dapagliflozin
Farxiga (dapagliflozin) is an SGLT2 inhibitor from AstraZeneca. It makes the kidneys excrete extra glucose, lowering blood sugar in type 2 diabetes, and it also protects against heart failure hospitalisation in people with diabetes and cardiovascular risk.
This page is based on FDA prescribing information and the EMA medicine record for dapagliflozin, cross-checked with MedlinePlus; the mechanism is explained in plain language, and analogies are used only where they stay accurate.
How it works
Explains what the medicine does in the body, not dosing, side effects, or safety.
An analogy
The kidney is a recycling plant that normally salvages every gram of sugar from the fluid it filters and sends it back into the blood. Dapagliflozin switches off the main conveyor belt, SGLT2, so when sugar levels run high the excess simply rides out with the urine instead of piling up in circulation.
In simple terms
The kidneys filter blood continuously and normally reclaim all the glucose so none is lost in urine. Dapagliflozin blocks SGLT2, the transporter responsible for most of that reclamation. Glucose then passes into the urine and leaves the body, which lowers blood sugar without stimulating insulin. The same kidney effect also changes salt and fluid handling, which helps explain the benefits seen in heart failure.
In depth
Dapagliflozin selectively and reversibly inhibits SGLT2 in the S1 segment of the proximal tubule, reducing renal glucose reabsorption and producing glycosuria independent of insulin secretion or action. The resulting osmotic diuresis and natriuresis lower preload and blood pressure, and shifts in substrate use may improve cardiac energetics. These mechanisms underpin glycaemic control in type 2 diabetes and the reduction in heart failure hospitalisation demonstrated in outcome trials.
See it in motion
A schematic animation of the mechanism — simplified for clarity, not drawn to scale.
How dapagliflozin, an SGLT2 inhibitor, works
- The kidney is a recycling plant that normally salvages every gram of sugar from the fluid it filters and sends it back into the blood.
- Dapagliflozin selectively and reversibly inhibits SGLT2 in the S1 segment of the proximal tubule, reducing renal glucose reabsorption and producing glycosuria independent of insulin secretion or action.
- The resulting osmotic diuresis and natriuresis lower preload and blood pressure, and shifts in substrate use may improve cardiac energetics.
- Glucose then passes into the urine and leaves the body, which lowers blood sugar without stimulating insulin.
Target: Sodium-glucose co-transporter 2 (SGLT2)
A transporter in the kidney that reclaims almost all filtered glucose back into the blood; blocking it lets surplus glucose leave the body in the urine.
Approved uses
Approved uses differ by country and change over time. Always follow your local prescribing information.
Approved uses in United States
FDA- As an adjunct to diet and exercise, to improve glycemic control in adults with type 2 diabetes mellitus
- To reduce the risk of hospitalization for heart failure in adults with type 2 diabetes mellitus and either established cardiovascular disease or multiple cardiovascular risk factors
Approved uses in European Union
EMA- In adults and children aged 10 years and above, for insufficiently controlled type 2 diabetes mellitus as an adjunct to diet and exercise, as monotherapy when metformin is considered inappropriate due to intolerance, or in addition to other medicinal products
Official sources
The statements on this page trace back to these records.
- Forxiga (dapagliflozin) — Summary of product characteristics and package leaflet, English version
European Medicines Agency
- U.S. Food and Drug Administration: dapagliflozin prescribing information
U.S. Food and Drug Administration
- MedlinePlus: dapagliflozin
MedlinePlus, U.S. National Library of Medicine
- National Cancer Institute: dapagliflozin
National Cancer Institute
This page explains how the medicine works — it isn’t the patient leaflet. For anything that applies to you, read the leaflet that came with your medicine or ask your pharmacist.
MedUnfold provides educational content and is not medical advice. Always follow your local prescribing information and healthcare professional.