Farxiga: how fast can you lose weight?

Farxiga (dapagliflozin) is a prescription medication that is FDA-approved to treat type 2 diabetes, chronic kidney disease (CKD), and heart failure. Like other diabetes medications, such as Ozempic and metformin, Farxiga has also been shown to cause weight loss for some people. 

But how many pounds can you actually expect to lose while taking Farxiga? And is this diabetes medication a good option for weight loss? Read on as we explain whether Farxiga works for weight loss, the risks and benefits, and more.

Farxiga (dapagliflozin) is an FDA-approved prescription medication that, when combined with diet and exercise, can be used to treat type 2 diabetes by lowering blood sugar levels. It is also approved to reduce the risk of hospitalization or death in people with chronic kidney disease (CKD) and heart failure. Because Farxiga has been shown to promote weight loss in people with diabetes, it may be prescribed off-label for weight management. 

Farxiga is a brand-name medication and there is no generic version yet available. Farxiga is an oral tablet that comes in two dosage strengths: 5 milligrams (mg) and 10 mg taken on a daily basis, with or without meals. Typically, health providers prescribe the 5 mg dosage strength to treat type 2 diabetes and the 10 mg dosage strength to treat CKD and heart failure. Depending on what it’s being used to treat, health providers may recommend combining Farxiga with other medications and lifestyle changes such as diet and exercise.

Dapagliflozin, the active ingredient in Farxiga, is also available in combination medications that treat diabetes, such as Qtern (dapagliflozin/saxagliptin) and Xigduo XR (dapagliflozin/metformin).

Yes, Farxiga does cause weight loss, typically around 4–7 pounds. In one study of people with type 2 diabetes and heart disease, Farxiga led to an average weight loss of around 6 pounds within one year; however, some people may achieve weight loss of 5% or more while taking Farxiga. 

While Farxiga causes weight loss, the results are less significant than other weight loss medications and even some diabetes medications, such as Ozempic. However, the amount of weight a person can lose on Farxiga can be significant enough to offer health benefits to people with type 2 diabetes and obesity. And, the research indicates that when Farxiga is combined with other diabetes drugs, the weight loss may be even more significant. For example:

• When combined with glimepiride, Farxiga leads to a weight loss of 3–5 pounds.

• When combined with metformin, Farxiga leads to a weight loss of 7–10 pounds. In one study, participants also reported ongoing improvements in their body weight, physical health, self-esteem, and overall quality of life at three separate checkpoints: six months, one year, and two years after starting treatment.

Farxiga contributes to weight loss by reducing body fat, including belly fat around the waistline. In clinical studies of Farxiga, fat loss accounted for about two-thirds of participants’ total weight loss. Medications like Farxiga may also improve metabolism and help the body better process and even burn fat, further aiding in weight loss. 

Farxiga belongs to a class of drugs known as sodium-glucose cotransporter 2 (SGLT2) inhibitors. SGLT2 inhibitors treat type 2 diabetes by blocking the amount of sugar absorbed by the kidneys and increasing the amount that leaves your body through your urine. This helps lower blood glucose levels, which is good for people with type 2 diabetes — but it’s also beneficial for those hoping to lose weight. When you have less glucose in your bloodstream, there is less available to be stored in the body. Farxiga removes about 75 grams of glucose from the bloodstream, which equates to roughly 300 calories.

While Farxiga primarily targets fat loss, it can lead to muscle loss as well, just like many other weight loss methods. To prevent losing muscle while taking Farxiga, talk to your healthcare provider about your options, such as increasing your protein intake and incorporating strength training into your routine. Building and maintaining muscle mass can not only boost your metabolism (leading to more sustained weight loss), but it can also improve muscle function, strength, mobility, and quality of life in general and for people with type 2 diabetes, obesity, and other health conditions.

Weight loss begins soon after you start taking Farxiga. Typically, people notice a drop in their body weight within the first 2–4 weeks, a lot of which can be from lost water weight. Some people notice this drop in water weight as soon as day 3. Because Farxiga causes fluid loss, it can cause weight loss — but also dehydration. (When taking Farxiga, it’s more important to ensure you get enough fluids on a daily basis.)

After the initial loss of water weight on Farxiga, the weight loss continues but at a slower pace and affects body fat and lean muscle mass. In one study, individuals lost nearly 6 pounds within just 12 weeks of starting treatment, with roughly 4.5 pounds of those coming from body fat.

However, while the rate of weight loss may slow down, it continued at stable rates even six months after starting treatment, according to one study. This is important, researchers have noted, because typically, weight loss from lifestyle changes alone tends to plateau right around 6 months. In some cases, there can even be a reversal at that point, with unwelcome weight gain. Farxiga may help patients continue to lose weight thereafter. 

When Farxiga is combined with other medications like metformin, patients may lose weight even faster. In clinical trials, people taking Farxiga and metformin lost nearly 6 pounds within three months, more than 9 pounds total within six months, and up to 10 pounds total after that.

Farxiga also starts working relatively quickly when treating other medical conditions. For example, when treating:

• Type 2 diabetes: Farxiga starts to lower blood sugar levels within hours of your first dose. While this will have an immediate effect on your ability to manage your diabetes, it will take months before these changes register on your HbA1c levels since your HbA1c is a reflection of your blood sugar over three prior months. 

• Heart failure: People taking Farxiga reported fewer symptoms and hospitalizations, along with improved well-being within two weeks of starting treatment with Farxiga. These improvements were sustained at 1- and 2-year follow-ups.

• Chronic kidney disease: The benefits of Farxiga can take longer to show up with CKD. In a study of people with CKD and/or diabetes, their likelihood of experiencing a reduction in kidney function, developing end-stage kidney disease, or dying from kidney or cardiovascular-related causes was significantly lower while taking Farxiga. These improvements were noticeable during the first year of the clinical trial and continued to improve over the next 2.4 years. 

Yes, Farxiga is a safe medication. But, like any prescription drug, it can cause side effects, some of which may be serious. Farxiga carries a greater risk for some people than others, including those who are older, pregnant or breastfeeding, or have kidney problems.

Common side effects of Farxiga

The most common side effects of Farxiga include (in order of frequency):

• Genital infections

• Cold-like symptoms

• Urinary tract infections

• Back pain

• Increased urination

• Nausea

• Flu

• High cholesterol

• Constipation

• Discomfort while urinating

• Pain in arms or legs

Both urinary tract infections (UTIs) and genital tract infections are more common with SGLT2 inhibitors like Farxiga. When taking Farxiga, women are more than twice as likely to develop a genital infection than men. People who have had genital infections before are also more likely to experience them when taking Farxiga. 

Dehydration can also occur when taking Farxiga, as the medication makes you pee more often. People who are older, follow a low-salt diet, take water pills (diuretics), or have kidney issues may be more likely to experience dehydration when taking Farxiga. Signs of dehydration include feeling dizzy, faint, lightheaded, or weak, particularly when standing up. Be sure to drink plenty of liquids while taking Farxiga and ask your health provider for guidance regarding how much water you need to drink when using Farxiga. 

Serious side effects of Farxiga

Serious side effects of Farxiga include:

• Diabetic ketoacidosis, a life-threatening complication of diabetes

• Volume depletion (low body sodium and water)

• Urosepsis––a blood infection that can develop from the urinary tract

• Pyelonephritis, a serious kidney infection

• Hypoglycemia (low blood sugar)

• Fournier’s Gangrene, a serious infection of the scrotum, penis, or perineum

• Genital infections

• An allergic reaction to Farxiga

Left untreated, these conditions can become serious and life-threatening. If you develop any of the following symptoms, contact your health provider immediately and stop taking Farxiga. It may be an early warning sign of a genital tract infection, diabetic ketoacidosis, or another potentially serious side effect of Farxiga.

• Frequent, urgent, burning, or painful urination

• Urine that smells or is cloudy, red, pink, or brown

• Decrease in the amount of urine

• Fever

• Nausea or vomiting

• Dry mouth or skin

• Dark urine

• Decreased sweating

• Pain in the pelvis, rectum, or stomach

• Feeling weak or tired

• Shortness of breath

• Rash, hives, or itching

• Difficulty breathing or swallowing

• Swelling of the face, throat, tongue, lips, mouth, or eyes

• Hoarseness 

• Pain, tenderness, rash, or swelling in the genitals or perineum (the area of skin between your genitals and your anus)

• Vaginal odor, itching, or abnormal discharge (lumpy, white, or yellow)

• Rash, redness, itching, or swelling of the penis or surrounding skin

• Foul-smelling discharge from the penis

Who should not take Farxiga?

Some people may be at increased risk of experiencing serious side effects when taking Farxiga, and some people should avoid taking Farxiga altogether. Farxiga is not recommended for children or people who:

• Are pregnant or breastfeeding

• Have type 1 diabetes

• Have polycystic kidney disease

• Have recently received immunosuppressive therapy to treat kidney disease

• Have an estimated glomerular filtration rate (GFR, a measure of kidney function) below 45%

• Have a known allergy to dapagliflozin or any of the inactive ingredients in Farxiga (microcrystalline cellulose, anhydrous lactose, crospovidone, silicon dioxide, magnesium stearate, polyvinyl alcohol, titanium dioxide, polyethylene glycol, talc, and yellow iron oxide)

Before taking Farxiga, it is important to tell your healthcare provider about your personal and family medical history and to give them a list of all the medications you take, including both prescription drugs and over-the-counter medicine, vitamins, and supplements. Also, be sure to tell your healthcare provider if you:

• Binge drink or drink alcohol often

• Are dieting or changing up what you eat

• Plan on having surgery

In these scenarios, your healthcare provider may recommend adjusting your diet or drinking less while taking Farxiga, or they may have you stop taking Farxiga before undergoing surgery. They may also recommend a different medication that could be a better fit, given your health history and weight loss goals.

Farxiga can be an effective treatment for people with type 2 diabetes, kidney disease, and heart failure. It can also lead to some weight loss, usually up to 7 pounds, but sometimes more. If you’re wondering whether Farxiga could be a good option for you, make an appointment with your healthcare provider.

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Current version

March 01, 2024

Written by

Amelia Willson

Fact checked by

Yael Cooperman, MD

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About the medical reviewer

Yael Cooperman, MD, Ro

Yael Cooperman is a physician and works as a Senior Manager, Medical Content & Education at Ro.