Short answer: Farxiga (dapagliflozin) and Invokana (canagliflozin) are once-daily SGLT2 tablets for type 2 diabetes. Farxiga is also approved for heart failure and chronic kidney disease with or without diabetes; Invokana's heart and kidney uses are for people with type 2 diabetes.12 Invokana's label warns about lower-limb amputation. Neither label reports a trial against the other.
| Farxiga (dapagliflozin) | Invokana (canagliflozin) | |
|---|---|---|
| Tablets | 5 mg or 10 mg once a day1 | 100 mg or 300 mg once a day, before the first meal2 |
| Blood sugar dosing | 5 mg, may go to 10 mg1 | 100 mg, may go to 300 mg if eGFR is 60 or more2 |
| Heart and kidney dosing | 10 mg1 | 100 mg2 |
| Approved without diabetes | Yes: heart failure and chronic kidney disease1 | No: all uses involve type 2 diabetes2 |
| Female genital yeast infections | 8.4% (5 mg) and 6.9% (10 mg) vs 1.5%1 | 10.6% (100 mg) and 11.6% (300 mg) vs 2.8%2 |
| Urinary tract infections | 5.7% and 4.3% vs 3.7%1 | 5.9% and 4.4% vs 3.8%2 |
| Amputation | No amputation warning1 | Warning: 3.3% vs 1.5% on placebo in CANVAS2 |
| Before surgery | Hold at least 3 days if possible1 | Hold at least 3 days if possible2 |
| Boxed warning | None1 | None2 |
Both lower blood sugar in type 2 diabetes from age 10.12 Farxiga is also approved for adults with chronic kidney disease at risk of progression and adults with heart failure, whether or not they have diabetes, and to lower heart failure hospitalization in type 2 diabetes with heart disease or risk factors.1 Invokana is approved to lower major heart events in type 2 diabetes with heart disease, and to lower kidney failure and related outcomes in type 2 diabetes with kidney disease and albuminuria over 300 mg/day.2
Both share ketoacidosis, fluid loss, genital and urinary infections including Fournier's gangrene, and low blood sugar with insulin or a sulfonylurea.12 Invokana adds warnings for lower-limb amputation (in CANVAS, 5.9 vs 2.8 per 1,000 patient-years) and bone fracture (1.59 and 1.79 vs 1.09 per 100 patient-years on 100 mg, 300 mg and placebo).2 The Farxiga label notes 13 fractures vs none on placebo in one trial of people with eGFR 30 to under 60.1 These numbers come from separate trials with different people, lengths and methods, so they are not a head-to-head comparison.
Your prescriber weighs these with your kidney function and other medicines. More detail: Farxiga side effects, Invokana side effects, the Farxiga and Invokana dosing schedules, and the Dapagliflozin and Canagliflozin guides.