Drugs in Perspective: Farxiga (dapagliflozin)
Antidiabetic drugs are considered to be first-line treatment options for individuals with type 1 and type 2 diabetes mellitus. It is estimated that type 2 diabetes affects about 24 million persons in the United States. Over time high blood levels can lead to complications such as heart disease, kidney damage, or blindness.1 When it comes to the treatment of type 2 diabetes individuals have the option of using oral hypoglycemic agents, compared to individuals with type 1 diabetes that requires insulin therapy.
Farxiga (dapagliflozin), in tablets for oral use, is a sodium-glucose cotransporter 2 (SGLT2) inhibitor that was approved by FDA in January 2014 as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes.2 As a SGLT2 inhibitor, it works in the proximal renal tubules and decreases the glucose reabsorption and increased glucose excretion.3,4 It is available as a 5-mg and 10-mg oral tablet.3 The suggested dosing regimen is 5 mg once daily in the morning, with or without food, with an increase to 10 mg once daily. For individuals with renal impairment, use is to be avoided in those with an estimated glomerular filtration rate (eGFR) of 30 to 59 and use is contraindicated in those with an eGFR less than 30.
Although there are many other antidiabetic drugs on the market dapagliflozin is unique in the novel approach that it takes to reduce blood sugar by blocking reabsorption of glucose by the kidneys, increasing the excretion of glucose in the urine, and reducing the glucose levels in the blood.5 It tends to differ from other drugs that decrease the amount of sugar that is absorbed from food and ultimately stored in the liver. It is the second drug of its kind, following canagliflozin, which was approved in March 2013.6