Farxiga vs. Actos

See how Farxiga and Actos compare on approved uses, dosing, side effects, and cost.

Key Takeaways

  • Farxiga treats type 2 diabetes, heart failure, and chronic kidney disease, while Actos is approved only for blood sugar control in type 2 diabetes.

  • Actos carries a boxed warning for worsening heart failure, while Farxiga is actually used to treat certain types of heart failure.

  • Farxiga's most common side effects involve genital and urinary infections, while Actos is more associated with respiratory infections, headache, and long-term risks like bladder cancer and fractures.

Farxiga vs. Actos Drug Summary

Farxiga

Farxiga (dapagliflozin) is an SGLT2 inhibitor used to control blood sugar in type 2 diabetes and is also approved to treat heart failure and slow chronic kidney disease progression. It comes as a tablet taken once a day, usually starting at 5 mg and increasing to 10 mg if needed.

Actos

Actos (pioglitazone) is a thiazolidinedione used to control blood sugar in type 2 diabetes, either alone or with other diabetes medications. It is taken as a once-daily tablet, typically starting at 15 mg and increasing up to 45 mg based on response.

Farxiga vs. Actos Side Effects

Farxiga

Most common
female genital mycotic infections (6.9%)
nasopharyngitis (6.3%)
urinary tract infections (4.3%)
back pain (4.2%)

Actos

Most common
upper respiratory tract infection (13.2%)
headache (9.1%)
sinusitis (6.3%)
myalgia (5.4%)

Farxiga vs. Actos Dosage

Farxiga

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 5 mg once daily At the start
Maximum dose 10 mg once daily If needed
Dose changes 1 increase As tolerated

Actos

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 15 mg once daily At the start
Maximum dose 45 mg once daily If needed
Dose changes 2 increases As tolerated

Farxiga vs. Actos Indications

Farxiga

Farxiga is FDA-approved for type 2 diabetes in adults and children 10 and older, and its use has expanded well beyond glucose control. It also treats heart failure with reduced or preserved ejection fraction and slows the progression of chronic kidney disease, even in people without diabetes.

  • Type 2 diabetes in adults and children 10+

  • Reduce risk of heart failure hospitalization

  • Treat heart failure (reduced or preserved EF)

Actos

Actos is FDA-approved only for blood sugar control in adults with type 2 diabetes, used alone or combined with other diabetes medications. It is sometimes prescribed off-label for nonalcoholic fatty liver disease, though this is not an FDA-approved use.

  • Type 2 diabetes blood sugar control

  • Used as monotherapy or combination therapy

  • Off-label: nonalcoholic fatty liver disease (NASH)

Farxiga vs. Actos Pros and Cons

Farxiga

Farxiga's clinical profile extends far beyond diabetes, with FDA approval for heart failure and chronic kidney disease that Actos does not share. It carries its own risks, including genital infections and rare but serious complications like Fournier's gangrene.

Pros

  • Also approved to treat heart failure

  • Slows chronic kidney disease progression

  • Approved for children 10 and older with diabetes

  • Reduces cardiovascular death risk in heart failure

Cons

  • Risk of genital yeast infections

  • Rare risk of Fournier's gangrene

  • Not recommended with significant kidney impairment

  • Risk of urinary tract infections

Actos

Actos has decades of use and a well-established side effect profile, but its boxed warning for heart failure limits who can safely take it. It remains a straightforward option for glucose control alone or in combination with other diabetes drugs.

Pros

  • Low-cost generic widely available

  • Long-term safety track record since 1999

  • No increased risk of genital infections

  • No dose adjustment needed for kidney function

Cons

  • Boxed warning for worsening heart failure

  • Contraindicated in advanced heart failure

  • Increased risk of bladder cancer with long-term use

  • Increased fracture risk in women

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