Farxiga side effects and Precautions

Farxiga (dapagliflozin) is a medication used to improve blood sugar control in adults with type 2 diabetes mellitus. It belongs to a class of drugs known as sodium-glucose cotransporter 2 (SGLT2) inhibitors. While it can be effective in managing blood sugar levels, like all medications, it can have side effects.

Farxiga side effects may include

1. Urinary Tract Infections (UTIs): Farxiga can increase the risk of developing UTIs, including bladder infections. Symptoms may include a frequent need to urinate, pain or burning with urination, and cloudy or foul-smelling urine.
2. Genital Fungal Infections: Both men and women may experience yeast infections in the genital area, such as Candida infections. Symptoms can include itching, redness, and swelling in the genital area, as well as a discharge.
3. Increased Urination: Farxiga works by causing the kidneys to remove more glucose from the body through urine, which can lead to increased urination, especially at the start of treatment.
4. Hypotension (Low Blood Pressure): Some people may experience low blood pressure, especially if they are also taking medications for high blood pressure or have certain medical conditions.
5. Hypoglycemia (Low Blood Sugar): When used in combination with other diabetes medications, such as insulin or sulfonylureas, Farxiga may increase the risk of low blood sugar.
6. Kidney Problems: In rare cases, Farxiga can cause acute kidney injury. Symptoms may include decreased urine output, swelling in the legs and feet, and fatigue.
7. Bone Fractures: Some studies suggest that SGLT2 inhibitors may increase the risk of bone fractures, although the exact relationship is not fully understood.
8. Volume Depletion: Farxiga can lead to a loss of body fluids, which can cause symptoms like dizziness, lightheadedness, and fainting, especially when standing up from a sitting or lying position (orthostatic hypotension).
9. Allergic Reactions: Although rare, some people may have an allergic reaction to Farxiga, which can include symptoms like rash, itching, swelling, severe dizziness, or trouble breathing.
10. Ketoacidosis: There have been reports of a serious condition called diabetic ketoacidosis (DKA) in people taking SGLT2 inhibitors, including Farxiga. DKA is a serious condition that requires immediate medical attention and can be life-threatening.
11. Necrotizing Fasciitis of the Perineum (Fournier’s Gangrene): This is a rare but serious bacterial infection of the tissue under the skin in the area between the genitals and the anus. It is a medical emergency and requires immediate treatment.

Not everyone will experience these side effects, and some people may experience other side effects not listed here. If you are taking Farxiga and experience any unusual symptoms or side effects, it is important to contact your healthcare provider for advice. They can provide guidance on managing side effects and determine if the medication is right for you.

Precautions and warnings to be aware of

Firstly, if you have a history of a severe allergic reaction to dapagliflozin or any of the other ingredients in Farxiga, you should not use this medication. Additionally, Farxiga is not recommended for use in patients with type 1 diabetes, as it may increase the risk of developing diabetic ketoacidosis.

Farxiga is not recommended for patients with severe kidney disease (or those undergoing dialysis) or for those with diabetic ketoacidosis. Before starting Farxiga, inform your doctor if you have liver disease, a history of bladder infections or other urinary problems, pancreatic issues (including a history of surgery), alcoholism, or if you are currently drinking a lot of alcohol, or if you are on a low-salt diet.

Farxiga is not recommended during the second or third trimester of pregnancy. If you are pregnant or planning to become pregnant, follow your doctor’s instructions regarding the use of Farxiga. It is important to control diabetes during pregnancy. This medication is also not recommended during breastfeeding, as it may cause serious side effects in the nursing infant.

Farxiga use may lead to dehydration, which can cause weakness or dizziness, especially when standing up. It is important to maintain proper hydration before starting treatment and to monitor for signs and symptoms of dehydration while taking this medication, especially in elderly patients, those with kidney impairment, or those with low blood pressure, and patients taking diuretics. If you become sick with vomiting or diarrhea, or if you are eating and drinking less than usual, inform your doctor.

Farxiga may increase the risk of genital fungal infections, particularly in patients with a history of genital fungal infections. If you experience pain, redness, swelling, fever, or discomfort, especially in the genital or perineal area, seek medical attention immediately.

Farxiga may cause urinary tract infections, which require prompt monitoring and treatment. Additionally, this medication can sometimes cause pain or pink/bloody urine, which is usually a sign of a urinary tract infection but can also be a sign of a rare condition (bladder cancer). If you experience these symptoms, inform your doctor immediately.

If you are using this medication to treat diabetes, it usually does not cause low blood sugar (hypoglycemia). However, hypoglycemia can occur if Farxiga is used with other glucose-lowering medications, or if your food intake is insufficient, or if you engage in unusually strenuous exercise. Discuss with your doctor or pharmacist whether you may need to reduce the dose of your other diabetes medications.

In the United States, Farxiga is manufactured by AstraZeneca. Here’s a brief introduction to AstraZeneca.AstraZeneca is a global, science-led biopharmaceutical company that focuses on the discovery, development, and commercialization of prescription medicines in Oncology, Cardiovascular, Renal & Metabolism, and Respiratory & Immunology.AstraZeneca is known for its robust pipeline of innovative drugs and has been involved in developing treatments for various diseases, including COVID-19 vaccine in collaboration with the University of Oxford.

Competition from several medications in the US market, including:

1. Kerendia (Finerenone): Developed by Bayer, this drug is used to treat chronic kidney disease and heart-related conditions in patients with type 2 diabetes. Kerendia is the first non-steroidal, selective mineralocorticoid receptor antagonist (MRA) approved for diabetic kidney disease and heart failure. It will directly compete with established SGLT2 inhibitors like Farxiga and Johnson & Johnson’s Invokana.
2. Glenmark’s Generic Drug: The US Food and Drug Administration (FDA) has approved a generic version of Farxiga developed by India’s Glenmark Pharmaceuticals. This will introduce competition for Farxiga, although it is currently unclear when the generic will be launched.
3. Jardiance (Empagliflozin): Developed by Eli Lilly and Boehringer Ingelheim, this SGLT2 inhibitor is used to treat type 2 diabetes and chronic kidney disease. Jardiance is gaining market share in the chronic kidney disease segment and is evenly matched with Farxiga in the US heart failure market.
4. Ozempic (Semaglutide): This GLP-1 receptor agonist, developed by Novo Nordisk, is used for the treatment of type 2 diabetes. Ozempic competes with Farxiga in the diabetes treatment field.

These medications compete with Farxiga in various indications and treatment areas, providing patients and doctors with a range of treatment options.

Advantages as a medication for the treatment of type 2 diabetes:

1. Cardiovascular Benefits: Farxiga has shown significant reductions in the risk of cardiovascular events, including heart attacks and strokes, in patients with established cardiovascular disease.
2. Kidney Protection: The drug has demonstrated the ability to slow the progression of kidney disease in patients with diabetes, offering a vital benefit for those at risk of developing chronic kidney disease.
3. Weight Loss: Farxiga can lead to modest weight loss, which is an important consideration for overweight or obese patients with diabetes.
4. Blood Pressure Reduction: It also helps to lower blood pressure, which is a common comorbidity in patients with diabetes.
5. Hypoglycemia Risk: Farxiga has a low risk of causing hypoglycemia (low blood sugar) when used as monotherapy, making it a safer option for some patients.
6. Convenience: The medication is taken orally and typically requires only once-daily dosing, which can improve patient compliance.
7. Broad Indications: Farxiga’s indications have expanded to include the treatment of heart failure, both with and without diabetes, broadening its potential patient population.

These advantages make Farxiga a significant player in the diabetes market, offering comprehensive benefits for patients with type 2 diabetes and related conditions.