Jardiance vs Farxiga: Trial Results, Dosing, Side Effects and 2026 US Prices

Jardiance (empagliflozin) and Farxiga (dapagliflozin, sold as Forxiga outside the US) are two of the most widely used SGLT2 inhibitors: in 2023, about 1.9 million and 1.0 million Medicare Part D enrollees used them. They work the same way, lower HbA1c by a similar amount, and each has large outcome trials in type 2 diabetes, heart failure and chronic kidney disease. The differences that matter are narrower than the marketing suggests: the starting dose, how far kidney function can fall before each stops being useful for blood sugar, two warning sections found only on the Jardiance label, and, in 2026, price. Generic dapagliflozin now costs US pharmacies about 18 cents a tablet. No generic empagliflozin appears in that US pharmacy cost survey.

This comparison uses the current US prescribing information for both drugs (Jardiance, revised January 2026; Farxiga, revised June 2026), the published outcome trials, the Medicaid NADAC price file and the Medicare negotiated price list. Every number is traceable to a source listed at the end.

The short answer

For most adults with type 2 diabetes, heart failure or chronic kidney disease, Jardiance and Farxiga are interchangeable at the class level. Both reduced heart failure hospitalization and kidney disease progression against placebo in large trials. Jardiance is the only one whose diabetes outcome trial lowered major adverse cardiovascular events (MACE), but the two diabetes trials enrolled very different patients, so that is not proof one drug protects the heart better. Farxiga starts at 5 mg for blood sugar and loses its glucose-lowering indication below an eGFR of 45; Jardiance starts at 10 mg and keeps it down to an eGFR of 30. In the US, dapagliflozin is the far cheaper choice now that multiple generics are on sale.

What these drugs are and how they work

Both are sodium-glucose co-transporter 2 (SGLT2) inhibitors. SGLT2 is the transporter in the kidney that pulls filtered glucose back into the blood. Blocking it makes the kidney excrete glucose in the urine: about 64 grams a day on Jardiance 10 mg and 78 grams a day on 25 mg, according to the Jardiance label. The drugs also reduce sodium reabsorption, which lowers pressure inside the kidney's filtering units and reduces the load on the heart. The labels say this sodium effect may influence heart and kidney function, which is one proposed reason the heart failure and kidney benefits were also seen in people without diabetes.

Because the effect depends on the kidney filtering glucose, blood sugar lowering shrinks as kidney function falls. The heart and kidney benefits do not shrink in the same way, which is why the labels set different kidney cut-offs for different uses.

Farxiga and Forxiga are the same AstraZeneca product with different brand names. In India, where our stock comes from, dapagliflozin is sold as Forxiga 10mg and Forxiga 5mg.

Approved uses side by side

Use (adults unless stated)	Jardiance (empagliflozin)	Farxiga (dapagliflozin)
Blood sugar control in type 2 diabetes	Yes, adults and children 10 years and older	Yes, adults and children 10 years and older
Heart failure	Reduce CV death and heart failure hospitalization	Reduce CV death, heart failure hospitalization and urgent heart failure visits
Chronic kidney disease at risk of progression	Yes	Yes
Type 2 diabetes with cardiovascular disease	Reduce CV death (established CV disease)	Reduce heart failure hospitalization (established CV disease or multiple risk factors)
Type 1 diabetes	Not recommended	Not recommended

Both labels exclude polycystic kidney disease and people on immunosuppressive therapy for kidney disease from the kidney indication, because they were not studied and the drugs are not expected to work there.

Dosing compared

	Jardiance	Farxiga
Blood sugar: starting dose	10 mg once daily in the morning	5 mg once daily
Blood sugar: maximum	25 mg once daily	10 mg once daily
Heart failure and kidney disease	10 mg once daily	10 mg once daily
Food	With or without food	With or without food
Missed dose	Take when remembered; never double	Take when remembered; never double
Before surgery or prolonged fasting	Stop at least 3 days before	Stop at least 3 days before
Tablets	10 mg and 25 mg, pale yellow	5 mg and 10 mg, yellow

The higher blood sugar dose only helps glucose. For heart failure and kidney disease both labels use a single dose of 10 mg, which is also the dose tested in every heart failure and kidney trial of both drugs.

Kidney function rules

This is where the labels differ most in practice.

eGFR (mL/min/1.73 m²)	Jardiance	Farxiga
45 and above	All uses	All uses
30 to 44	All uses, but less glucose lowering	Heart and kidney uses only; not recommended for blood sugar
25 to 29	Heart and kidney uses; not recommended for blood sugar	Heart and kidney uses only
20 to 24	Heart and kidney trials enrolled people down to 20	Starting not recommended below 25; people already on it may continue
Below 20 or on dialysis	Not studied at the start of treatment	Not studied at the start of treatment

Both labels allow patients who were already on treatment in the outcome trials to continue as eGFR fell below these thresholds. Starting an SGLT2 inhibitor causes a small, expected dip in eGFR in the first weeks. The Jardiance label describes it as generally no more than 0.1 mg/dL in creatinine and 9 mL/min/1.73 m² in eGFR at week 4, reversing after the drug is stopped. That dip is not a reason to stop on its own; a larger or continuing fall needs medical review.

Blood sugar lowering

In their placebo-controlled 24-week monotherapy trials, the two drugs lowered HbA1c by similar amounts: 0.7 to 0.9 points more than placebo for Jardiance and 0.5 to 0.7 points for Farxiga. These were separate trials with different patients, so a gap of 0.2 points is not proof that one is stronger.

24-week monotherapy trial	Baseline HbA1c	HbA1c change	Difference from placebo	Reached HbA1c under 7%
Jardiance 10 mg	7.9%	-0.7	-0.7	35%
Jardiance 25 mg	7.9%	-0.8	-0.9	44%
Jardiance placebo	7.9%	+0.1		12%
Farxiga 5 mg	7.8%	-0.8	-0.5	44.2%
Farxiga 10 mg	8.0%	-0.9	-0.7	50.8%
Farxiga placebo	7.8%	-0.2		31.6%

A drop of 0.5 to 0.9 points is moderate, in the same range the Januvia label reports for sitagliptin in its own monotherapy trials. In adults, neither drug caused low blood sugar on its own in trials; in children aged 10 to 17, Jardiance raised the rate of low blood sugar even without insulin. The risk appears when they are added to insulin or a sulfonylurea such as glimepiride, and the labels advise lowering those doses. Our comparison of metformin and glimepiride explains why sulfonylureas carry that risk.

Heart outcomes in type 2 diabetes

This is the result most often used to rank the two drugs, and it is the one most often misread.

EMPA-REG OUTCOME (Jardiance) enrolled 7,020 adults with type 2 diabetes who all had established atherosclerotic cardiovascular disease, followed for a median of 3.1 years. Jardiance reduced MACE (cardiovascular death, non-fatal heart attack or non-fatal stroke) with a hazard ratio of 0.86. The whole effect came from fewer cardiovascular deaths: 3.7% against 5.9% on placebo, a hazard ratio of 0.62. Heart attacks and strokes did not fall.

DECLARE-TIMI 58 (Farxiga) enrolled 17,160 adults with type 2 diabetes, but only 40.6% had established cardiovascular disease; the rest had risk factors only. Over a median of 4.2 years, MACE was not significantly reduced (hazard ratio 0.93, 95% CI 0.84 to 1.03). The co-primary endpoint of heart failure hospitalization or cardiovascular death was reduced (0.83), driven by fewer heart failure admissions (0.73).

The two trials tested different populations at different baseline risk. A trial full of people who already have heart disease has more events for a drug to prevent. That difference alone could explain the MACE result, and no trial has compared the two drugs directly on heart outcomes. What can be said is narrower: Jardiance is the one with a labelled indication to reduce cardiovascular death in people with type 2 diabetes and established cardiovascular disease.

Heart failure trials

Here the two drugs look alike. Each has one trial in reduced ejection fraction (LVEF 40% or less) and one in mildly reduced or preserved ejection fraction (LVEF above 40%), all at 10 mg once daily, all on top of standard heart failure treatment, and all including people with and without diabetes.

Trial	Drug	Patients	Primary endpoint result	Cardiovascular death
EMPEROR-Reduced	Jardiance	3,730, LVEF 40% or less	24.7% to 19.4%, HR 0.75	HR 0.92 (not significant)
DAPA-HF	Farxiga	4,744, LVEF 40% or less	HR 0.74	HR 0.82 (0.69 to 0.98)
EMPEROR-Preserved	Jardiance	5,988, LVEF above 40%	17.1% to 13.8%, HR 0.79	HR 0.91 (not significant)
DELIVER	Farxiga	6,263, LVEF above 40%	HR 0.82	HR 0.88 (not significant)

The primary endpoints were close but not identical: the Farxiga trials also counted urgent heart failure visits, and DAPA-HF counted deaths of undetermined cause as cardiovascular. In all four trials most of the benefit came from fewer heart failure hospitalizations. DAPA-HF is the only one of the four where the cardiovascular death component on its own reached significance.

Kidney disease trials

	EMPA-KIDNEY (Jardiance 10 mg)	DAPA-CKD (Farxiga 10 mg)
Patients	6,609	4,304
Kidney function at entry	eGFR 20 to 44, or 45 to 89 with urine albumin-to-creatinine ratio 200 mg/g or more	eGFR 25 to 75 and urine albumin-to-creatinine ratio 200 to 5,000 mg/g
Had type 2 diabetes	About 44%	68%
Median follow-up	24 months	28.5 months
Primary endpoint	Sustained 40% eGFR decline, eGFR under 10, kidney failure, or CV or kidney death	Sustained 50% eGFR decline, kidney failure, or CV or kidney death
Result	16.9% to 13.1%, HR 0.72	HR 0.61
All-cause death	Not a labelled result	HR 0.69 (0.53 to 0.88)

DAPA-CKD's hazard ratio looks stronger, but its endpoint required a larger fall in kidney function and its patients had much more protein in the urine, so the two numbers cannot be compared directly. Both trials support the same practical conclusion: in chronic kidney disease with albuminuria, adding either drug to an ACE inhibitor or ARB slows progression. The Jardiance label notes the benefit was not evident in people with very low albuminuria, although there were few events in that group.

All the outcome trials in one view

Figure 1 puts the primary result of each trial on one scale. Each point is measured against that trial's own placebo group, not against the other drug.

Is one of them better?

No head-to-head randomized trial has compared empagliflozin with dapagliflozin on heart or kidney outcomes. Everything above is drug against placebo, in different patients, with different endpoints. When you line the results up, the confidence intervals overlap almost everywhere.

Three differences are real and label-based:

• Blood sugar with reduced kidney function: Jardiance can still be used for glucose control at an eGFR of 30 to 44; Farxiga cannot.
• Cardiovascular death indication in diabetes: only Jardiance carries it, based on EMPA-REG OUTCOME.
• Starting dose for glucose: Farxiga has a 5 mg starting strength; Jardiance starts at 10 mg.

Everything else, including heart failure and kidney protection, is best treated as a class effect until a direct trial says otherwise.

Side effects compared

The common side effects come from glucose in the urine. The table uses each label's pooled placebo-controlled diabetes trials (Jardiance: 5 trials of 18 to 24 weeks; Farxiga: 12 trials of 12 to 24 weeks).

Adverse reaction	Jardiance placebo	Jardiance 10 mg	Jardiance 25 mg	Farxiga placebo	Farxiga 5 mg	Farxiga 10 mg
Genital fungal infection, women	1.5%	5.4%	6.4%	1.5%	8.4%	6.9%
Genital fungal infection, men	0.4%	3.1%	1.6%	0.3%	2.8%	2.7%
Urinary tract infection	7.6%	9.3%	7.6%	3.7%	5.7%	4.3%
Increased urination	1.0%	3.4%	3.2%	1.7%	2.9%	3.8%

The urinary tract infection rows show why rates from different trial pools should not be compared directly: the Jardiance placebo group had twice the infection rate of the Farxiga placebo group, because the pools used different definitions and patients. What each table shows is how much the drug adds over its own placebo, and for both drugs the largest addition is genital yeast infection in women. In the Jardiance trials, 0.2% of patients stopped treatment because of a genital infection. People with a history of recurrent genital or urinary infections are more likely to get them.

Serious warnings on both labels

• Ketoacidosis. Both can cause life-threatening ketoacidosis, and fatal cases have been reported after marketing in type 2 diabetes. It can occur with blood glucose below 250 mg/dL, which makes it easy to miss. Triggers include illness, reduced food intake, a ketogenic diet, surgery, dehydration, alcohol excess and cutting insulin doses; a history of pancreatitis or pancreatic surgery also raises the risk. Symptoms are nausea, vomiting, abdominal pain, tiredness and breathlessness. Stop the drug and get urgent care if they appear. Both drugs are not recommended for glucose control in type 1 diabetes because of this risk.
• Serious urinary infections. Urosepsis and kidney infection (pyelonephritis) have been reported, some needing hospital care.
• Fournier's gangrene. A rare, life-threatening infection of the genital and perineal area has been reported with SGLT2 inhibitors; cases have needed multiple operations and some patients died. Pain, redness or swelling there with fever needs same-day medical attention.
• Dehydration and low blood pressure. Higher risk in older people, those on loop diuretics and those with reduced kidney function. Acute kidney injury has been reported after marketing.
• Low blood sugar with insulin or sulfonylureas. The dose of those drugs may need to come down.
• Allergy. Both are contraindicated after an allergic reaction to the drug: Jardiance after any hypersensitivity to empagliflozin or its ingredients, Farxiga after a serious hypersensitivity reaction such as anaphylaxis or angioedema.
• Pregnancy and breastfeeding. Both labels say not recommended in the second and third trimesters or while breastfeeding.
• Lithium. Both can lower lithium levels, so levels should be checked more often when starting or changing the dose.
• Urine glucose tests will be positive and the 1,5-AG blood test becomes unreliable on either drug.

Where the safety labels differ

The current Jardiance label has a lower limb amputation section. Across four Jardiance outcome trials, amputation rates were 4.3 per 1,000 patient-years on placebo and 5.0 on Jardiance (hazard ratio 1.05, 95% CI 0.81 to 1.36, not significant). In EMPA-KIDNEY the rates were 2.9 and 4.3 per 1,000 patient-years, mostly toes and mid-foot. The label advises routine foot care and prompt treatment of foot sores. The current Farxiga label has no equivalent section. The absence of a section is not proof that dapagliflozin carries no such risk, so foot care advice is sensible with either drug if you have diabetes and poor circulation.

Jardiance also has a separate warning section on serious allergic reactions such as angioedema reported after marketing. The Farxiga label covers serious allergic reactions under its contraindication and adverse reaction sections instead.

Both labels report small rises in LDL cholesterol: 4.6% on Jardiance 10 mg and 6.5% on 25 mg against 2.3% on placebo, and 2.9% on Farxiga 10 mg against -1.0% on placebo. The Jardiance label also reports a higher rate of low blood sugar in children aged 10 to 17 (19.2% against 7.5% on placebo), regardless of insulin use.

How the body handles each drug

	Empagliflozin	Dapagliflozin
Time to peak level	About 1.5 hours	Usually within 2 hours (fasting)
Half-life	About 12.4 hours	About 12.9 hours
Effect of a high-fat meal	Exposure 16% lower, peak 37% lower; not clinically relevant	Peak up to 50% lower, total exposure unchanged; not clinically relevant
Protein binding	About 86%	About 91%
Main metabolism	Glucuronidation (UGT2B7, 1A3, 1A8, 1A9)	Glucuronidation (UGT1A9)

Both are once-daily drugs with similar half-lives and no important food effect. Neither relies on the CYP liver enzymes that cause many drug interactions.

Combination tablets

Both molecules are sold in fixed-dose combinations, which cut pill count but lock the doses together. In India, where our stock is made, the common ones are empagliflozin with metformin (Jardiance Met 12.5mg/500mg, Jardiance Met 12.5mg/1000mg, Jardiance Met 5mg/500mg), dapagliflozin with sitagliptin (Oxra-S 10/100, Oxra-S 5/50), dapagliflozin with linagliptin (Oxra-L) and dapagliflozin with vildagliptin (Vysov D). Metformin in a combination tablet counts toward the daily metformin limit; our metformin dosage guide covers that ceiling. For the DPP-4 half of those combinations, see our Januvia vs Tradjenta comparison.

What they cost in the US in 2026

The Medicaid NADAC survey records what US retail pharmacies pay to buy each drug. It is not the price you pay, but it shows the underlying cost and it is updated weekly.

Product (week of 23 September 2026)	Pharmacy cost per tablet	30 tablets
Farxiga 10 mg	$12.07703	$362.31
Jardiance 10 mg or 25 mg	$11.18929 to $11.18970	$335.68 to $335.69
Generic dapagliflozin 10 mg (20 listings)	$0.18391	$5.52
Generic dapagliflozin 5 mg	$0.16272	$4.88
Generic empagliflozin	No listings

In January 2026 the only generic dapagliflozin in the file was a single listing at $11.43 a tablet, barely below the brand. By September, 20 generic listings carried a cost of about 18 cents. That kind of drop happens when several manufacturers compete. Empagliflozin has not reached that point in the US, so anyone paying cash there will find dapagliflozin much cheaper. The brand prices themselves also fell in 2026: Jardiance's pharmacy cost dropped from about $20 a tablet in 2025 to about $11.

Medicare's negotiated prices

Jardiance and Farxiga were both in the first group of ten drugs whose prices Medicare negotiated under the Inflation Reduction Act. The negotiated prices apply to Medicare Part D from 1 January 2026.

Drug	2023 list price, 30 days	2026 negotiated price, 30 days	Cut	Part D users in 2023
Jardiance	$573.00	$197.00	66%	1,883,000
Farxiga	$556.00	$178.50	68%	994,000

The negotiated price is what Part D plans pay, not a fixed copay. Your share still depends on your plan's deductible and cost-sharing.

Indian versions and what we stock

Outside the US both molecules are widely available as the original brands and as locally made versions. We stock Jardiance 10mg and Jardiance 25mg (Boehringer Ingelheim India), Gibtulio 25mg (empagliflozin co-marketed by Boehringer Ingelheim and Lupin), Empasmart 25mg (empagliflozin), and Forxiga 10mg and Forxiga 5mg (AstraZeneca India). We also carry the third SGLT2 inhibitor, canagliflozin, as Glifozenix 100, which this comparison does not cover.

Two practical points. These are prescription medicines in the US, UK, Canada and Australia, and importing them for personal use is subject to each country's rules; our guide to cross-border pharmacy rules explains the US position. And with US generic dapagliflozin now so cheap, a US patient on dapagliflozin should compare a local generic price before looking abroad.

Which one fits which situation

Situation	What the labels and trials support
Type 2 diabetes with established heart disease	Either; only Jardiance carries the cardiovascular death indication
Heart failure, reduced ejection fraction	Either, 10 mg
Heart failure, preserved ejection fraction	Either, 10 mg
Chronic kidney disease with albuminuria	Either, 10 mg
Blood sugar control with eGFR 30 to 44	Jardiance (Farxiga not recommended for glucose here)
Wants the smallest starting dose	Farxiga 5 mg
Paying cash in the US	Generic dapagliflozin
Type 1 diabetes	Neither for glucose control
History of recurrent genital or urinary infections	Either with caution; discuss with the prescriber

Switching from one to the other

Neither label gives a conversion rule, because there is no dose equivalence study behind one. For heart failure and kidney disease the question is simpler, because both labels use 10 mg once daily, the single dose tested in every one of those trials. Never take both together: they act on the same transporter and no trial has tested combining them. Any switch should be done by the prescriber who monitors your kidney function, especially if eGFR is near 45 or 30.

If you are weighing an SGLT2 inhibitor against other diabetes medicines, our type 2 diabetes treatment overview compares the main drug classes, and our generic semaglutide guide covers the GLP-1 option now that generic versions exist in some countries.

Sources

• JARDIANCE (empagliflozin) US prescribing information, Boehringer Ingelheim, revised January 2026: sections 1, 2, 4, 5, 6.1, 7, 8, 12 and 14 (Tables 2, 5 and 15 to 18). DailyMed
• FARXIGA (dapagliflozin) US prescribing information, AstraZeneca, revised June 2026: sections 1, 2, 4, 5, 6.1, 7, 8, 12 and 14 (Tables 1, 7 and 15 to 17). DailyMed
• Zinman B et al. Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes. N Engl J Med 2015;373(22):2117-28. PMID 26378978.
• Wiviott SD et al. Dapagliflozin and cardiovascular outcomes in type 2 diabetes. N Engl J Med 2019;380(4):347-357. PMID 30415602.
• Packer M et al. Cardiovascular and renal outcomes with empagliflozin in heart failure. N Engl J Med 2020;383(15):1413-1424. PMID 32865377.
• McMurray JJV et al. Dapagliflozin in patients with heart failure and reduced ejection fraction. N Engl J Med 2019;381(21):1995-2008. PMID 31535829.
• Heerspink HJL et al. Dapagliflozin in patients with chronic kidney disease. N Engl J Med 2020;383(15):1436-1446. PMID 32970396.
• The EMPA-KIDNEY Collaborative Group (Herrington WG et al). Empagliflozin in patients with chronic kidney disease. N Engl J Med 2023;388(2):117-127. PMID 36331190.
• Centers for Medicare and Medicaid Services. National Average Drug Acquisition Cost (NADAC) files 2024 to 2026, as of 23 September 2026. data.medicaid.gov
• Centers for Medicare and Medicaid Services. Medicare Drug Price Negotiation Program: Negotiated Prices for Initial Price Applicability Year 2026, fact sheet, August 2024. CMS

This article is for information only and is not medical advice. Jardiance and Farxiga are prescription medicines. Do not start, stop or switch them without a prescriber who knows your kidney function and your other medicines. Symptoms of ketoacidosis or a genital infection with fever need urgent medical care.