Farxiga, made simple.
Farxiga is one small pill a day, but it does more than one job. It helps with blood sugar, it protects the heart, and it protects the kidneys. This guide explains how it works, how to take it safely, and the few warning signs that are worth knowing. A Mississippi pharmacist who fills Farxiga every day wrote it for you.
This guide is here to teach you. It is not medical advice, and it does not replace your doctor or pharmacist. Always do what your doctor tells you, and ask a pharmacist before you change how you take any medicine.
Print this guide for your fridgeThe warning every Farxiga patient must know
- Ketoacidosis can happen on Farxiga even when your blood sugar is not extremely high. Get urgent help for nausea, vomiting, abdominal pain, unusual tiredness, weakness, or trouble breathing, even when blood glucose is below 250 mg/dL.
- The risk rises with reduced eating or prolonged fasting, serious illness, surgery, dehydration, a major insulin reduction, or heavy alcohol use. Before surgery, prolonged fasting, or a serious illness, contact the clinician who manages your Farxiga.
Your 60 second Farxiga safety checklist
- Take it once daily.Take Farxiga at the same time each day, with or without food.
- Know why you take it.It may be prescribed for blood sugar, heart failure, kidney protection, or a combination of these reasons.
- Stay hydrated.Farxiga can increase urination and contribute to dehydration or low blood pressure. Drink enough fluid unless your clinician has given you a fluid restriction.
- Watch for ketoacidosis.Nausea, vomiting, abdominal pain, unusual tiredness, or trouble breathing require urgent evaluation, even when blood glucose is below 250 mg/dL.
- Check before surgery or fasting.Farxiga is generally withheld for at least three days before scheduled surgery. Your own clinician must provide the exact stop and restart plan.
- Report infection symptoms promptly.Burning urination, fever, genital itching, discharge, redness, pain, or swelling should not be ignored.
What Farxiga is and why your doctor gave it to you
Farxiga is a once a day pill. Its other name is dapagliflozin. It is the same medicine.
Doctors give Farxiga for one or more of these reasons.
- Type 2 diabetes. Farxiga helps lower blood sugar, used along with healthy eating and activity.
- Heart failure. Farxiga lowers the chance of being in the hospital for heart failure, and helps the heart work under less strain.
- Chronic kidney disease. Farxiga can slow down kidney disease and help protect kidney function over time.
The simple version: Farxiga started as a diabetes pill, but doctors learned it also protects the heart and the kidneys. Farxiga can protect the heart and kidneys even when it is not being used primarily to lower blood sugar. That is why your doctor may have given it to you even if your blood sugar is not the main concern.
How Farxiga works
Normally your kidneys catch sugar and put it back into your blood, so none is wasted.
Farxiga blocks that catching step. Extra sugar passes out of your body in your urine instead.
That lowers your blood sugar. The same action also removes a little extra salt and water, which takes pressure off your heart and your kidneys. That is why one pill can help with three different things. Because the medicine pulls sugar into the urine, you will probably urinate a bit more, and that is expected.
Your dose
Farxiga is a small pill taken once a day, usually in the morning. You can take it with or without food. Your doctor picks your dose and your pharmacist checks it.
Farxiga tablets come in 5 mg and 10 mg strengths. The correct dose depends on why it is prescribed and how well your kidneys work. Never change between the strengths yourself. This page will not tell you what dose to take. If you are not sure your dose is right, ask your pharmacist. That is exactly the kind of question we answer at Fairview.
Timing, and what to do if you miss a dose
Take Farxiga once a day. Most people take it in the morning. Pick a time that is easy to remember and stay with it.
There is one situation that is different from a normal missed dose, and it is important: surgery. If you have a major surgery coming up, or any procedure where you will not be able to eat for a while, Farxiga usually needs to be stopped about 3 days beforehand. Always tell your surgeon you take Farxiga, and ask your own doctor when to stop and start.
If you miss a dose:
- If you miss a dose, take it as soon as you remember that day.
- If it is almost time for the next dose, skip the one you missed. Just take the next one.
- Never take two doses at once to catch up.
- If you are not sure what to do, call your pharmacist.
Side effects, what is normal and what is not
Normal. This is the medicine working.
- You urinate a little more than before.
- A positive urine sugar test. Because Farxiga sends sugar into the urine on purpose, a urine sugar strip will read positive. That is expected and harmless. It does not mean your diabetes got worse.
Call your doctor if you see:
- A yeast infection in the genital area. This is common on Farxiga and can affect both women and men. It is treatable, so tell your doctor or pharmacist.
- A urinary tract infection, with burning, urgency, or needing to go often.
- Significant dizziness, fainting, severe weakness, a very dry mouth, or not being able to keep fluids down. These can mean dangerous dehydration, not just extra urination.
- Fever, chills, back or side pain, blood in your urine, or urinary symptoms that are getting worse.
- Any sore, cut, or infection on your feet or legs that is slow to heal.
Go to the emergency room right away if:
- You have nausea, vomiting, stomach pain, and trouble breathing, even if your blood sugar looks normal. With this kind of medicine, a dangerous condition called ketoacidosis can happen even when sugar is not high. Do not wait it out.
- You have pain, tenderness, redness, or swelling in the genital or rear area, along with fever or feeling very unwell. This is a rare but serious infection that needs care right away.
- You have signs of a severe allergic reaction, like swelling of the face or throat or trouble breathing.
What to be careful with
The biggest thing to be careful with on Farxiga is staying hydrated, and being thoughtful about water pills. Drink enough fluid unless your clinician has given you a fluid restriction. Ask how much fluid is appropriate for your heart and kidney condition.
If you take a water pill, also called a diuretic, Farxiga adds to its effect, because both make you lose fluid. Together they can drop your blood pressure or stress your kidneys. That does not mean you cannot take both. It means your doctor should know, and you should watch for feeling dizzy or lightheaded.
Getting dehydrated for any reason, a stomach bug, a hot day, hard exercise, raises your risk of problems on Farxiga. On sick days, when you cannot keep fluids down, call your pharmacist or doctor and ask whether to hold the medicine for a day or two.
Farxiga alone does not usually cause low blood sugar. The risk increases when it is combined with insulin or insulin-releasing medicines such as glipizide, glimepiride, or glyburide. Ask whether those doses need adjustment when Farxiga is started.
The simple rule: before you start or stop any medicine, especially a water pill, and any time you are sick or dehydrated, tell your pharmacist you take Farxiga. Every single time.
What it costs
The cost is different for every person, because every insurance plan is different.
Here is the honest way to find your price. If you pay cash, call Fairview and we will give you a price for your situation. If you have private insurance, there may be a coupon or a savings program from the maker of the drug that helps lower your cost, and we will check if one is available for you. The best step is to let a pharmacist look at your plan. We do this for every patient.
Do not let cost make you skip doses. Call us first. There is almost always something we can do.
Availability and insurance coverage can change. Fairview will check whether an FDA approved lower cost alternative, a manufacturer savings program, an insurance exception, or another cost saving option is available for your specific prescription.
What should be checked
Farxiga does not need a special blood test of its own, but a few things should be watched while you take it.
Your doctor should check, now and then:
- How well your kidneys work. A small dip soon after starting is expected and usually settles.
- Your blood pressure and whether you feel lightheaded, especially if you take a water pill.
- Your blood sugar and your A1C, if you have diabetes.
- Your feet, for any slow-healing sores, if you are at higher risk.
Your pharmacist should, now and then:
- Check your other medicines, especially water pills.
- Remind you of the warning signs of ketoacidosis.
- Remind you to hold Farxiga before surgery and on bad sick days.
- Make sure your dose still fits your kidney function.
At Fairview, we keep an eye on our Farxiga patients. If a refill is late, we call you. If you are starting a water pill or heading into surgery, we make sure the plan around your Farxiga makes sense.
Special situations
Before surgery.
Before surgery, prolonged fasting, or a serious illness, contact the clinician who manages your Farxiga. Farxiga is generally withheld for at least three days before scheduled surgery, but do not stop or restart it without your individualized plan. Tell your surgeon you take Farxiga. Do not guess.
Sick days.
When you are sick and cannot keep food or fluids down, the risk of dehydration and ketoacidosis goes up. Call your pharmacist or doctor and ask whether to hold Farxiga for a day or two until you are eating and drinking normally again.
Yeast and urinary infections.
Because Farxiga puts sugar into the urine, yeast infections and urinary infections are more common. Good hygiene helps. If you get them often, tell your doctor. These are treatable and not a reason to feel embarrassed.
Pregnancy and breastfeeding.
Tell your clinician promptly if you are pregnant, planning pregnancy, or breastfeeding. Farxiga is generally not used in the second and third trimesters of pregnancy because of concern about the baby's kidney development, and it is not recommended while breastfeeding.
Older adults.
Older adults are more likely to feel the fluid-lowering effect of Farxiga, especially alongside a water pill. Watch for dizziness when standing, keep up with fluids, and let the pharmacy know if you feel unsteady.
How Fairview helps Farxiga patients
When you fill Farxiga at Fairview, here is what you get. This is normal care for us, not something extra.
At your first fill:
- We explain the warning signs of ketoacidosis in plain words.
- We tell you about the surgery hold and sick day rule.
- We check all your other medicines, especially water pills.
- We let you know the urine sugar test will read positive, so it does not worry you.
At every refill:
- We check your file for any new medicines.
- We check that you are refilling on time.
- We answer any new questions before you leave.
On our own, without being asked:
- If a refill is late, we call you.
- If we see a problem, we call your doctor.
- If there is important news about Farxiga, we tell you.
- We check your cost at every fill to make sure you are paying the best price for your plan.
Questions people ask about Farxiga
That is expected. Farxiga works by sending extra sugar and water out of your body through your urine. Urinating a bit more is part of how the medicine helps you.
Related guides
Have a question about your Farxiga? Ask a pharmacist who knows it well.
Farxiga is a simple pill that quietly does a lot, for your blood sugar, your heart, and your kidneys. Knowing the few warning signs makes it easy to take with confidence. If something made you wonder, ask us. And if you want a pharmacy that takes the time to explain your medicine, Fairview is here. Moving your prescription to us takes one phone call.