Farxiga dosage, forms, and strengths

Farxiga is a brand-name prescription drug that helps to control blood sugar in people with Type 2 diabetes mellitus. It is also prescribed to reduce the risk of heart failure in people with Type 2 diabetes who have heart disease, to reduce the risk of hospitalization and death in people with congestive heart failure, and slow the progression of chronic kidney disease. Dapagliflozin, the active ingredient in Farxiga, works on the kidneys to reduce both glucose and sodium levels in the blood. 

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Farxiga forms and strengths

Farxiga film-coated tablets are prescribed in two dose strengths:

• Tablets: 5 mg, 10 mg

Farxiga dosage for adults

Farxiga is used along with diet and exercise to control blood sugar in people diagnosed with Type 2 diabetes. However, Farxiga is not prescribed to people diagnosed with Type 1 diabetes. It is also FDA approved to reduce the risk of hospitalization and death for people who have congestive heart failure or people who have both Type 2 diabetes and cardiovascular disease. Lastly, Farxiga is prescribed to people with chronic kidney disease to reduce the risk of cardiovascular death, hospitalization, or further loss of kidney function. 

Source: Epocrates, Prescriber’s Digital Reference

Farxiga dosage for Type 2 diabetes

Farxiga is prescribed in addition to diet and exercise to reduce blood glucose levels in people with Type 2 diabetes mellitus. The active ingredient in Farxiga, dapagliflozin, belongs to a family of diabetes medications called sodium-glucose co-transporter 2 (SGLT2) inhibitors. They work by allowing more glucose and sodium to pass out of the body in the urine. Normally, glucose and sodium are passed from the blood into the urine early in the kidneys’ filtration process. Then, much of the glucose and sodium is reabsorbed back into the bloodstream as the urine passes through tiny filtration tubes in the kidneys. Because dapagliflozin prevents glucose from being reabsorbed by the kidneys, blood glucose levels go down.

• Standard dosage for Type 2 diabetes in adults: 5–10 mg taken once daily in the morning

• Maximum dosage for Type 2 diabetes in adults: 10 mg per day

Farxiga dosage to reduce heart failure risk

The U.S. Food and Drug Administration (FDA) has also approved Farxiga to reduce the risk of heart failure in patients who have both Type 2 diabetes and cardiovascular disease or multiple risk factors for cardiovascular disease such as high blood pressure or excess weight. 

SGLT2 inhibitors like Farxiga increase the body’s elimination of both glucose and sodium, reducing both in the bloodstream. Reducing sodium helps to reduce the amount of work the heart needs to do to pump blood. By reducing the load on the heart, dapagliflozin helps to prevent structural changes to the heart that lead to congestive heart failure. 

• Standard dosage to reduce heart failure risk in adults with Type 2 diabetes and cardiovascular disease: 10 mg taken once daily in the morning

• Maximum dosage to reduce heart failure risk in adults with Type 2 diabetes and cardiovascular disease: 10 mg per day

Farxiga dosage for congestive heart failure

Healthcare professionals prescribe Farxiga to reduce the risk of hospitalization and death for people who have congestive heart failure with reduced ejection fraction.  A reduced ejection fraction means that there are changes to the heart that make it unable to pump out enough blood to the body. SGLT-2 inhibitors like Farxiga lower sodium in the bloodstream and reduce the amount of work the heart has to do to pump blood. In this way, it prevents further changes to the heart that will make heart failure worse. 

• Standard dosage for congestive heart failure with reduced ejection fraction in adults: 10 mg taken once daily in the morning

• Maximum dosage for congestive heart failure with reduced ejection fraction in adults: 10 mg taken once daily in the morning

Farxiga dosage for chronic kidney disease (CKD)

People with chronic kidney disease who are at risk for progression are prescribed Farxiga to prevent further decline of renal function and to prevent end-stage kidney disease, cardiovascular death (CV death), and hospitalization for heart failure. Because dapagliflozin is eliminated from the body by the kidneys, Farxiga will not be used in people with severe kidney disease. As with treatment for congestive heart failure, patients with kidney disease can be prescribed Farxiga without regard to blood sugar levels. 

As an SGLT-2 inhibitor, Farxiga lowers sodium levels. This reduces pressure in the tiny areas of the kidneys that filter substances from the blood. When these areas are damaged, the kidneys don’t filter the blood well.  Kidney function is measured in “glomerular filtration rate” or eGFR. The lower the eGFR, the more severe the kidney disease. Farxiga helps to prevent further damage to the kidneys. Its effects on sodium in the bloodstream also help reduce the load on the heart. 

• Standard dosage for chronic kidney disease: 10 mg taken once daily in the morning

• Maximum dosage for chronic kidney disease: 10 mg taken once daily in the morning

Farxiga dosage for children

Farxiga is not approved for use in children.

Farxiga dosage restrictions

Farxiga will not be prescribed to people with certain conditions. Called contraindications, these conditions make Farxiga too hazardous to take. People who have Type 1 diabetes, diabetic ketoacidosis (a life-threatening condition in which the blood fills with ketones), who have severe kidney disease or receive dialysis, or are allergic to Farxiga should not take this medication. People with volume depletion (low fluid levels or dehydration) will not be able to take Farxiga until the condition is resolved. 

• Renally impaired patients (kidney disease): 

For treatment of Type 2 diabetes mellitus

• Mild renal impairment— eGFR >45: No dose adjustment

• Moderate to severe renal impairment— eGFR <45: Farxiga is not recommended

• Dialysis: Farxiga is contraindicated

• For treatment of congestive heart failure, cardiovascular disease, and chronic kidney disease:

  • Mild to moderate renal impairment—eGFR 25 - 60: no dose adjustment but use with caution

  • Severe renal impairment— eGFR <25: Initiation of Farxiga treatment is not recommended, but ongoing Farxiga treatment can continue at 10 mg per day with caution

  • Dialysis: Farxiga is contraindicated

How to take Farxiga

Farxiga is taken as a tablet once in the morning on an empty stomach or with a meal.

• Take Farxiga exactly as instructed by a healthcare provider. 

• A Farxiga prescription includes a medication guide with important information on taking this drug, side effects, and what to watch out for. Please read the entire medication each time a prescription is filled or refilled. 

• Farxiga may be prescribed with a diet and exercise regimen. Stay on this diet and keep to this exercise regimen while taking Farxiga.

• Farxiga may be prescribed with other diabetes medications. Take these medications as directed.

• Store Farxiga at room temperature (68°F to 77°F) in a closed container.

Farxiga dosage FAQs

What happens if I miss a dose of Farxiga?

Take the missed dose as soon as possible, unless it’s almost time for the next dose. In that case, skip the missed dose and take the next dose on time. Never take two doses to make up for a missed dose.

How do I stop taking Farxiga?

Do not stop taking Farxiga except under the medical advice of a healthcare professional. Farxiga does not cause withdrawal symptoms if it is discontinued, but it can cause blood sugar levels to rise to unhealthy levels.

Farxiga treatment may not be right for everyone. Some people may need to stop taking Farxiga because it doesn’t work. Serious side effects of dapagliflozin may require the drug to be stopped immediately. These include serious allergic reactions, ketoacidosis, severe urinary tract infection (UTI), kidney damage, orthostatic hypotension (a sudden drop in blood pressure when standing), or Fournier’s gangrene( a painful, severe, and rapidly progressing infection of the scrotum, penis, or lower abdomen). Genital mycotic infections (yeast infections) and UTIs could also mean the medicine needs to be stopped. These conditions could rapidly worsen, so people should get medical help if they occur while taking Farxiga. Even common side effects such as back pain, constipation, runny nose and sneezing (nasopharyngitis), or nausea may be too hard to take and require Farxiga to be stopped. 

For people with diabetes, a wide range of other antidiabetic medications are available. These include biguanides (such as metformin), sulfonylureas (also called glipizides), meglitinides, glitazones, DPP-4 inhibitors, alpha-glucosidase inhibitors, dopamine-2 agonists, GLP-1 agonists, thiazolidinediones, and insulin.

Patients with heart failure can also be prescribed a wide spectrum of medications to slow the progress of the disease including diuretics, ACE inhibitors, angiotensin-2 receptor blockers (ARBs), and medicines more specialized for heart failure. Most medications for chronic kidney disease, though, are designed to treat the underlying cause or the symptoms.

Can you overdose on Farxiga?

An overdose of Farxiga can cause severely low blood sugar, a condition called hypoglycemia. Symptoms of hypoglycemia include headache, drowsiness, weakness, dizziness, sweating, confusion, or fast heartbeat. If too much Farxiga has been taken, call a poison helpline or seek medical help. 

What interacts with Farxiga?

Because of possible drug interactions, always carry a list of all the prescription drugs, over-the-counter medications, or dietary supplements that are being taken. Share that list with healthcare providers before getting a new prescription. In particular, make sure the healthcare professional who is prescribing Farxiga knows about the following medications:

• Diabetes medications: Although Farxiga is often prescribed with one or more antidiabetic medications, hypoglycemia is always a potential risk when one or more diabetes medications are taken. When taking Farxiga, the risk of hypoglycemia is highest when it is combined with insulin, insulin secretagogues (sulfonylureas and meglitinides), and other SGLT2 inhibitors.

• Diuretics: Combining Farxiga with diuretics raises the risk of volume depletion (dehydration), low blood pressure (hypotension), electrolyte imbalances, and kidney problems.

• Blood pressure medicines: Farxiga may cause volume depletion and hypotension in people who are taking medicines intended to lower blood pressure.

What happens when you mix Farxiga and alcohol?

People taking antidiabetic agents such as Farxiga should limit their intake of alcohol because of the risk for hypoglycemia. 

Is it safe to take Farxiga during pregnancy?

Farxiga is not recommended in the second and third trimesters of a pregnancy and is generally avoided in the first trimester, as well. Animal studies have shown that dapagliflozin can irreversibly affect the development of a fetus’ kidneys.

Healthcare providers will consider using other medications to treat women who are breastfeeding. Although there are no studies on the safety of dapagliflozin while breastfeeding, in theory, the drug could have irreversible effects on the baby’s kidney development in its first two years.

Related resources for Farxiga dosages:

• Dapagliflozin drug summary, Prescriber’s Digital Reference

• Farxiga, Epocrates

• Farxiga prescribing information, U.S. National Library of Medicine