Farxiga is a brand-name prescription medication with multiple uses in adults with type 2 diabetes, heart failure, and chronic kidney disease. While not specifically approved for weight loss, some people taking Farxiga have experienced this as a side effect, sparking interest in its potential role in weight management. This article examines Farxiga's approved uses, its mechanisms of action, the evidence behind its impact on weight, and important safety considerations.
What is Farxiga?
Farxiga, containing the active drug dapagliflozin, belongs to a class of medications called sodium-glucose co-transporter 2 (SGLT2) inhibitors. It is available as a once-daily oral tablet.
Approved Uses
The Food and Drug Administration (FDA) has approved Farxiga for the following uses:
- Type 2 Diabetes: To improve blood sugar levels when used alongside diet and exercise, and to reduce the risk of hospitalization for heart failure in people with heart disease or risk factors for heart disease.
- Heart Failure: To reduce the risk of either hospitalization for heart failure or cardiovascular death in people with reduced ejection fraction (EF), with or without type 2 diabetes.
- Chronic Kidney Disease: To reduce the risk of lowered glomerular filtration rate (GFR), end-stage kidney disease, cardiovascular death, and hospitalization for heart failure in people with chronic kidney disease that may worsen.
Farxiga is not approved for use in type 1 diabetes or for the treatment of diabetic ketoacidosis (DKA). It's also not indicated for type 2 diabetes in certain people with kidney problems, or for kidney problems in certain people.
How Farxiga Works
Farxiga works by affecting the way the kidneys handle glucose (sugar). Under normal circumstances, the kidneys filter sugar from the blood and then reabsorb most of it back into the body. Farxiga blocks this reabsorption process. By inhibiting the SGLT2 protein in the kidney proximal tubule, Farxiga causes the kidneys to filter more sugar, sodium, and water from the blood into the urine. This results in the excretion of glucose and calories through urine, leading to a negative energy balance. It's estimated that people taking SGLT2 inhibitors like Farxiga excrete roughly 75 grams of sugar a day, which equates to approximately 300 calories.
Read also: The Role of Farxiga and Metformin in Weight Management
Farxiga also reduces the increased activity of the sympathetic nervous system, which contributes to the progression of heart failure and the increased intraglomerular pressure that contributes to chronic kidney disease.
Farxiga and Weight Loss: The Evidence
While Farxiga was initially developed to help people with type 2 diabetes lower blood sugar levels, a side effect of gradual weight loss has been observed. The weight loss comes from the body losing calories along with the sugar that’s excreted. This creates a metabolic shift where your body has to find a new source of energy.
Clinical studies have shown that Farxiga can lead to modest reductions in body weight.
- One study showed people taking Farxiga alone, at either 5 mg or 10 mg daily, lost about 6 pounds over 24 weeks.
- Another study of Japanese T2DM patients found that dapagliflozin treatment significantly decreased body weight and total fat mass without affecting skeletal muscle mass.
However, it's important to note that the weight loss effect is generally smaller compared to newer medications like GLP-1 receptor agonists (such as Wegovy or Zepbound), which are designed to directly target appetite. Also, the effect tends to level off after a while, which is why Farxiga works best when paired with a balanced diet and regular physical activity.
Dosage and Administration
Farxiga is taken as a once-daily oral tablet. The maximum recommended dose is 10 mg per day, regardless of the condition being treated. Many patients start at the 5 mg dose so their doctor can monitor how well they tolerate the medication and check for potential side effects. The healthcare provider will base this decision on several factors, including the patient's overall health, kidney function, and treatment goals.
Read also: Weight Loss with SGLT2 Inhibitors
Consistency is key: it’s important to take it consistently at the same time each day. If a dose is forgotten, it should be taken as soon as remembered, unless it’s almost time for the next one. In that case, the missed pill should be skipped, and the normal schedule resumed. Doses should never be doubled.
Side Effects and Risks
Farxiga can cause side effects, typically mild to moderate and manageable at home. However, more serious conditions can occur. These effects are usually tied to how Farxiga works, by removing extra sugar through the urine.
More Common Side Effects
- Genital yeast infection
- Respiratory infections, such as the common cold or the flu
- Urinary tract infection
- Increased urination
- Back pain
- Nausea
- Increased cholesterol levels
- Constipation
Serious Side Effects
Serious side effects from Farxiga aren’t common, but they can occur. It's important to call a doctor right away if you experience any serious side effects. Call 911 if symptoms feel life-threatening or if you think you’re having a medical emergency.
- Dehydration: Symptoms can include dizziness, feeling faint, lightheadedness, weakness (especially when standing up), fatigue, and thirst.
- Hypoglycemia: (low blood sugar level), if Farxiga is used in combination with insulin or a sulfonylurea drug such as glipizide (Glucotrol). Symptoms can include drowsiness, headache, confusion, weakness, hunger, irritability, sweating, feeling jittery, and fast heart rate.
- Severe allergic reaction: Symptoms of a severe allergic reaction can include swelling under your skin, typically in your eyelids, lips, hands, or feet, swelling of your tongue, mouth, or throat, and trouble breathing.
- Kidney damage: Symptoms of kidney damage can include reduced urination, swelling in your legs or ankles, and confusion.
- Serious urinary tract infections (UTIs):
- Ketoacidosis: Symptoms may include nausea and vomiting, pain in your abdomen (belly), weakness or fatigue (lack of energy), fruity-smelling breath, trouble breathing, and confusion.
- Fournier’s gangrene: (necrotizing fasciitis of the perineum). Symptoms can include pain, tenderness, swelling, and discoloration in the genital or rectal area, fever, and malaise (overall feeling of discomfort).
Important Warnings
- Allergic reaction: Do not take FARXIGA if you are allergic to dapagliflozin or any of the ingredients in FARXIGA.
- Ketoacidosis: FARXIGA can cause ketoacidosis, a serious condition which may require hospitalization and lead to death.
- Dehydration: FARXIGA can cause dehydration (the loss of body water and salt).
- Serious urinary tract infections (UTI): Serious urinary tract infections (UTI), some that lead to hospitalization, occurred in people taking FARXIGA.
- Low blood sugar (hypoglycemia): Low blood sugar (hypoglycemia) can occur if you take FARXIGA with another medicine that can cause low blood sugar, such as sulfonylureas or insulin.
- Bacterial infections: Rare but serious infections that cause severe tissue damage under the skin of the genitals and areas around them have happened with FARXIGA.
- Pregnancy and breastfeeding: if you are pregnant, or plan to become pregnant. if you are breastfeeding, or plan to breastfeed.
- Genetic conditions: FARXIGA is not for people with certain genetic forms of polycystic kidney disease, or who are taking or have recently received immunosuppressive therapy to treat kidney disease.
Cost and Availability
Without insurance, the list price for Farxiga is around $600 for a month’s supply, but you can get it cheaper through different discount programs. Insurance coverage and savings programs can help bring down the cost, but it is unlikely to be covered for weight loss, as coverage generally only applies when the drug is prescribed for conditions like diabetes.
- Medicare: Most plans include Farxiga for diabetes, but people can’t use the manufacturer’s savings card if they’re enrolled in Medicare.
- Medicaid: Some state Medicaid programs do cover Farxiga, but coverage policies vary.
- Manufacturer’s discount: The Farxiga Savings Card allows eligible commercial insurance holders to pay as little as $0 per month, with a capped savings amount (often up to $175 per month).
Farxiga vs. Other Weight Loss Options
Farxiga is not a medication designed specifically for weight loss, but research shows it can lead to modest weight loss of around 4 to 5% of body weight. There are also other options in pill form, like Qsymia, Contrave, and Metformin (off-label), that may support weight management in different ways.
Read also: Weight Loss Guide Andalusia, AL
Newer medications like GLP-1 receptor agonists (such as Wegovy or Zepbound) are designed to directly target appetite and are more effective for weight loss than Farxiga.
Lifestyle Considerations
- Alcohol: It’s best to be cautious. Both alcohol and Farxiga can lower blood sugar and increase your risk of dehydration.
- Diet: A balanced diet with lean proteins, fruits and vegetables, fiber-rich carbs, and healthy fats works well alongside Farxiga.
- Exercise: Combine a healthy diet with regular physical activity, anything from daily walks to structured exercise, and you can boost results.
Long-Term Use and Discontinuation
Farxiga is meant for long-term use when prescribed for diabetes, heart failure, or chronic kidney disease by your healthcare provider. Many people take it safely for years with regular check-ups. When it comes to weight loss, though, there isn’t clear research yet on how long Farxiga can be used safely for that purpose.
Farxiga doesn’t usually cause withdrawal symptoms, but you should not stop on your own. Talk with your doctor first so they can adjust your plan safely.