diabetes can cause hair loss. This is due having too much sugar in your blood, which can cause damage to the blood supply that nourishes your hair.
If you experience bothersome hair loss while taking Farxiga, talk with your doctor. They can help determine whats causing the hair loss and the best way to treat it.
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 doesnt lower your blood sugar levels enough , 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.
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Farxiga Dosages And Recommendations
Farxiga comes in two strengths: 5 mg and 10 mg.
The recommended starting dose is 5 mg taken once daily in the morning with or without food. For patients who need additional glycemic control, doctors may increase the dose to 10 mg.
Patients should get their kidneys tested before starting Farxiga or Xigduo XR.
Farxiga and Xigduo XR are not recommended in patients with major kidney impairment, according to the medication insert. Doctors should monitor kidney function in patients taking Farxiga.
What Are The Possible Side Effects Of Qtern Or Farxiga
QTERN or FARXIGA may cause serious side effects including:
The most common side effects of QTERN include upper respiratory tract infection, urinary tract infection, and abnormal amounts of fats in the blood .
The most common side effects of FARXIGA include yeast infections of the vagina or penis, and changes in urination, including urgent need to urinate more often, in larger amounts, or at night.
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Who Should Not Take Qtern Or Farxiga
Do not take QTERN or FARXIGA if you:
- are allergic to dapagliflozin , saxagliptin or any of the ingredients in QTERN. Symptoms of a serious allergic reaction may include: swelling of the face, lips, throat and other areas of your skin difficulty with swallowing or breathing skin rash, itching, flaking or peeling raised red areas on your skin . If you have any of these symptoms, stop taking QTERN or FARXIGA and call your health care provider or go to the hospital emergency room right away
- have moderate to severe kidney problems or are on dialysis. Your health care provider should do blood tests to check how well your kidneys are working before and during your treatment with QTERN or FARXIGA
What Farxiga Does For Diabetes
Farxiga belongs to a class of drugs called sodium-glucose co-transporter 2 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.
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Jardiance Vs Invokana Vs Farxiga
In 2013, the U.S. Food and Drug Administration approved the first medication in a new class of drugs to fight type 2 diabetes mellitus, known as SGLT2 inhibitors. Since then several other drugs in the class have been approved to help lower blood sugar in people with diabetes.
The most popular SGLT2 inhibitors today are:
- Farxiga/Forxiga – made by AstraZeneca
- Invokana – made by Janssen Pharmaceuticals, a division of Johnson & Johnson
- Jardiance – made by Boehringer Ingelheim
Together, these three drugs accounted for more than $3.4 billion in sales in 2017. According to the pharmaceutical companies’ most recent annual reports, sales of both Farxiga and Jardiance increased significantly over the previous year, while Invokana’s sales decreased somewhat.
Given the growth in the use of all three SGLT2 inhibitors over the last five years, we’ve put together a comparison between the most popular SGLT2 inhibitors to help you understand the relative risks of each. While the action of the mechanism is the same – they all block the sodium-glucose co-transporter 2 protein – there are some differences between each of these diabetes medicines. In particular, they differ to some degree in terms of side effects, drug interactions, and contraindications .
Important: This comparison should not be considered as medical advice. Talk to your doctor or pharmacist if you have any questions about how these diabetes drugs could affect you.
But Isnt Farxiga Used To Treat Chronic Kidney Disease
In April 2021, the US Food and Drug Administration approved Farxiga to reduce the risk of kidney function decline, kidney failure, cardiovascular death and hospitalization for heart failure in adults with CKD who are at risk of disease progression.
A large phase III trial called DAPA-CKD, which was conducted in patients with or without diabetes who had CKD stages 2-4, found that treatment with Farxiga was beneficial in this group of patients and prolonged survival. Patients with stage 2 kidney disease have a mild form of kidney disease, while those with stage 4 disease have moderate to severe damage to their kidneys.
Despite being approved for use in certain patients with CKD, Fargixa is not recommended for the treatment of type 2 diabetes in patients with a estimated glomerular filtration rate of less than 45 ml/min/1.73m2, which indicates stage 3 kidney disease.
Before prescribing Farxiga, doctors will also consider factors such as whether you have congestive heart failure, decreased blood volume, or take medications such as a diuretic, angiotensin-converting enzyme inhibitor, angiotensin receptor blocker or nonsteroidal anti-inflammatory drug , which may put you at greater risk of developing AKI while taking Farxiga.
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Do Not Take Farxiga If You:
- are allergic to dapagliflozin or any of the ingredients in FARXIGA. Symptoms of a serious allergic reaction may include skin rash, raised red patches on your skin , swelling of the face, lips, tongue, and throat that may cause difficulty in breathing or swallowing. If you have any of these symptoms, stop taking FARXIGA and contact your healthcare provider or go to the nearest hospital emergency room right away
- have severe kidney problems or are on dialysis. Your healthcare provider should do blood tests to check how well your kidneys are working before and during your treatment with FARXIGA
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 its taken. And it reaches its peak effect about 2 hours after its been taken. When first starting Farxiga, it may take days to weeks to see the drugs full effects on your blood sugar level.
Its not known for sure how quickly Farxiga works to lower the risk of certain complications in people with heart failure.
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What Should I Tell My Healthcare Provider Before Taking Farxiga
Before you take FARXIGA, tell your healthcare provider:
- all of your medical conditions, including problems with your kidneys, liver, bladder, or pancreas
- if you have had, or have risk factors for, ketoacidosis
- if you are pregnant, or plan to become pregnant. FARXIGA may harm your unborn baby
- if you are breastfeeding, or plan to breastfeed. It is unknown if FARXIGA passes into your breast milk
- about all the medicines you take, including prescription and nonprescription medicines, vitamins, and herbal supplements
Other Possible Uses For Farxiga
The FDA hasnt 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 its not approved to treat type 1 diabetes. In one clinical study , Farxiga reduced blood sugar levels, hemoglobin A1c ,* and total daily insulin doses in people with type 1 diabetes. However, right now theres 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 isnt recommended.
* A1C is a measurement that shows your average blood sugar levels over the past 2 to 3 months. The American Diabetes Association 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 hasnt been studied or approved as an aid to weight loss. You should only take Farxiga as prescribed by your doctor.
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