Dapagliflozin
Farxiga
Farxiga, containing Dapagliflozin, an FDA-approved SGLT2 inhibitor, is prescribed primarily for type 2 diabetes. It effectively lowers blood sugar levels by aiding the kidneys in removing glucose through urine. It is typically available in tablet form with strengths of 5 mg and 10 mg. It is taken orally once daily, often in conjunction with diet, exercise, or other antidiabetic medications. Side effects like urinary tract and genital yeast infections may occur, requiring prompt reporting to healthcare providers. Patients with kidney issues or urinary tract infections should take caution while using it. Store Farxiga at room temperature, away from moisture and heat. Follow your healthcare provider’s instructions diligently for safe and optimal use.
Product Overview
Farxiga (Dapagliflozin) belongs to a class of drugs called sodium-glucose cotransporter 2 (SGLT2) inhibitors. Farxiga is primarily used for the treatment of type 2 diabetes mellitus. It works by aiding the kidneys in clearing glucose from the bloodstream through the urine, thereby lowering blood sugar levels. This mechanism of action helps improve glycemic control in individuals with type 2 diabetes.
Farxiga is available in tablet form with strengths of 5 mg and 10 mg. The medication is taken orally, usually once daily, with or without food. It is suitable for adults having type 2 diabetes who require additional management beyond diet and exercise or other antidiabetic medications. Farxiga may also be prescribed in combination with other diabetes medications to optimize blood sugar control.
Farxiga may cause side effects such as increased urination, genital yeast infections, and urinary tract infections. You should report any severe reactions to your healthcare provider. Precautions should be taken in people with a history of kidney diseases or urinary tract infections. In case of a missed dose, patients should take it as soon as possible unless it’s almost time for the next dose. Overdose may lead to dehydration and electrolyte imbalances. Farxiga should be kept at room temperature, away from dampness and heat, and out of reach of children. You should adhere to the guidelines provided by your healthcare providers regarding the use of Farxiga to ensure safe and effective treatment.
Uses
Targeted Treatment
- Type 2 diabetes
[Important warning: Farxiga is not approved for children and the treatment of type 1 diabetes].
Benefits
- Lowering blood sugar levels.
- Reduces the events of cardiovascular events in diabetic patients.
- Decrease the risk of end-stage kidney disease.
[Note: Do not take Farxiga without consulting your doctor. They will determine whether you need this medication based on your conditions.]
Farxiga Dosage
Forms & Strengths
Form: Oral tablet
Strengths: 5mg, 10mg
Recommended Dosages
For Type 2 Diabetes
-
- For Adults: The initial dose is 5 mg orally once daily. If needed, the dose can be increased to 10 mg orally once daily.
- For Heart Patients: The recommended dosage is 10 mg orally once daily.
- For Kidney Patients: 10 mg orally once daily is the typical dosage to reduce the risk of further worsening of kidney disease.
-
- Those with eGFR lower than 45 ml/min/1.73 m² may continue on 10 mg orally once daily.
- Initiation in patients with an estimated glomerular filtration rate (eGFR) lower than 25 ml/min/1.73 m² is not recommended.
[Note: These Farxiga recommendations may vary from person to person. Discuss it with your doctor, and they’ll customize your Farxiga dosage accordingly.]
How to Take It?
- Take Farxiga orally, usually once daily.
- It can be taken with or without food.
- Swallow the Farxiga tablet whole with a full glass of water.
- Follow the dosage guidance provided by your healthcare provider.
[Note: Your healthcare professional will determine the right amount of Farxiga for you based on your condition. They may adjust it as needed over time.]
How Does Farxiga Work?
Farxiga works by inhibiting the sodium-glucose cotransporter 2 (SGLT2) in the kidneys. This action prevents the reabsorption of sugar back into the bloodstream, resulting in improved glucose excretion in the urine. By promoting the elimination of excess glucose, it helps to lower blood glucose levels in those with type 2 diabetes mellitus. This mechanism of action offers an additional avenue for glycemic control beyond insulin and other antidiabetic medications, making Farxiga a valuable treatment option for managing diabetes.
Important Safety Information
Side Effects
Common side effects of Farxiga may include:
- Urinary tract infections
- Genital yeast infections
- Increased urination
- Nasopharyngitis (common cold)
Mild side effects of Farxiga may include:
- Headache
- Nausea
- Back pain
- Increased thirst
Serious side effects of Farxiga may include:
- Hypotension (low blood pressure)
- Dehydration
- Ketoacidosis (a serious complication of diabetes)
- Acute kidney injury
- Hypoglycemia, when used in combination with insulin or insulin secretagogues
- Pancreatitis (inflammation of the pancreas)
- Serious urinary tract infections or genital infections
[Note: This list may not cover all possible Farxiga side effects. Always consult with your healthcare giver for medical advice about side effects.]
Warnings
- Genital Yeast Infections: Farxiga may increase the risk of genital yeast infections, especially in women. Patients should be advised to watch for symptoms such as itching, burning, or unusual discharge and to seek medical help if these signs occur.
- Urinary Tract Infections (UTIs): Farxiga may increase the risk of urinary tract infections. You should learn about the signs and symptoms of UTIs, such as painful urination or frequent urination, and be advised to seek medical attention if these symptoms occur.
- Dehydration and Hypotension: Farxiga can lead to dehydration and a decrease in blood pressure, particularly in elderly patients or those with kidney problems. Patients should be instructed to drink a sufficient amount of liquids, particularly during hot weather or vigorous exercise, and to be cautious when standing up quickly to avoid dizziness or fainting.
- Ketoacidosis: There have been reports of ketoacidosis (a severe condition where the body creates high levels of blood acids called ketones) associated with Farxiga use, particularly in patients with type 1 diabetes or those with a history of ketoacidosis. You should seek medical attention immediately if you encounter signs such as nausea, vomiting, abdominal pain, confusion, or difficulty breathing.
- Renal Impairment: For individuals with type 2 diabetes mellitus, it’s advised not to initiate Farxiga treatment if their estimated glomerular filtration rate (eGFR) is below 45 ml/min/1.73 m² to enhance blood sugar management. Starting Farxiga in patients with an eGFR below 25 ml/min/1.73 m² isn’t recommended for certain indications. Nevertheless, ongoing treatment might potentially mitigate the risk of progressive renal decline, end-stage kidney disease, cardiovascular incidents, and hospitalizations due to heart failure.
- Lower Limb Amputation: There have been reports of an increased risk of lower limb amputation (such as toe, foot, or leg) associated with Farxiga use, particularly in patients with a history of cardiovascular disease or peripheral vascular disease. You should monitor for signs of infection or ulcers in the lower limbs and seek medical attention promptly if any abnormalities occur.
Boxed Warning
- Diabetic Ketoacidosis: Farxiga may increase the risk of diabetic ketoacidosis, a serious condition necessitating urgent medical care that could result in coma or death. It’s not suitable for patients with type 1 diabetes. Caution is advised in individuals with risk factors for ketoacidosis, including a history of pancreatitis, alcohol misuse, or decreased caloric intake. You should closely monitor the signs and symptoms of ketoacidosis, such as nausea, vomiting, abdominal pain, confusion, and unusual fatigue. If ketoacidosis is suspected or confirmed, discontinue Farxiga promptly.
Precautions
- Dehydration Risk: Patients should be advised to maintain adequate hydration, particularly during periods of increased fluid loss, such as hot weather or vigorous exercise. Farxiga may increase the risk of dehydration, particularly in older people or those with renal issues.
- Hypoglycemia: When used in combination with insulin or insulin secretagogues, Farxiga may increase the risk of hypoglycemia (low blood sugar). You should learn about the signs and symptoms of low blood glucose and how to manage it.
- Surgery and Illness: Patients should inform healthcare providers that they are taking Farxiga before undergoing surgery or if they become ill. Temporary discontinuation of Farxiga may be necessary during these periods.
- Pediatric and Geriatric Use: The safety and efficacy of Farxiga in pediatric patients or elderly patients aged 65 and older have not been established. Use in these populations should be approached with caution.
Contraindications
- Known hypersensitivity to Dapagliflozin or any other components.
- Patients who are undergoing dialysis
Missed Dose
- If a dose of Farxiga is missed, it should be taken as soon as remembered on the same day.
- If the missed dose is not remembered until the following day, you should skip the missed dose and resume your standard dosing plan.
- Double doses should not be taken to make up for the missed one.
- You should not take more than one dose of Farxiga in a single day.
[Note: If you have missed a dose of your medication and are unsure about when to take the next one, immediately consult your healthcare professional or pharmacist.]
Overdose
Call your doctor if you notice these symptoms of overdose:
- Hypotension
- Dehydration
- Electrolyte imbalances
- Impaired renal function
[Note: If you consumed more than the recommended Farxiga dose, get medical help right away or call the Poison Help line at 1-800-222-1222.]
Storage
- Farxiga should be kept at room temperature (20°C to 25°C).
- It should be kept in its original box, tightly closed, and distant from moisture and light.
- Keep Farxiga out of reach of children and pets.
- Do not use Farxiga beyond the expiration date printed on the packaging.
- If any unused or expired medication needs to be disposed of, follow local regulations or consult a healthcare professional for guidance on proper disposal methods.
[Note: Consult your healthcare professional about the correct disposal of any unused Farxiga medicine and any questions you may have regarding its storage.]
Farxiga Interactions
- Amlodipine
- Aspirin
- Atorvastatin
- Carvedilol
- Clopidogrel
- Eliquis (apixaban)
- Entresto (sacubitril / valsartan)
- Fenofibrate
- Gabapentin
- Glimepiride
- Glipizide
- Hydrochlorothiazide
- Januvia (sitagliptin)
- Levothyroxine
- Lisinopril
- Losartan
- Metformin
- Metoprolol
- Omeprazole
- Ozempic (semaglutide)
- Pantoprazole
- Potassium chloride
- Rosuvastatin
- Spironolactone
- Tamsulosin
- Trulicity (dulaglutide)
- Vitamin B12 (cyanocobalamin)
- Vitamin D3 (cholecalciferol)
Alcohol/Food Interaction: It’s essential to be cautious when consuming alcohol while taking this medication.
[Note: This list doesn’t contain all the medicines that may interact with Farxiga. Make sure to tell your healthcare professional about any prescription, over-the-counter drug, and herbal products you’re taking.]
Farxiga Alternatives
- Invokana (canagliflozin)
- Jardiance (empagliflozin)
- Canagliflozin (canagliflozin)
- Steglatro (ertugliflozin)
- Empagliflozin (empagliflozin)
- Dapagliflozin (dapagliflozin)
- Qtern (dapagliflozin/saxagliptin)
- Synjardy (empagliflozin/metformin)
[Note: Your doctor will choose what’s the best alternative to Farxiga for you. Don’t use any of these alternative drugs without consulting your healthcare professional. Taking them without consultation may cause serious side effects.]
Quick Tips
Frequently Asked Questions
1. Can Farxiga cause kidney damage?
Farxiga may cause acute kidney injury (AKI). Symptoms to watch out for include urinating less or swelling in your legs or feet. Before starting Farxiga, your doctor will assess if you are at increased risk for AKI. Postmarketing studies revealed that some patients on SGLT2 inhibitors required hospitalization and dialysis due to AKI. Farxiga was initially approved for type-2 diabetes but later also for heart failure and chronic kidney disease (CKD). It’s essential to monitor kidney function while using Farxiga.
2. Does Farxiga cause weight loss?
It is possible that Farxiga leads to modest weight loss, even though it’s not specifically a weight loss drug. Clinical studies revealed that patients taking Farxiga (5 mg or 10 mg daily) lost almost 6 pounds over 24 weeks. The initial weeks of treatment may cause faster weight loss, likely due to fluid loss, followed by a gradual decline in weight loss.
3. How long does it take for Farxiga to work?
Farxiga starts working after just one dose. However, it may take approximately a week for Farxiga to take full effect. In patients with type 2 diabetes, Farxiga prevents sugar reabsorption in the kidneys, resulting in improved glucose excretion in urine. The drug is rapidly absorbed, reaching maximum blood plasma concentrations within 2 hours. For heart failure, Farxiga eases the heart’s workload by altering sodium levels in the kidneys. Its mechanism in chronic kidney disease (CKD) is related to reducing intraglomerular pressure.
4. What is the recommended dosage of Farxiga?
The recommended dosage for Farxiga depends on the patient’s estimated glomerular filtration rate (eGFR):
- For glycemic control in adults having type 2 diabetes mellitus and an eGFR of 45 or greater, start with 5 mg orally once daily. It can be raised to 10 mg for additional control.
- For other indications, the starting dose is 10 mg orally once daily.
- Those with an eGFR of 25 to less than 45 can also take 10 mg once daily.
- For eGFR less than 25, initiation is not recommended, but patients may continue 10 mg to reduce the risk of kidney decline and cardiovascular events.
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