Farxiga vs. Glipizide
See how Farxiga and Glipizide compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Farxiga and glipizide both lower blood sugar in type 2 diabetes, but Farxiga also treats heart failure and chronic kidney disease, while glipizide is approved only for diabetes.
Farxiga is taken once daily with no dose titration, while glipizide often requires gradual dose increases and, with the immediate-release form, can mean multiple daily doses.
Glipizide costs far less out of pocket than Farxiga, but it carries a higher risk of hypoglycemia and older concerns about cardiovascular safety tied to sulfonylureas.
Farxiga vs. Glipizide Drug Summary
Farxiga
Farxiga (dapagliflozin) is an SGLT2 inhibitor that helps the kidneys remove extra sugar through urine. It's approved for type 2 diabetes in adults and children 10 and older, and also for heart failure and chronic kidney disease. It comes as an oral tablet taken once daily, usually starting at 5 mg.
Glipizide
Glipizide is a sulfonylurea that lowers blood sugar by triggering the pancreas to release more insulin. It's approved only for adults with type 2 diabetes, taken as an oral tablet once or twice daily depending on the immediate-release or extended-release form. Dosing typically starts low and is adjusted upward over time.
Farxiga vs. Glipizide Side Effects
Farxiga
Glipizide
Farxiga vs. Glipizide Dosage
Farxiga
Glipizide
| 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 |
| STAGE | DOSE | WHEN |
| Starting dose | 5 mg once daily | At the start |
| Maximum dose | 5-20 mg once daily | If needed |
| Dose changes | 5 increases | As tolerated |
Farxiga
| 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 |
Glipizide
| STAGE | DOSE | WHEN |
| Starting dose | 5 mg once daily | At the start |
| Maximum dose | 5-20 mg once daily | If needed |
| Dose changes | 5 increases | As tolerated |
Farxiga vs. Glipizide Indications
Farxiga
Farxiga is an SGLT2 inhibitor that lowers blood sugar by causing the kidneys to remove extra glucose through urine. It's approved for type 2 diabetes in adults and children 10 and older, and separately approved to treat heart failure and slow chronic kidney disease, even in people without diabetes.
Type 2 diabetes blood sugar control (adults and children 10+)
Reduce risk of heart failure hospitalization in at-risk patients
Treat heart failure, reducing cardiovascular death and hospitalization
Slow chronic kidney disease progression and reduce kidney failure risk
Glipizide
Glipizide is a sulfonylurea that lowers blood sugar by prompting the pancreas to release more insulin. It's approved only for blood sugar control in adults with type 2 diabetes, used alongside diet and exercise as part of a broader treatment plan.
Blood sugar control in adults with type 2 diabetes
Used as an add-on to diet and exercise
Available as immediate-release and extended-release tablets
Not approved for heart failure or kidney disease
Farxiga vs. Glipizide Pros and Cons
Farxiga
Farxiga stands out for treating heart failure and chronic kidney disease in addition to type 2 diabetes, giving it value beyond blood sugar control. It carries a higher price tag and specific risks around genital infections and volume depletion that patients should watch for.
Pros
Also treats heart failure and chronic kidney disease, not just diabetes
Approved for pediatric patients 10 and older with type 2 diabetes
Low risk of hypoglycemia when used alone
Once-daily oral tablet with simple, non-titrated dosing
Cons
Carries risk of serious genital and urinary infections, including rare Fournier's gangrene
Not recommended for glycemic control once kidney function is significantly reduced
Higher list price, roughly $400 to $785 per month before insurance
Can cause volume depletion and low blood pressure, especially in older adults
Glipizide
Glipizide is a low-cost, well-established option that reliably lowers blood sugar but only addresses diabetes, without the added cardiovascular or kidney benefits of newer drugs. Its main drawbacks are a higher risk of hypoglycemia and older questions about cardiovascular safety compared with newer classes.
Pros
One of the least expensive diabetes medications, roughly $10 to $35 per month
Long track record of use dating back to 1984
Available in extended-release form for once-daily dosing
No genital infection or urinary tract risk
Cons
Higher risk of hypoglycemia, especially in older or malnourished patients
Possible increased cardiovascular mortality risk flagged in older sulfonylurea studies
Only approved for type 2 diabetes, with no cardiovascular or kidney benefit
Immediate-release form may require multiple daily doses and gradual titration
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