Forxiga: Advanced SGLT2 Inhibitor for Type 2 Diabetes Management
| Product dosage: 10mg | |||
|---|---|---|---|
| Package (num) | Per pill | Price | Buy |
| 42 | $3.63 | $152.61 (0%) | 🛒 Add to cart |
| 56 | $3.57 | $203.48 $199.80 (2%) | 🛒 Add to cart |
| 70 | $3.54 | $254.35 $247.99 (2%) | 🛒 Add to cart |
| 84 | $3.50 | $305.22 $294.17 (4%) | 🛒 Add to cart |
| 98 | $3.48
Best per pill | $356.09 $341.36 (4%) | 🛒 Add to cart |
Synonyms | |||
Forxiga (dapagliflozin) is a prescription medication belonging to the sodium-glucose cotransporter 2 (SGLT2) inhibitor class. It is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus. By inhibiting SGLT2 in the proximal renal tubules, Forxiga reduces renal glucose reabsorption and increases urinary glucose excretion, offering a unique, insulin-independent mechanism of action. This profile provides a comprehensive overview of its features, clinical benefits, and essential safety information for healthcare professionals.
Features
- Active ingredient: Dapagliflozin (as dapagliflozin propanediol monohydrate)
- Available strengths: 5 mg and 10 mg film-coated tablets
- Pharmacologic class: Sodium-glucose cotransporter 2 (SGLT2) inhibitor
- Administration: Oral, once daily, with or without food
- Manufacturer: AstraZeneca
- Regulatory approvals: EMA, FDA, and other major agencies worldwide
Benefits
- Effectively lowers HbA1c through an insulin-independent mechanism, providing a complementary approach to diabetes management.
- Promotes weight loss, a beneficial secondary effect for many patients with type 2 diabetes who are overweight or obese.
- Demonstrates cardiovascular benefits, including a reduction in the risk of hospitalization for heart failure in indicated patient populations.
- Shows renal protective effects, slowing the progression of renal disease and reducing albuminuria in patients with chronic kidney disease.
- Offers a convenient once-daily dosing regimen, supporting medication adherence.
- Functions independently of insulin secretion or sensitivity, making it suitable for use across various stages of type 2 diabetes.
Common use
Forxiga is primarily used to improve glycemic control in adults with type 2 diabetes mellitus. It is prescribed as monotherapy when metformin is contraindicated or not tolerated, or more commonly, as part of combination therapy with other glucose-lowering medicinal products including insulin, when these, together with diet and exercise, do not provide adequate glycemic control. Beyond glycemic management, it is also approved to reduce the risk of cardiovascular death and hospitalization for heart failure in adults with type 2 diabetes and established cardiovascular disease or multiple cardiovascular risk factors, and to reduce the risk of sustained eGFR decline, end-stage kidney disease, cardiovascular death, and hospitalization for heart failure in adults with chronic kidney disease.
Dosage and direction
The recommended starting dose is 5 mg or 10 mg orally once daily. The dose can be increased to 10 mg once daily for additional glycemic effect. Administration can occur with or without food. For patients with volume depletion, correcting this condition prior to initiation is advised. Dose adjustments are not recommended based on age, gender, race, or hepatic impairment. For patients with moderate renal impairment (eGFR between 45 and 60 mL/min/1.73 m²), the 10 mg dose is not recommended for glycemic control; the 5 mg dose may be used. It is not recommended for initiation in patients with eGFR less than 45 mL/min/1.73 m² for diabetes or less than 25 mL/min/1.73 m² for heart failure and CKD, as efficacy is likely diminished.
Precautions
Monitor renal function before initiation and periodically thereafter. Assess volume status and correct volume depletion before starting therapy. Monitor for signs and symptoms of genital mycotic infections and urinary tract infections, and treat appropriately. Consider periodic monitoring of hematocrit. Educate patients on the symptoms of ketoacidosis (e.g., nausea, vomiting, abdominal pain, malaise, shortness of breath), even if blood glucose levels are not markedly elevated. Use with caution in patients on concomitant medications that can cause volume depletion (e.g., diuretics, ACE inhibitors, ARBs, NSAIDs) or in those with low systolic blood pressure. Not recommended during the second and third trimesters of pregnancy.
Contraindications
Hypersensitivity to dapagliflozin or any excipients in the formulation. Severe renal impairment (eGFR less than 30 mL/min/1.73 m²), end-stage renal disease, or patients on dialysis. History of serious hypersensitivity reactions to Forxiga, such as anaphylaxis or angioedema.
Possible side effect
Common adverse reactions (≥5% incidence) include genital mycotic infections, urinary tract infections, and nasopharyngitis. Other reported side effects include increased urination, thirst, constipation, nausea, back pain, dyslipidemia, and discomfort with urination. Serious but less common side effects include ketoacidosis, volume depletion, acute kidney injury, urosepsis and pyelonephritis, hypersensitivity reactions, and Fournier’s gangrene (a rare but serious necrotizing infection of the perineum).
Drug interaction
No clinically significant drug-drug interactions were observed in studies with metformin, pioglitazone, sitagliptin, glimepiride, valsartan, warfarin, digoxin, or simvastatin. The pharmacodynamic effects may be increased when used with insulin or insulin secretagogues (e.g., sulfonylureas), increasing the risk of hypoglycemia; a lower dose of the concomitant agent may be required. Diuretics may enhance the potential for volume depletion. The efficacy of Forxiga is dependent on renal function; co-administration with drugs that reduce renal function may diminish its glycemic efficacy.
Missed dose
Instruct the patient to take the missed dose as soon as it is remembered on the same day. If the missed dose is not remembered until the next day, the patient should skip the missed dose and take the next dose at the regular time. Do not take a double dose to make up for a missed one.
Overdose
In the event of an overdose, contact a poison control center or seek immediate medical attention. The most likely manifestations of overdose would be related to its pharmacologic effect, including hypoglycemia and dehydration from osmotic diuresis. There is no specific antidote. Treatment should consist of general supportive measures, including hydration and correction of electrolyte abnormalities and hypoglycemia, as clinically indicated. Dapagliflozin is not expected to be dialyzable.
Storage
Store at room temperature between 20°C to 25°C (68°F to 77°F); excursions permitted between 15°C and 30°C (59°F and 86°F). Keep in the original blister package to protect from moisture. Keep out of reach of children and pets. Do not use after the expiration date printed on the packaging.
Disclaimer
This information is intended for educational purposes and healthcare professionals. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or medication. Never disregard professional medical advice or delay in seeking it because of something you have read here. The prescribing physician should be consulted for complete and current information specific to an individual patient.
Reviews
“Forxiga has been a valuable addition to our armamentarium for type 2 diabetes. Its insulin-independent mechanism and cardiorenal benefits make it a foundational therapy for many of my patients, particularly those with comorbid heart failure or chronic kidney disease. The once-daily dosing is well-received by patients.” — Endocrinologist, 15 years experience.
“The weight loss and glycemic efficacy are notable. We do have to be vigilant about counseling patients on the signs of genital infections and dehydration, but these are generally manageable. It’s a well-tolerated option for many.” — Primary Care Physician, 10 years experience.
“From a cardiology perspective, the data supporting its use for reducing heart failure hospitalizations is robust and practice-changing. It’s now a standard part of care for my diabetic patients with cardiovascular disease.” — Cardiologist, 20 years experience.
“The renal protective data is compelling. It allows us to address multiple comorbidities—diabetes, CKD, and CVD risk—with a single agent, which simplifies regimens and improves outcomes.” — Nephrologist, 12 years experience.