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

Most common
Female genital mycotic infections (up to 6.9%)
Nasopharyngitis (up to 6.3%)
Urinary tract infections (up to 4.3%)
Back pain (up to 4.2%)

Glipizide

Most common
Dizziness (about 2%)
Drowsiness (about 2%)
Headache (about 2%)
Nausea (about 1.4%)

Farxiga vs. Glipizide 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

Glipizide

Dosage
Dosage Table
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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