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Farxiga alternatives: What can I take instead of Farxiga?

Alternatives to Farxiga include Jardiance, Glipizide, metformin, Januvia, and Rybelsus. Get the full list of Farxiga alternatives here.
By | Feb. 20, 2022
Three prescription pill bottles: Compare Farxiga alternatives

Key takeaways

  • Some alternatives to Farxiga for managing Type 2 diabetes include Jardiance, glipizide, metformin, Januvia, or Rybelsus, each with unique side effects and benefits.

  • Farxiga, an SGLT2 inhibitor, offers benefits such as weight loss, reduced blood pressure, and lower hypoglycemia risk, but has drawbacks like cost and potential serious side effects.

  • Lifestyle changes and natural alternatives like low carbohydrate diets, exercise, weight loss, and dietary supplements can also help achieve glucose control in Type 2 diabetes mellitus.

  • Switching from Farxiga to an alternative should be discussed with a healthcare provider to ensure the new medication aligns with the patient’s health needs.

Compare Farxiga alternatives | Jardiance | Glipizide | Metformin | Januvia | Rybelsus | Natural alternatives | How to switch meds

Farxiga is the brand-name version of dapagliflozin, one of the sodium-glucose cotransporter 2 (SGLT2) inhibitors. It’s manufactured by AstraZeneca. This drug class facilitates blood glucose (sugar) control in Type 2 diabetes mellitus by increasing urinary glucose, so more sugar is eliminated from the body. Much attention has been paid to the SGLT2 inhibitors in recent years as cardiac and renal (kidney) benefits have come to light. Based on advantages in heart failure treatment and the setting of renal impairment, Farxiga and other members of the class are increasingly being chosen for Type 2 diabetes mellitus therapy. Their usage is bolstered by the potential for weight loss and lower blood pressure with use and the lack of a hypoglycemia (low blood sugar) side effect in the absence of other diabetic medications. Their once-a-day oral dosing is also attractive in comparison to injectable drugs. Despite all of these positive attributes, SGLT2 inhibitors like Farxiga have important detractors to make note of, particularly their cost and serious side effects. Knowing about the alternatives to Farxiga is beneficial when its side effects and expense are unacceptable. We will explore Farxiga alternatives here.

RELATED: What is Farxiga used for?

Farxiga is the brand-name version of dapagliflozin, one of the sodium-glucose cotransporter 2 (SGLT2) inhibitors. It’s manufactured by AstraZeneca. This drug class improves blood glucose (sugar) control in Type 2 diabetes mellitus by increasing urinary glucose, so more sugar is eliminated from the body. SGLT2 inhibitors have cardiac and renal (kidney) benefits that are helpful in reducing the risks of hospitalization from heart failure and worsening renal impairment. Farxiga and other SGLT2 inhibitors have also gained popularity for Type 2 diabetes therapy. Farixga has the potential for weight loss, it lowers blood pressure, and it has a lower risk of hypoglycemia (low blood sugar), which is a more common side effect of other diabetic medications. Farxiga’s once-a-day oral dosing is also more attractive to patients than injectable drugs. Despite the advantages, SGLT2 inhibitors have some disadvantages too. These alternatives to Farxiga may be more cost-effective and pose less of a risk for certain side effects.

What can I take in place of Farxiga?

There are many drugs similar to Farxiga. However, it’s important to always discuss medication changes with a healthcare professional before stopping Farxiga. A healthcare provider or pharmacist will be able to provide you with the right prescribing information and medication guides to inform your decision. These Farxiga alternatives may have different uses, side effects, and dosages, which are highlighted in the table below.

Compare Farxiga alternatives
Drug name Uses Side effects Dosage Get coupon
Farxiga (dapagliflozin) Type 2 diabetes mellitus, heart failure risk reduction in Type 2 diabetes mellitus with heart disease or multiple cardiovascular risk factors, heart failure risk reduction in those with reduced cardiac ejection fractions, heart failure, and kidney disease progression risk reduction in those with chronic renal disease Genital yeast infections, UTI, urinary frequency, nausea, constipation, renal impairment, ketoacidosis, orthostatic hypotension, gangrene 5-10 mg once daily Get Farxiga coupons
Jardiance (empagliflozin) Type 2 diabetes mellitus, cardiovascular event risk reduction in Type 2 diabetes mellitus, heart failure risk reduction in those with reduced cardiac ejection fractions Yeast infections, UTI, urinary frequency, nausea, abnormal cholesterol, renal impairment, ketoacidosis, orthostatic hypotension, gangrene  10-25 mg once daily Get Jardiance coupons
Invokana (canagliflozin) Type 2 diabetes mellitus, cardiovascular event risk reduction in Type 2 diabetes mellitus with cardiovascular disease, kidney disease progression risk reduction, and cardiovascular event risk reduction in those with Type 2 diabetes mellitus and nephropathy and albuminuria >300 mg/day Yeast infections, UTI, urinary frequency, nausea, constipation, high cholesterol, renal impairment, ketoacidosis, orthostatic hypotension, bone density loss, fracture, pancreatitis, gangrene, lower limb amputation risk, renal cell cancer risk 100-300 mg once daily Get Invokana coupons
Glipizide Type 2 diabetes mellitus Hypoglycemia, nervousness, tremor, drowsiness, diarrhea, nausea, low blood cell counts, liver impairment, low sodium 2.5-20 mg twice daily Get glipizide coupons
Amaryl (glimepiride) Type 2 diabetes mellitus Hypoglycemia, dizziness, diarrhea, nausea, low blood cell counts, liver impairment, hyponatremia 1-4 mg once daily Get Amaryl coupons
Repaglinide Type 2 diabetes mellitus Hypoglycemia, diarrhea, nausea, low blood cell count, chest pain, pancreatitis, liver impairment, hyponatremia  0.5-4 mg before meals up to four times daily Get repaglinide coupons
Metformin Type 2 diabetes mellitus, polycystic ovarian syndrome (off-label) Diarrhea, nausea, indigestion, vitamin B12 deficiency, liver toxicity, lactic acidosis 500-1000 mg twice daily Get metformin coupons
Trulicity (dulaglutide) Type 2 diabetes mellitus, cardiovascular event risk reduction in those with Type 2 diabetes and cardiovascular disease or multiple risk factors Nausea, diarrhea, abdominal pain, pancreatitis, gallbladder inflammation, renal impairment, thyroid cancer risk 0.75-4.5 mg subcutaneous (under the skin) injection once weekly Get Trulicity coupons
Ozempic (semaglutide) Type 2 diabetes mellitus, cardiovascular event risk reduction in those with Type 2 diabetes and cardiovascular disease Nausea, diarrhea, abdominal pain, pancreatitis, gallbladder inflammation, renal impairment, diabetic retinopathy, thyroid cancer risk 0.5-1 mg subcutaneous injection once weekly Get Ozempic coupons
Rybelsus (semaglutide) Type 2 diabetes mellitus Nausea, diarrhea, abdominal pain, pancreatitis, gallbladder inflammation, renal impairment, diabetic retinopathy, thyroid cancer risk 7-14 mg once daily Get Rybelsus coupons
Victoza (liraglutide) Type 2 diabetes mellitus, cardiovascular event risk reduction in those with Type 2 diabetes and cardiovascular disease Nausea, diarrhea, hypoglycemia, abdominal pain, pancreatitis, gallbladder inflammation, renal impairment, thyroid cancer risk 1.2-1.8 mg subcutaneous injection once daily Get Victoza coupons
Januvia (sitagliptin) Type 2 diabetes mellitus Headache, diarrhea, abdominal pain, heart failure, pancreatitis, renal impairment, joint pain 100 mg once daily Get Januvia coupons
Precose (acarbose) Type 2 diabetes mellitus Gas, diarrhea, abdominal pain, inflamed liver, slowing of the bowels, gas within the intestinal wall 50-100 mg three times daily Get Precose coupons
Actos (pioglitazone) Type 2 diabetes mellitus Fluid retention, swelling, congestive heart failure, diabetic macular edema, weight gain, headache, bladder cancer risk, fracture risk 15-45 mg once daily Get Actos coupons
Lantus Solostar (insulin glargine) Type 2 diabetes mellitus, Type 1 diabetes mellitus Hypoglycemia, weight gain, muscle pain, edema, low potassium Individualized dose injected subcutaneously once daily Get Lantus Solostar coupons
Xigduo XR (dapagliflozin/metformin extended release [ER]) Type 2 diabetes mellitus Yeast infections, UTI, urinary frequency, nausea, diarrhea, vitamin B12 deficiency, constipation, renal impairment, liver toxicity, lactic acidosis, ketoacidosis, orthostatic hypotension, gangrene 1-2 tablets every morning (2.5-10 mg of dapagliflozin with 500-1000 mg of extended release metformin per tablet) Get Xigduo XR coupons

Other alternatives to Farxiga

Top 5 Farxiga alternatives

1. Jardiance

Like Farxiga, Jardiance is an SGLT2 inhibitor. They are both expensive and have similar side effects. Farxiga and Jardiance are associated with a risk of genital yeast infections and urinary tract infections (UTIs). 

Both have a diuretic effect by eliminating fluid from the body while they reduce sugar. Consequently, they can be helpful in the setting of congestive heart failure with a reduced cardiac ejection fraction (lower percentage of blood squeezed out of the pumping chambers with a heartbeat) and can help to reduce blood pressure. 

Conversely, Jardiance was shown to reduce the risk of cardiovascular morbidity and mortality in individuals with Type 2 diabetes and high cardiovascular risk, so it may be a better alternative to Farxiga in those with high cardiovascular risk.

Based on a clinical trial, Farxiga has an additional indication from the Food and Drug Administration (FDA) for reducing the risk of kidney problems and kidney disease progression in chronic renal disease. 

RELATED: Jardiance side effects | Jardiance dosage

2. Glipizide

Glipizide is a generic medication with a significantly lower cost compared to Farxiga. As a much older medicine, there is a longer track record with glipizide, leading some patients and healthcare providers to be more comfortable with it. However, the sulfonylurea drug class, including glipizide, is less favored than in the past. Sulfonylureas have a significant hypoglycemia (low blood sugar level) risk, an association with weight gain, and the lack of additional cardiac indications.

RELATED: Glipizide side effects | Glipizide dosage

3. Metformin

The preferred initial drug and foundational maintenance drug for Type 2 diabetes mellitus is metformin, the one available member of the biguanide class. Metformin avoids weight gain and hypoglycemia, and it can slow the progression of diabetes. 

Not only is it typically a better alternative to Farxiga as a first medication for diabetes, but also it is usually continued when Farxiga is added. Xigduo XR actually provides both drugs by combining extended-release metformin and dapagliflozin in one tablet. 

Metformin may also be more suitable than Farxiga for women who are pregnant or breastfeeding.

Metformin, a generic medication, is much less expensive than Farxiga. Contraindications to metformin, such as advanced renal disease, and gastrointestinal adverse effects, like diarrhea, are limiting factors. The extended-release formulation of metformin is tried at times to lessen diarrhea effects.

RELATED: Metformin side effects | Metformin vs. metformin ER

4. Januvia

While it is also an expensive brand-name medication, Januvia does have some advantages over Farxiga. Januvia and other dipeptidyl peptidase-4 (DPP-4) inhibitors, such as Tradjenta, Onglyza, and Nesina, avoid side effects of the genitals and urinary organs as well as orthostatic hypotension (low blood pressure upon standing) that can affect Farxiga users. However, Januvia does not have FDA indications for cardiac or renal protection.

RELATED: Januvia side effects | Januvia dosage

5. Rybelsus

Rybelsus and other glucagon-like peptide-1 (GLP-1) receptor agonists, such as Ozempic, Victoza, and Trulicity, are viable alternatives to Farxiga. Although they are expensive, the GLP-1 agonists can help with weight loss efforts. Ozempic, Victoza, and Trulicity have been shown to reduce cardiovascular event risk in certain individuals, but unlike Rybelsus, they are taken by injection. Unlike the SGLT2 inhibitors, the GLP-1 agonists do not have indications for heart failure.

Natural alternatives to Farxiga

Prescription drugs are not the only avenue for reaching diabetic treatment goals. Lifestyle measures like a low carbohydrate diet, exercise, and weight loss have proven beneficial. Dietary supplements may also help. A meta-analysis of clinical studies determined that dietary fiber is helpful in achieving glucose control in Type 2 diabetes mellitus. Cinnamon may assist somewhat as well. Always check with your doctor about allergic reactions or drug interactions that may occur prior to using natural alternatives. For some, these alternatives may not negate the need for prescription medication, but they are worth getting medical advice about from a healthcare professional.

RELATED: What’s the best diabetes diet?

How to switch to a Farxiga alternative

If you want to stop taking Farxiga, discuss your reasoning with your healthcare provider. Whether you are looking for a cheaper option or one that avoids a particular side effect, an alternative likely exists. Farxiga can be stopped without a taper, but worsening of glucose levels or heart failure symptoms could be experienced upon discontinuation. For this reason, it is best to understand how to monitor for these problems and make sure the prescribing provider is in agreement with stopping the drug.