Farxiga For Heart Failure
Farxiga is approved for use in adults with heart failure. For this use, the drug is given to people with reduced ejection fraction * to reduce the risk for:
- hospitalization for heart failure, and
- cardiovascular death
* With reduced EF, your heart isnt able to pump out as much blood to the rest of your body as usual.
With heart failure, your heart isnt working as well to pump blood throughout your body. Without enough blood flow, your body cant function normally. Typical symptoms of heart failure can include:
- shortness of breath
- edema in your legs, ankles, and feet
Effectiveness for reducing death in people with heart failure
In a clinical study, people taking Farxiga had an 18% lower rate of death due to heart or blood vessel problems compared with people taking a placebo. People in this study were followed for 18 months.
Effectiveness for reducing hospitalization risk of heart failure
In the same clinical study as above, people taking Farxiga had a 30% lower likelihood of being hospitalized for heart failure compared with people taking a placebo.
What Does Farxiga Cost
Costs of prescription drugs can vary depending on many factors. These factors include what your insurance plan covers and which pharmacy you use. To find current prices for Farxiga tablets in your area, visit GoodRx.com.
If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. You can also visit the Farxiga manufacturers website to see if it has support options. This website also provides estimates of cost with Medicare, Medicaid, private insurance, or no insurance.
Your doctor will recommend the dosage of Farxiga thats right for you. Below are commonly used dosages, but always take the dosage your doctor prescribes.
Farxiga And Bladder Cancer
According to clinical studies, patients who take Farxiga may have a very small risk of bladder cancer. When the FDA approved the drug, it found a small connection between bladder cancer and dapagliflozin but with no other SGLT2 drug. Because people with Type 2 diabetes are already at greater risk for bladder cancer, it is difficult to determine whether the drug increases the risk.
In 22 clinical trials, researchers found four cases of newly diagnosed bladder cancer with Farxiga and none with the placebo. The number is too small to determine whether the bladder cancer was related to the medication, according to a 2014 press release from AstraZeneca, the company that sells the drug. There is also no information on how the drug affects people with pre-existing bladder tumors.
Farxiga should not be used in patients with active bladder cancer and should be used with caution in patients with a prior history of bladder cancer, according to the drugs most recent prescribing information from Oct. 26, 2018.
AstraZeneca funded a study by Dr. Agata Ptaszynska and colleagues that found nine out of 5,936 patients who took dapagliflozin had bladder cancer versus one out of 3,403 people who took another drug. Authors found these people had increased risk factors for bladder cancer such as being older than 60 and smoking.
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If You Take Farxiga To Help Prevent Problems From Heart Failure Are The Side Effects Different Compared With Taking The Drug To Treat Type 2 Diabetes
The possible side effects of Farxiga are very similar regardless of the condition youre taking the drug to treat. In studies, there were no major differences in side effects reported by people taking Farxiga for type 2 diabetes, heart failure, or chronic kidney disease.
But its possible that you may have a higher risk for certain side effects if you take Farxiga for heart failure. For example, if youre also taking a diuretic medication such as furosemide , this could increase your risk for dehydration .
Your doctor will monitor you for side effects throughout Farxiga treatment. They can also tell you the side effects to watch for based on your condition and your other medications.
Does Farxiga Cause Diarrhea
No, you probably wont have diarrhea with Farxiga. This side effect wasnt reported in studies of the drug.
Other drugs prescribed for treating type 2 diabetes may cause diarrhea, including metformin . Metformin is sometimes used together with Farxiga.
If you have diarrhea while taking Farxiga, talk with your doctor. They may check to see whats causing it. It may be caused by other drugs you take, such as other diabetes medications.
Also, be sure to drink plenty of fluids. Diarrhea can increase your risk of dehydration . And this is a possible serious side effect of Farxiga.
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Can Taking Farxiga Lead To Bladder Cancer
Its not likely. A few cases of bladder cancer were reported in early studies of Farxiga. But there wasnt enough information to know if the drug was involved in causing the cancer.
No links have been made between bladder cancer and Farxiga since the medication has been widely prescribed.
If youre concerned about bladder cancer with Farxiga, talk with your doctor.
How Do The Infections Happen
Type 2 diabetes occurs when the body can’t remove sugar from the bloodstream, because cells fail to respond to insulin, the hormone that helps move sugar into the cells. SGLT2 inhibitors work to lower blood sugar by causing the kidneys to remove sugar from the body through urine. This stabilizes blood sugar levels.
So, how can this lead to infections? Anywhere there is higher blood sugar, there’s an increased chance of bacterial infection, Jamie Alan, an assistant professor of pharmacology and toxicology at Michigan State University, told SELF. “We have bacteria all over us, and one of the foods that bacteria likes is ,” Alan said. She explained that eliminating more sugar through urine means there is more of bacteria’s favorite food in the genital area, so this spot becomes a rather inviting environment for them.
The bacteria become a problem only if there is an entry point to infect, such as a small cut from shaving or a skin ulcer near the genitals. And that’s exactly what happens, Adalja told SELF. The infections are serious and often require many surgeries to remove all the infected tissues, Adalja said.
The FDA warning instructs patients taking the drugs to seek medical attention right away if they experience any signs of swelling, itching or irritation in the genitals area or have a fever above 100.4 degrees Fahrenheit and generally don’t feel well. The bacteria that cause necrotizing fasciitis can spread quickly, so it’s important to seek treatment immediately.
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Farxiga And Other Medications
Below is a list of medications that can interact with Farxiga. This list doesnt contain all drugs that may interact with Farxiga.
Before taking Farxiga, be sure to tell your doctor and pharmacist about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.
If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.
Farxiga and drugs that increase the risk of low blood sugar
Taking Farxiga with certain medications can lower your blood sugar levels and increase your risk of hypoglycemia. If you take these medications, you may need to check your blood sugar levels more often. Also, your doctor may need to change the dosage of your diabetes medications.
Examples of these medications include:
- other diabetes medications, such as:
Farxiga and Jardiance are both in the same class of medications: sodium-glucose co-transporter 2 inhibitors. This means they work in the same way to treat type 2 diabetes.
Uses
Both Farxiga and Jardiance are FDA-approved to improve blood sugar control in adults with type 2 diabetes when used with improved diet and exercise.
Farxiga is also approved to:
Jardiance is also approved to:
Drug forms and administration
Side effects and risks
More common side effects
Costs
What Is Jardiance Used For
Jardiance is a prescription drug used to help control glucose in adult patients with type 2 diabetes. Jardiance is also approved by the FDA to lower the risk of cardiovascular death in adults with heart disease and type 2 diabetes. It is also approved to reduce the risk of death and hospitalization in patients with heart failure.
Jardiance is given as an oral tablet once daily and is used in addition to diet and exercise. It can be added to other medicines for type 2 diabetes such as metformin, sulfonylureas, pioglitazone, and insulin as well as other heart medications like statins, beta blockers, ACE inhibitors, and diuretics. Jardiance, classified as an SGLT-2 inhibitor, is made by Boehringer Ingelheim Pharmaceuticals and Eli Lilly.
SGLT-2 inhibitors have been shown to be effective at lowering hemoglobin A1c levels, improving weight loss and lowering blood pressure in type 2 diabetes. They carry a low risk of hypoglycemia when used alone .
SGLT-2 inhibitors come as single-ingredient products or combined with other diabetes medicines. Other single-ingredient FDA approved medications in the SGLT-2 inhibitor class include:
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Pregnancy And Breastfeeding While Taking Farxiga
If youre pregnant or planning to become pregnant, your doctor will likely recommend that you do not take Farxiga.
Farxiga is not recommended during the second and third trimesters of pregnancy because animal studies suggest it may have harmful effects on the fetus. It is not known if Farxiga is safe to take in the first trimester of pregnancy.
Talk with your doctor about other medications that are more suitable for use during pregnancy. This is especially important if you have type 2 diabetes. If your diabetes isnt well managed during pregnancy, this can also have harmful effects on the fetus.
It isnt known if Farxiga passed into breast milk. Because of the risk for potentially serious side effects in a breastfed child, breastfeeding is not recommended if youre taking Farxiga. Your doctor can recommend other ways to feed your child. Or they can recommend a medication for your condition other than Farxiga.
If youre pregnant, breastfeeding, or planning to become pregnant or breastfeed, talk with your doctor before using Farxiga.
Note: Pregnancy trimester timing for the first trimester is 112 weeks. The second trimester is 1328 weeks, and the third trimester is 2940 weeks.
Do Farxigas Side Effects Vary Depending On Whether I Take The 5
No, Farxigas side effects dont vary depending on whether you take the 5-milligram or 10-mg strength. In clinical studies of people with diabetes, the same side effects were seen in people taking either dose of the drug.
That said, side effects may vary based on the condition you are taking Farxiga to treat. Researchers studied the side effects of Farxiga on people taking it for diabetes, heart failure, and kidney disease. Severe low blood sugar and ketoacidosis were only seen in people taking Farxiga for diabetes.
In addition, you may be at a higher risk for some side effects if you take Farxiga in combination with certain other medications. Low blood sugar only occurred in people taking Farxiga with certain other diabetes medications, such as insulin or a sulfonylurea drug. Low blood sugar wasnt seen when Farxiga was taken alone.
If you have questions about your risk of side effects given your prescribed dosage, talk with your doctor.
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Do Farxiga And Metformin Both Cause Weight Loss
Yes, both Farxiga and metformin can cause weight loss. In clinical studies, people taking Farxiga lost up to about 7 pounds over 24 weeks of treatment. In clinical studies of metformin, mild weight loss has also occurred, usually from less than 1 pound up to about 8 pounds .
When these medications are taken together, people usually lose more weight than when taking these drugs by themselves.
Farxiga For Type 2 Diabetes
Farxiga is FDA-approved for use in adults with type 2 diabetes to:
- improve blood sugar levels when used along with improved diet and exercise
- reduce the risk of hospitalization for heart failure in people with either heart disease or risk factors* for heart disease
Diabetes is a chronic condition. With diabetes, the level of sugar in your bloodstream builds up. Normally, a hormone called insulin helps to move glucose from your bloodstream into your cells.
But with type 2 diabetes, your bodys cells dont respond to insulin as well as they should. And in the later stages of diabetes, your body also might not make enough insulin.
Having type 2 diabetes thats not managed can cause your blood glucose level to be high all the time. And this can cause several symptoms that may lead to serious complications, such as heart failure.
* Some examples of risk factors for heart disease include being of an older age, having high cholesterol or high blood pressure, and smoking.
How type 2 diabetes and heart failure are connected
Many of the risk factors and changes in bodily functions are the same for both type 2 diabetes and heart failure. So both of these conditions can be a risk factor for the other.
In clinical studies , people with type 2 diabetes were two to four times more likely to develop heart failure. They also had a 50% higher risk of hospitalization than someone without diabetes.
Effectiveness for glucose control in type 2 diabetes
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Consuming Alcohol During Farxiga Treatment
Farxiga isnt known to interact with alcohol. If you drink alcohol, ask your doctor or pharmacist if its safe for you to drink while taking Farxiga. Your doctor may ask you how often and how much alcohol you drink.
Drinking alcohol often or in large amounts can be dangerous with Farxiga. Alcohol misuse can increase the risk of ketoacidosis with Farxiga.
How To Use Farxiga 5 Mg Tablet Antihyperglycemic
Read the Medication Guide provided by your pharmacist before you start taking dapagliflozin and each time you get a refill. If you have any questions, ask your doctor or pharmacist.
Take this medication by mouth with or without food as directed by your doctor, usually once daily in the morning. The dosage is based on your medical condition and response to treatment.
Use this medication regularly to get the most benefit from it. To help you remember, take it at the same time each day.
Tell your doctor if your condition does not improve or if it worsens.
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Low Blood Sugar Level
Low blood sugar is possible during treatment with Farxiga. But in studies, Farxiga only caused low blood sugar when taken with insulin or other medications that increase your insulin levels.
If you take other medications for your diabetes, be sure to tell your doctor before you start Farxiga treatment. While taking Farxiga, you should watch for symptoms of low blood sugar, such as:
What might help
If youre taking Farxiga with other diabetes drugs, your doctor may recommend that you monitor your blood sugar more often to make sure it doesnt get too low.
You should talk with your doctor about what to do if your blood sugar does get too low. They may recommend that you carry glucose tablets or drink some juice or soda to increase your blood sugar levels.
In addition, your doctor may recommend decreasing your dose of your other diabetes medications when you first start taking Farxiga or if youre experiencing low blood sugar. This can may help prevent low blood sugar.
Farxiga Side Effects List For Healthcare Professionals
The following important adverse reactions are described below and elsewhere in the labeling:
- Volume Depletion
- Necrotizing Fasciitis of the Perineum
- Genital Mycotic Infections
Clinical Trials Experience
- Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in clinical practice.
- Farxiga has been evaluated in clinical trials in patients with type 2 diabetes mellitus and in patients with heart failure.
- The overall safety profile of Farxiga was consistent across the studied indications.
- Severe hypoglycemia and diabetic ketoacidosis were observed only in patients with diabetes mellitus.
Clinical Trials In Patients With Type 2 Diabetes Mellitus
Pool of 12 Placebo-Controlled Studies for Farxiga 5 and 10 mg for Glycemic Control
Table 2 shows common adverse reactions associated with the use of Farxiga. These adverse reactions were not present at baseline, occurred more commonly on Farxiga than on placebo, and occurred in at least 2% of patients treated with either Farxiga 5 mg or Farxiga 10 mg.
Table 2: Adverse Reactions in Placebo-Controlled Studies of Glycemic Control Reported in =2% of Patients Treated with Farxiga
Pool of 13 Placebo-Controlled Studies for Farxiga 10 mg for Glycemic Control
Volume Depletion
| Pool of 12 Placebo-Controlled Studies | Pool of 13 Placebo-Controlled Studies |
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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 or kidney disease.
Questions About Farxigas Dosage
Below are answers to some common questions about Farxigas dosage.
- What if I miss a dose of Farxiga? If you miss a dose of Farxiga, take it as soon as possible. But if its nearly time for your next dose, skip the missed dose. Take your next scheduled dose as usual. Dont take an extra dose to make up for a missed dose. Doing so could cause side effects.
- Will I need to take Farxiga long term? Yes. If Farxiga works for you without causing troublesome side effects, youll likely take it long term.
- How long does Farxiga take to work? Farxiga starts working when you take your first dose. But it might take a few weeks for your blood sugar level to improve. Its not known how long it takes for Farxiga to help lower the risk of complications from heart failure or kidney disease.
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