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
Invokana
Farxiga vs. Invokana Dosage
Farxiga
Invokana
| 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 | 100 mg once daily | At the start |
| Maximum dose | 100 mg once daily | Same as starting |
| Dose changes | None | Fixed dose |
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 |
Invokana
| 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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