Farxiga vs. Invokana

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

Key Takeaways

  • Both are once-daily SGLT2 inhibitor pills, but Farxiga's approvals span heart failure and chronic kidney disease while Invokana's focus on cardiovascular risk reduction and diabetic kidney disease.

  • Farxiga is prescribed at a single fixed dose with no titration, while Invokana starts at 100 mg and may step up to 300 mg based on response and kidney function.

  • Invokana carries a boxed warning for lower limb amputation risk that does not appear on Farxiga's label.

Farxiga vs. Invokana Drug Summary

Farxiga

Farxiga (dapagliflozin) is an SGLT2 inhibitor that lowers blood sugar in adults and children 10 and older with type 2 diabetes. It is also approved to treat heart failure and to slow chronic kidney disease, and is taken as one tablet by mouth once a day.

Invokana

Invokana (canagliflozin) is also an SGLT2 inhibitor, taken as one tablet by mouth once a day to control blood sugar in adults and children 10 and older with type 2 diabetes. It is also approved to lower cardiovascular risk in people with heart disease and to slow diabetic kidney disease.

Farxiga vs. Invokana Side Effects

Farxiga

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

Invokana

Most common
Genital yeast infection (up to 11%)
Urinary tract infection (up to 6%)
Increased urination (up to 5%)
Male genital yeast infection (up to 4%)

Farxiga vs. Invokana 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

Invokana

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 100 mg once daily At the start
Maximum dose 100 mg once daily Same as starting
Dose changes None Fixed dose

Farxiga vs. Invokana Indications

Farxiga

Farxiga is approved for more than blood sugar control. It also treats heart failure across the full range of ejection fraction and slows chronic kidney disease, and it is approved for type 2 diabetes in adults and children 10 and older.

  • Type 2 diabetes blood sugar control (adults and children 10+)

  • Reduce heart failure hospitalization risk in type 2 diabetes with CV risk

  • Treat heart failure (reduced or preserved ejection fraction)

  • Slow chronic kidney disease progression and reduce kidney failure risk

Invokana

Invokana is approved for more than blood sugar control too. It reduces major cardiovascular events in adults with type 2 diabetes and established heart disease, and it slows diabetic kidney disease while cutting heart failure hospitalization risk in that group.

  • Type 2 diabetes blood sugar control (adults and children 10+)

  • Reduce major cardiovascular events in type 2 diabetes with heart disease

  • Slow diabetic kidney disease progression

  • Reduce heart failure hospitalization risk in diabetic kidney disease

Farxiga vs. Invokana Pros and Cons

Farxiga

Farxiga carries no boxed warning and has the broadest label of the two, covering diabetes, heart failure, and chronic kidney disease. Its single fixed dose also keeps day-to-day use simple compared with drugs that require titration.

Pros

  • Approved for four separate conditions: type 2 diabetes, heart failure, and chronic kidney disease

  • No boxed warning for amputation risk

  • Single fixed daily dose with no titration schedule

Cons

  • Not recommended for glycemic control once eGFR drops below 45

  • Lacks a dedicated indication for reducing major cardiovascular events like heart attack or stroke

  • Contraindicated in severe kidney impairment or dialysis

Invokana

Invokana has one of the longest track records of any SGLT2 inhibitor and includes a distinct cardiovascular risk-reduction indication for people with established heart disease. Its label also carries a boxed warning for lower limb amputation that patients and prescribers need to weigh against its benefits.

Pros

  • Approved specifically to reduce major cardiovascular events (heart attack, stroke, CV death)

  • Longest track record on the market of the two, approved since 2013

  • Maintenance dose is adjusted specifically by kidney function

Cons

  • Boxed warning for lower limb amputation risk requires foot monitoring

  • Not approved as a standalone heart failure treatment

  • Requires titration and dose changes rather than one fixed dose

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