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Oct 18, 2023

Diabetes

SGLT2 Inhibitors

Farxiga for Type 2 Diabetes

Farxiga: A Medication for Diabetes and Heart Health

Farxiga, also known by its generic name "dapagliflozin," falls into the category of medications known as sodium-glucose cotransporter-2 (SGLT2) inhibitors. These medications have gained popularity due to their dual benefits for managing type 2 diabetes and congestive heart failure, thanks to their heart-protective properties.

Farxiga holds three FDA-approved indications, each serving a specific purpose:

  • Type 2 Diabetes Mellitus
    Farxiga is used in combination with dietary improvements and regular exercise to manage type 2 diabetes mellitus effectively.
  • Reducing Heart Failure Risk
    For adults with type 2 diabetes mellitus and established heart disease or heart-related risk factors, Farxiga helps reduce the risk of heart failure-related hospitalization.
  • Managing Heart Failure with Reduced Ejection Fraction
    In adults with heart failure characterized by reduced ejection fraction, Farxiga can assist in reducing the risk of heart-related hospitalization and mortality.

Farxiga is not intended for the treatment of type 1 diabetes mellitus or for individuals experiencing diabetic ketoacidosis, a serious complication resulting from poorly controlled diabetes. Farxiga's versatile benefits make it a valuable tool for individuals managing type 2 diabetes and heart conditions, but its usage should align with these approved indications. Always consult with a healthcare professional for guidance tailored to your specific health needs.

How Farxiga Works

Farxiga operates somewhat differently when it comes to managing type 2 diabetes and reducing hospitalizations for heart failure.

  • For Type 2 Diabetes Mellitus: Farxiga tackles diabetes by increasing the amount of
    Farxiga tackles diabetes by increasing the amount of sugar you expel through urine. This means less sugar in your body. It does this by preventing your kidneys from reabsorbing sugar as it passes through them, instead allowing it to exit your body via urine. This results in lower blood sugar levels and a better A1C score, which reflects your average blood sugar levels over the past three months.
  • Reducing Hospitalizations and Death in Heart Failure:
    When it comes to lowering the risk of hospitalizations and death in heart failure, the exact process isn't entirely clear. One of the major problems in heart failure is keeping a proper balance of sodium and fluid in your body. SGLT2 inhibitors like Farxiga usher sugar into your urine, and they bring along sodium and fluid. The reduced hospitalization risk likely ties into this decrease in sodium and fluid volume.

In short, Farxiga helps manage diabetes by flushing out excess sugar, and it may help heart failure by controlling the balance of sodium and fluid in your body.

Common Side Effects of Farxiga

Farxiga may cause several side effects, primarily stemming from increasing sugar excretion in urine. This elevation in sugar levels within the urinary tract can create an environment for bacteria and yeast growth, potentially leading to infections.

  • Genital Fungal (Yeast) Infections (the risk is higher in women than men)
  • Urinary Tract Infections
  • Increased Urination (frequency and volume)

Weight Effects of Farxiga

Many people wonder if certain type 2 diabetes medications can help with weight loss. Some of these medications, like SGLT2 inhibitors, can indeed lead to weight loss, although not as dramatically as some others. In clinical studies, medications like Farxiga caused about 4 to 6 lb of weight loss.

The cause of weight loss with Farxiga is likely a decrease in calories absorbed from the sugars lost in the urine. This is a side effect of the medication, and not an FDA-approved indication. This medication is not recommended to be used for the purpose of weight loss, but rather for the approved indications of type 2 diabetes mellitus and/or heart failure.

Understanding the Risks of Farxiga

Many people with type 2 diabetes are interested in medications that can potentially help with weight loss. Some SGLT2 inhibitors are known to have this side effect, although it may not be as pronounced as with other medications. However, it's important to note that during clinical trials assessing the efficacy and safety of Invokana, it did not demonstrate any significant impact on weight.

Warnings About Taking Farxiga

As this medication makes changes to the body, it comes with rare but dangerous risks.

These risks include:

  • Low blood sugar (Hypoglycemia)
    When used in combination with other diabetes medications like insulin or sulfonylureas, Brenzavvy can lower blood sugar levels too much, causing hypoglycemia.
  • Ketoacidosis
    Ketoacidosis is a rare condition that occurs when your blood becomes too acidic because of a build-up of “ketones”. This happens when your body can’t use sugars for energy, and instead starts using up fat, which breaks down to ketones. This causes the blood to be very acidic and is dangerous if not treated quickly.
  • Lower limb amputations
    Benzavvy use is associated with a slightly higher risk of lower-limb amputations in individuals with risk factors for or established heart disease. This risk is generally higher for those with a history of amputation, peripheral vascular disease, or neuropathy. It’s also important to monitor any changes while taking the medication, such as pain or sores on the lower limbs.
  • Fluid Volume Decrease
    In some cases, Brenzavvy may lead to a decrease in body fluids, potentially causing low blood pressure. This is of particular concern for individuals with impaired kidney function, older individuals, and those taking loop diuretics.
  • Necrotizing Fasciitis
    Rarely, the use of Brenzavvy has been associated with a serious skin infection called necrotizing fasciitis in the genital area. This infection can be severe, requiring hospitalization and sometimes resulting in death. Any redness, tenderness, or swelling in the genital region while taking Brenzavvy should be promptly assessed by a healthcare provider.

Farxiga Combination Pill: Xigduo XR

Xigduo RX is a combination pill that contains both dapagliflozin (the active ingredient of Farxiga) and metformin. Metformin is a commonly prescribed medication for managing type 2 diabetes mellitus and often considered a first-line treatment for the condition

Given the frequent use of SGLT2 inhibitors as complementary therapies in diabetes management, it makes perfect sense for them to be offered in a combination pill. This streamlines your medication routine, allowing you to take a single pill rather than two separate medications. For many individuals, this convenience is a significant advantage.

However, there is a trade-off to this convenience. While combining these medications simplifies your daily routine, it can make dose adjustments more challenging. For instance, if you want to maintain your metformin dosage while adjusting the dapagliflozin portion, you'll need to either switch to a combination pill that aligns with your needs or potentially return to individual pills to achieve the desired dosage. The choice ultimately comes down to your personal preferences and healthcare recommendations.

Cost of Farxiga

Farxiga, like many medications used to manage type 2 diabetes mellitus, comes with a significant price tag. For a one-month supply, you can expect to pay upwards of $650. Regrettably, Farxiga is exclusively available in its brand-name form, and there is currently no generic alternative, which keeps the cost relatively high.

Brenzavvy: An Affordable SGLT-2 Inhibitor. Availabe at Marley Drug for $49.95/month

When Will There Be a Generic For Farxiga?

Generic medications are highly sought after for their cost-effectiveness compared to branded counterparts. However, the path to generic availability is not always straightforward. Here's what you need to know about when a generic version of Farxiga might become available.

When new medications are introduced to the market, they are initially approved with a brand name. The pharmaceutical company behind the drug is granted a period of market exclusivity to recoup their research and development costs. During this time, there are no direct competitors, which often results in higher prices for the medication.

The length of this market exclusivity period varies depending on several factors, and it can extend for a significant number of years. Only after this period ends can other pharmaceutical companies create their own scientifically equivalent versions of the branded medication and offer them at lower costs. This benefits consumers by reducing the financial burden and offers a competitive product in the market.

So, when will a generic version of Farxiga (or its combination, Xigduo) become available? The timeline for this largely depends on various regulatory and legal considerations. It's likely that we'll have to wait several years before a more affordable generic alternative to these medications hits the market. Unfortunately, this means that Farxiga and Xigduo are expected to remain expensive for the foreseeable future.

Compare SGLT-2 Inhibitors

To learn more about Farxiga, and how to get a prescription from Marley Drug, call us at 1-800-810-7790.

References:

  1. FARXIGA® (dapagliflozin) tablets, for oral use. Food and Drug Administration. (2014; Revised 05/2020). Retrieved October 6, 2023, from https://www.accessdata.fda.gov
  2. XIGDUO® XR (dapagliflozin and metformin HCL extended-release) tablets, for oral use. Food and Drug Administration. (2014; Revised 07/2017). Retrieved October 7, 2023, from https://www.accessdata.fda.gov
  3. FARXIGA (dapagliflozin). GoodRx. (n.d.). October 7, 2023, from: https://www.goodrx.com

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