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Farxiga vs Metformin

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Comparative Analysis


For patients with type 2 diabetes, certain drugs that regulate the level of glucose in the bloodstream can help in managing blood sugar levels and avoiding complications. Farxiga and Metformin are two such medications often prescribed for this condition. Both have different mechanisms of action but aim to control high blood sugar levels in patients with type 2 diabetes. Farxiga, known as a sodium-glucose co-transporter 2 (SGLT2) inhibitor, works by preventing the kidneys from reabsorbing glucose back into the blood and instead promotes its excretion through urine. On the other hand, Metformin is classified as a biguanide; it lowers glucose production in your liver and improves your body's response to insulin.

Farxiga vs Metformin Side By Side

Brand NameFarxigaMetformin
ContraindicationsSevere kidney disease or on dialysisSevere renal impairment
CostAround $520 for 30 tablets of 10 mgAround $14 to $50 for 60 tablets of 500 mg
Generic NameDapagliflozinMetformin
Most Serious Side EffectKetoacidosis, severe urinary tract infectionsLactic acidosis
Severe Drug InteractionsNot specifically mentioned in the text, but patients should be cautious of interactions that could lead to increased risk of dehydration or ketoacidosis.Not specifically mentioned in the text, but caution is advised with drugs that can affect renal function or lead to increased risk of lactic acidosis.
Typical Dose5 mg per day, may require 10 mg/day for optimal control500 mg twice per day or 850 mg once per day, up to a maximum of 2550 mg/day

What is Farxiga?

Dapagliflozin (the generic name for Farxiga) is a relatively new drug in the class of Sodium-Glucose Cotransporter-2 (SGLT2) inhibitors. This innovative group of drugs was designed to tackle type 2 diabetes by causing the kidneys to expel sugar from the body through urine, effectively reducing glucose levels in the bloodstream. Dapagliflozin was first approved by the FDA in 2014 and has since been prescribed as part of a comprehensive treatment plan that includes diet and exercise.

On the other hand, Metformin is an older but well-established medication belonging to the biguanide class. It works differently than Dapagliflozin: rather than increasing glucose excretion, it decreases hepatic glucose production and improves insulin sensitivity. As such, metformin does not run into potential adverse effects associated with frequent urination like SGLT2 inhibitors might.

While both drugs are effective at lowering blood sugar levels, they do so via different mechanisms and have different side effect profiles which may make one or another more suitable depending on individual patient circumstances.

What conditions is Farxiga approved to treat?

Farxiga is approved for the treatment of various types of diabetes and heart conditions:

  • Type 2 Diabetes, as both a standalone medication or in combination with other diabetic medications
  • Reduction of risk for hospitalization due to heart failure in patients with type 2 diabetes and established cardiovascular disease (CVD) or multiple CVD risk factors
  • Treatment to reduce the risk of cardiovascular death and hospitalization for heart failure in adults with heart failure (reduced ejection fraction).

How does Farxiga help with these illnesses?

Farxiga assists in managing type 2 diabetes by reducing the reabsorption of filtered glucose and allowing more glucose to be excreted in urine. It specifically inhibits a protein called sodium-glucose co-transporter 2 (SGLT2), which is involved in the majority of glucose reabsorption by the kidneys. By blocking this process, Farxiga effectively lowers blood sugar levels for individuals with diabetes.

Glucose is a primary source of energy for cells in our bodies and plays crucial roles in numerous bodily functions including brain function, muscle movement, hormone regulation among others. In people with type 2 diabetes, their bodies either resist the effects of insulin — a hormone that regulates the movement of sugar into your cells — or doesn't produce enough insulin to maintain normal glucose levels.

Therefore, by preventing excessive absorption and enabling efficient elimination through urine, Farxiga aids diabetic patients manage their condition better as well as stabilize their blood sugar levels.

What is Metformin?

Metformin is a first-line medication for the treatment of type 2 diabetes, particularly in people who are overweight. It's also used in those with polycystic ovary syndrome. Unlike Farxiga (dapagliflozin), which is a sodium-glucose co-transporter 2 inhibitor that works by helping the kidneys get rid of glucose from your bloodstream, Metformin primarily decreases hepatic glucose production and increases insulin sensitivity.

First approved by the FDA in 1995, Metformin operates as a biguanide antihyperglycemic agent to lower both basal and postprandial plasma glucose levels. Its mechanism does not stimulate insulin secretion; therefore it is less likely to cause hypoglycemia unlike other classes of anti-diabetic drugs such as sulfonylureas. Despite its long track record, it has minimal effects on body weight making it an ideal choice for patients who are overweight or obese.

What conditions is Metformin approved to treat?

Metformin is a first-line medication endorsed by the American Diabetes Association for the treatment of type 2 diabetes, particularly in overweight and obese individuals. Its primary functions include:

  • Lowering blood glucose levels in adults with type 2 diabetes
  • Improving glycemic control when diet and exercise alone does not provide adequate management
  • It may also be used alongside other medications in more complex cases or for prediabetes prevention.

How does Metformin help with these illnesses?

Metformin is a medication that primarily works by decreasing glucose production in the liver and increasing insulin sensitivity, thereby reducing the level of sugar in one's blood. It plays significant roles in managing type 2 diabetes, preserving memory function, aiding weight loss efforts, and potentially extending lifespan. Unlike Farxiga which eliminates excess sugar through urine and may lead to urinary tract infection or yeast infections as side effects, metformin does not significantly affect kidney function. Metformin has been used for many decades with a strong safety profile making it often the first-line treatment when a patient is diagnosed with type 2 diabetes or shows signs of prediabetes.

How effective are both Farxiga and Metformin?

Both dapagliflozin (Farxiga) and metformin have established histories of success in treating patients with type 2 diabetes, although they were approved by the FDA several years apart. Since they act on different biochemical pathways, they may be prescribed under different circumstances. The effectiveness of dapagliflozin and metformin in managing blood glucose levels was directly studied in a double-blind clinical trial; both drugs exhibited similar efficacy as well as promising safety profiles.

A review of meta-analysis reports on metformin demonstrated that it is effective at controlling blood glucose levels from the onset of treatment, its side effect profile is generally favorable over many other antidiabetic medications, and it is well-tolerated even in elderly populations. Metformin has become one of the most widely prescribed antidiabetic drugs globally due to its long history and extensive body of research supporting its use. The dose showing optimal efficacy can vary but often lies within 1-2 grams per day range.

On the other hand, a recent review indicated that dapagliflozin seems to be more effective than placebo at reducing HbA1c levels while also offering benefits such as weight loss and lowering systolic blood pressure - advantages not typically seen with all antidiabetes treatments. Despite these benefits, dapagliflozin might be considered after or alongside first-line treatments like metformin due to price considerations or potential increased risk for genital infections compared to other diabetes medications. Regardless, because each patient's needs are unique, either drug could emerge as an optimal choice depending upon individual medical histories.

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At what dose is Farxiga typically prescribed?

Oral dosages of Farxiga generally start at 5 mg per day, although some people may require a higher dose of 10 mg/day for optimal control of their diabetes. This is typically assessed and adjusted by the treating physician based on the individual's response to therapy. On the other hand, Metformin dosage usually starts from 500 mg twice daily or 850 mg once daily, with potential increments after a few weeks if there isn't sufficient glycemic control. The maximum recommended daily dose is up to 2550 mg in adults while children aged above ten years should not exceed doses of 2000mg/day.

At what dose is Metformin typically prescribed?

Metformin treatment typically begins at a dosage of 500 mg twice per day or 850 mg once per day, taken with meals. If well tolerated, the dose can then be increased to a maximum of 2000 mg/day for those taking metformin twice daily or up to 2550 mg/day for those on the once-daily regimen. This is divided into two doses if you are consuming it twice daily and should be spaced out accordingly during your meals time. For individuals using extended-release Metformin, the maximum dose is generally limited to 2000mg/day. The adjustment towards these higher doses may only occur after examining patient response over one or two weeks, invoking step-by-step increments in dosage.

What are the most common side effects for Farxiga?

Common side effects of Farxiga include:

  • Tendency to urinate more frequently
  • Genital yeast infections in women and men
  • Urinary tract infections (UTIs)
  • Changes in urination, including urgent need to go, discomfort while urinating, or a higher amount of urine than usual
  • Thirsty feelings
  • Dehydration resulting from excessive peeing

On the other hand, Metformin also has common side effects such as:

-Nausea and vomiting -Diarrhea, stomach pain or discomfort -Loss of appetite -Taste disturbance usually metallic taste -Fatigue and weakness -Hypoglycemia (low blood sugar) symptoms like dizziness & sweating

Always remember that these lists do not contain all possible side effects. If you encounter any abnormal symptoms while on medication it is important to notify your healthcare provider.

abstract image of a patient experiencing side effect

Are there any potential serious side effects for Farxiga?

In rare cases, Farxiga can cause severe side effects that require immediate medical attention, including:

  • Symptoms suggestive of urinary tract infection or yeast infection: burning sensation during urination, cloudy or strong-smelling urine, frequent urge to urinate
  • Signs of allergic reaction such as hives; difficulty breathing; swelling in your face or throat
  • Severe skin reactions: redness, soreness, itching skin rash with peeling and blistering
  • Dehydration symptoms like dizziness, fainting or lightheadedness due to low blood pressure
  • A condition called ketoacidosis (too much acid in the blood), which may have symptoms such as trouble breathing; nausea and vomiting; abdominal pain
  • Kidney problems - little or no urinating; painful or difficult urination; swelling in your feet or ankles.

If you experience any of these side effects when taking Farxiga, seek urgent medical help.

What are the most common side effects for Metformin?

Common side effects of Metformin, a widely prescribed drug for managing Type 2 diabetes, may include:

  • Nausea or vomiting
  • Diarrhea or constipation
  • Abdominal discomfort and loss of appetite
  • Weight loss
  • A metallic taste in the mouth
  • Headache or dizziness
  • Sleep problems (insomnia) While less common, some patients might experience more severe symptoms like slow heart rate and muscle pain. It is important to consult with your healthcare provider if you are experiencing any of these symptoms while on Metformin.

Are there any potential serious side effects for Metformin?

While Metformin is usually well-tolerated, it can also result in some severe side effects. These might include:

  • Signs of an allergic reaction such as hives; difficulty breathing; swelling of your face, lips, tongue or throat
  • Symptoms related to lactic acidosis - a buildup of lactic acid in the body which could be fatal. These symptoms include unusual muscle pain, trouble breathing, stomach pain or vomiting, dizziness or feeling cold
  • Low blood sugar (hypoglycemia) which may cause symptoms like headache, confusion, sweating and fast heartbeat
  • Unusual weakness or tiredness
  • Trouble with sleep due to respiratory issues

Should any of these occur while on Metformin treatment – especially if they persist – seek immediate medical attention.

Contraindications for Farxiga and Metformin?

Both Farxiga and Metformin, like many other medications for diabetes, can sometimes cause unpleasant side effects. If you notice symptoms such as unusual fatigue, unexplained weight loss or gain, frequent urination or thirst, blurred vision or recurrent infections while taking these medicines, it may be a sign that your blood sugar levels are not well controlled. In such cases, please seek immediate medical attention.

Farxiga should not be taken if you have severe kidney disease or are on dialysis; similarly Metformin should also be avoided if you have severe renal impairment. Always inform your doctor about all the medications that you are currently taking including over-the-counter drugs and dietary supplements; certain medicine combinations may require close monitoring to prevent harmful interactions with either Farxiga or Metformin.

It's worth mentioning that both of these drugs aren't suitable for treating type 1 diabetes mellitus and can lead to a dangerous condition called ketoacidosis (high ketones in your blood) if used incorrectly. Therefore always use them under the supervision of an experienced healthcare provider.

How much do Farxiga and Metformin cost?

For the brand name versions of these drugs:

  • The price of 30 tablets of Farxiga (10 mg) averages around $520, which works out to approximately $17.33/day.
  • The price of 60 tablets of Metformin (500 mg) ranges from about $14 to $50, working out to roughly $0.23 - $0.83/day.

Thus, if you are on the standard dosage for Farxiga (10 mg/day), then brand-name Metformin is less expensive on a per-day treatment basis. Please note that cost should not be a primary consideration in determining which drug is right for you.

For the generic versions of Metformin and there's no generic version available for Farxiga:

  • Metformin (500 mg tablets) is available in packs starting at 60 tablets up to higher quantities with an approximate cost as low as $.05 per day depending upon your dose and where it's purchased.

There might be some potential savings programs or insurance coverage making any drug more affordable so always consult with your healthcare provider or pharmacist regarding costs.

Popularity of Farxiga and Metformin

Farxiga (dapagliflozin) is a newer type of medication for the treatment of type 2 diabetes that was estimated to have been prescribed to about 1.5 million people in the US in 2020. Farxiga, which belongs to a class of drugs known as SGLT2 inhibitors, accounted for just over 17% of prescriptions within its drug class last year. The popularity and prescription rates for this drug have been steadily increasing since its approval by the FDA in 2014.

Metformin, on the other hand, has long been established as a first-line therapy for managing blood sugar levels in patients with type-2 diabetes due to its efficacy and favorable safety profile. In fact, it's one of the most commonly-prescribed medications globally; approximately 80 million prescriptions were filled for metformin alone in the US during 2020. This accounts for nearly half (48%) of all anti-diabetic medicine prescriptions written last year. Despite being an older drug, metformin’s prevalence has remained steady over recent years due to its effectiveness and affordable cost.


Both Farxiga (dapagliflozin) and Metformin have substantial histories of usage in patients with Type 2 diabetes, and are supported by numerous clinical studies indicating they are more effective than placebo treatments. In some cases, the two drugs can be combined to improve blood sugar control. However, this needs careful consideration as the combination may also increase risk of adverse effects such as hypoglycemia or genital infections. The mechanisms of action differ between these medications; Metformin primarily reduces glucose production in the liver and improves insulin sensitivity while Farxiga works by preventing reabsorption of glucose by kidneys thus leading to its excretion via urine.

Both drugs are available in generic form which represents significant cost savings for patients paying out-of-pocket. It's worth noting that both Farxiga and Metformin may require an adjustment period when starting or changing doses.

The side effect profile is somewhat similar between the two medications although there are differences due to their unique mechanisms; metformin is associated with gastrointestinal disturbances while dapagliflozin could lead to dehydration or urinary tract infections. Regardless, all patients should closely monitor their blood sugars particularly when initiating therapy with either medication.