Dapagliflozin Reference

Plain English

What it is

Dapagliflozin is a prescription pill sold as Farxiga in the United States and Forxiga in Europe. It belongs to a group of drugs called SGLT2 inhibitors, which make the kidneys clear extra sugar out through the urine. The FDA has approved it for type 2 diabetes, heart failure, and chronic kidney disease.

What people use it for

Doctors prescribe it to help control blood sugar in type 2 diabetes and to protect the heart and kidneys. In the peptide and GLP-1 community it is best known as the SGLT2 inhibitor people point to for heart failure, including in people who do not have diabetes, which is also an FDA-approved use.

What the science shows

A large human trial called DAPA-HF in people with weakened hearts found fewer heart failure events and heart-related deaths compared with a placebo, and the benefit held whether or not the person had diabetes. Later trials extended the heart and kidney benefits, so it is now a well-studied, foundational treatment for these conditions.

The catch

This is a real prescription medicine with real risks, not a casual supplement, and it is used under medical supervision. The label lists side effects like genital yeast infections, urinary tract infections, and dehydration or low blood pressure, plus a rare but life-threatening risk of diabetic ketoacidosis that can happen even when blood sugar looks near normal. People with reduced kidney function may need changes to how it is used.

Reference summary

DAPA-HF (McMurray 2019 NEJM, n=4,744 adults with heart failure and reduced EF) reported a 26 percent relative reduction in the primary composite of worsening heart failure or cardiovascular death - notably in patients with and without diabetes. DAPA-CKD established CKD benefit. DELIVER established benefit in heart failure with preserved EF. The cumulative dataset positioned dapagliflozin alongside empagliflozin as a foundational therapy for cardiometabolic disease.

Regulatory and posture

Categories

Metabolic

Aliases

Farxiga, Forxiga, SGLT2 inhibitor (small molecule, not a peptide)

Evidence posture

human

Regulatory status

FDA-approved as Farxiga (Forxiga in EU) for type 2 diabetes (2014), heart failure with reduced ejection fraction (2020), chronic kidney disease (2021), and heart failure across the ejection fraction spectrum (2023). Fixed-dose combinations with metformin (Xigduy XR) and saxagliptin (Qtern) are also approved.

Content review status

label verified