Dr. Ahmed Ozempic and Farxiga are two of the most popular medicines used for the treatment of diabetes and obesity. Because of the increasing demand, Ozempic has gone short nowadays. Eye on alternative medicines that are effective as Ozempic for diabetes as well as weight loss.
Here we compare Ozempic Vs Farxiga in terms of their efficacy in lowering A1C, blood glucose, weight, and belly fat, and their effects on cardiovascular outcomes.
What is Ozempic Vs Farxiga?
Ozempic is a once-weekly injectable Semaglutide. It is indicated for the treatment of diabetes. It is marketed by Novo Nordisk under three brands:
- Ozempic: Injectable once-weekly injection for diabetes
- Rybelsus: Oral tablet is taken once daily for diabetes
- Wegovy: Injectable once weekly Semaglutide in high doses for obesity.
Farxiga, on the other hand, belongs to a different class of drugs called SGLT2 Inhibitors. It is the brand name of Dapagliflozin. Farxiga is marketed by AstraZeneca Pharmaceuticals.
Farxiga is the brand of Dapagliflozin in the US while Farxgia is the marker name in Europe.
Ozempic vs Farxiga – Differences
The table below summarizes the basic differences between Ozempic and Farxiga:
Ozempic | Farxiga | |
| Drug Class | GLP-1 receptor agonist | SGLT2 inhibitor |
| FDA Approved Uses | Type 2 diabetes mellitus | Type 2 diabetes mellitus |
| Dosage Forms | Subcutaneous injection | Oral tablet |
| Dosing Schedule | Once weekly | Once daily |
| Mechanism of Action | Increases insulin secretion, decreases glucagon secretion, slows gastric emptying, and increases feelings of fullness | Inhibits SGLT2 transporters in the kidney, which reduces the reabsorption of glucose and increases urinary glucose excretion |
| Use in Liver disease | No dose adjustment is necessary for mild to moderate hepatic impairment (Child-Pugh A or B).Not recommended in Child Class C (Severe hepatic impairment). It has not been studied in these patients. | No dose adjustment is necessary for mild to moderate hepatic impairment (Child-Pugh A or B). Not recommended in Child Class C (Severe hepatic impairment). It has not been studied in these patients. |
| Use in Kidney disease | In patients with eGFR of 15 to less than 30 mL/min/1.73 m², the starting dose of Ozempic is 0.25 mg once weekly, and the maximum recommended dose is 0.5 mg once weekly. Ozempic is not recommended in patients with an eGFR less than 15 mL/min/1.73 m² or end-stage renal disease. | No dosage adjustment is recommended in patients with eGFR of more than 45 mL/min/1.73 m².The dose is reduced to 5 mg once daily in patients with eGFR of 30 – 45 mL/min/1.73m² Farxiga is not recommended in patients with eGFR less than 30 mL/min/1.73 m² or end-stage renal disease. |
Comparing Side Effects of Farxiga Vs Ozempic:
Ozempic primarily acts on the stomach and gastrointestinal tract and hence most side effects are related to the GI system. These include:
- Constipation,
- Diarrhea
- Nausea
- Fullness
- Bloating
- Abdominal Pain.
Whereas, Farxiga is an SGLT2 inhibitor and acts on the renal tubules. It causes the excretion of glucose in the urine by inhibiting its reabsorption. Thus most of the side effects are related to the urogenital tract. These include:
- Urinary tract infections
- Genital yeast infections
- Dehydration
- Hypotension
- Dry mouth
Ozempic vs Farxiga – Side effects
Here is a table comparing the side effects of Ozempic Vs Farxiga:
Ozempic | Farxiga | |
| Common Side Effects |
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| Precautions/Warnings |
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| Contraindications |
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| Interactions with Other Drugs |
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How effective is Ozempic Vs Farxiga for Diabetes and Weight Loss?
Ozempic is one of the most highly potent diabetes medications, second only to Mounjaro (Tirzepatide). Farxiga is considered less potent as per the 2023 ADA Diabetes Guidelines.
Likewise, the weight loss effects of Ozempic far outweigh that of Farxiga.
Here is a table comparing the A1C lowering effects and weight loss effects of Ozempic Vs Farxiga:
Ozempic | Farxiga | |
| Efficacy in A1c Reduction | Lowers A1c levels by 1.5% to 1.8% | Lowers A1c levels by 0.5% to 1.0% |
| Efficacy in Weight Loss | This can result in weight loss of 5% to 10% | This can result in weight loss of 2% to 3% |
| Efficacy in heart failure | Not indicated for the treatment of heart failure | Approved for all patients with heart failure regardless of their Ejection Fraction |
| Cost | Very Expensive (USD 800 to USD 1000) | Less expensive compared to Ozempic (USD 400 to USD 500) |
Efficacy of Ozempic Vs Farxiga in various diabetes and obesity parameters:
The efficacy of Ozempic Vs Farxiga on fasting blood glucose, prandial blood glucose, A1C, weight, waist circumference, and insulin requirements are tabulated below:
Criteria | Ozempic | Farxiga |
| Fasting Blood Glucose | 36 mg/dL to 54 mg/dL | 19 mg/dL to 37 mg/dL |
| Random Blood Glucose | 46 mg/dL to 69 mg/dL | 15 mg/dL to 33 mg/dL |
| Body Weight | 5% to 10% of their body weight after 6 months of treatment with Ozempic. | 2% to 3% of their body weight after 6 months of treatment with Farxiga. |
| Waist Circumference | 3.9 cm to 7.6 cm in waist circumference after 26 to 52 weeks of treatment. | 2.5 cm to 3.8 cm in waist circumference after 24 weeks of treatment. |
| Insulin Requirements | 22% to 35%. | 12% to 16%. |
Cardiovascular and renal benefits of Ozempic Vs Farxiga:
Diabetes medications are not only aimed to lower the A1C but also to improve cardiovascular outcomes.
Both Ozempic and Farxiga have been shown to significantly reduce cardiovascular mortality rates and symptoms of heart failure.
In fact, Farxiga and Jardiance (Empagliflozin) have now been approved for the treatment of heart failure regardless of the status of diabetes and ejection fraction.
Farxiga has been recently approved for the treatment of heart failure in patients without diabetes and for all spectrums of patients including those with normal ejection fraction.
Ozempic vs Farxiga – Mortality and CVD outcomes
Here is a table summarizing the mortality and cardiovascular outcomes of Ozempic Vs Farxiga:
Criteria | Ozempic | Farxiga |
| Heart Failure | In the SUSTAIN-6 trial, patients treated with Ozempic had a 26% reduction in the risk of cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke compared to placebo. | In the DAPA-HF trial, patients with heart failure treated with Farxiga had a 26% reduction in the risk of cardiovascular death or hospitalization for heart failure compared to placebo. |
| Hospitalization due to Heart Failure | In the SUSTAIN-6 trial, patients treated with Ozempic had a 39% reduction in the risk of hospitalization due to heart failure compared to the placebo. | In the DAPA-HF trial, patients with heart failure treated with Farxiga had a 30% reduction in the risk of hospitalization due to heart failure compared to the placebo. |
| Myocardial Infarction | In the SUSTAIN-6 trial, patients treated with Ozempic had a 32% reduction in the risk of nonfatal myocardial infarction compared to placebo. | In the DECLARE-TIMI 58 trial, patients with type 2 diabetes and established cardiovascular disease or multiple cardiovascular risk factors treated with Farxiga had a 27% reduction in the risk of hospitalization due to heart failure compared to placebo. |
| Death | In the SUSTAIN-6 trial, patients treated with Ozempic had a 20% reduction in the risk of cardiovascular death compared to placebo. | In the DECLARE-TIMI 58 trial, patients with type 2 diabetes and established cardiovascular disease or multiple cardiovascular risk factors treated with Farxiga had a 17% reduction in the risk of cardiovascular death compared to placebo. |
| Stroke | In the SUSTAIN-6 trial, patients treated with Ozempic had a 24% reduction in the risk of non-fatal stroke compared to placebo. | In the DECLARE-TIMI 58 trial, patients with type 2 diabetes and established cardiovascular disease or multiple cardiovascular risk factors treated with Farxiga had a 16% reduction in the risk of stroke compared to placebo. |
| Renal Outcomes | In the SUSTAIN-6 trial, patients with type 2 diabetes and high cardiovascular risk treated with Ozempic had a 24% reduction in the risk of new or worsening nephropathy (kidney disease) compared to placebo | In the DECLARE-TIMI 58 trial, patients with type 2 diabetes and established cardiovascular disease or multiple cardiovascular risk factors treated with Farxiga had a 47% reduction in the risk of new or worsening nephropathy compared to placebo |
It can be observed that both drugs are highly effective in lowering cardiovascular mortality in patients with diabetes.
Summary
A summarized version of the above table is given below:
Criteria | Ozempic | Farxiga |
| Heart Failure | 26% | 26% |
| Hospitalization due to Heart Failure | 39% | 30% |
| Myocardial Infarction | 32% | 27% |
| Death | 20% | 17% |
| Stroke | 24% | 16% |
| Renal Outcomes | 24% | 47% |
