Alternatives to Farxiga If You Can't Fill Your Prescription

Farxiga (dapagliflozin) is a highly effective medication for type 2 diabetes, heart failure, and chronic kidney disease — but sometimes filling it becomes a battle with insurance, cost, or pharmacy availability. If you're in that situation right now, the good news is that there are several proven alternatives in the same drug class that your doctor may be able to prescribe. Here's how they compare.

First: Can You Get Generic Dapagliflozin Instead?

Before switching medications entirely, ask your pharmacy and doctor whether generic dapagliflozin is available. The FDA approved the first generics of Farxiga on April 7, 2026, and these generics are bioequivalent — they contain the exact same active ingredient at the same dose. Your insurance may cover the generic at a lower cost tier than the brand, making this a simple fix without any clinical change.

Alternative #1: Jardiance (Empagliflozin)

Jardiance is the most commonly prescribed SGLT2 inhibitor in the U.S. and is often the preferred alternative when patients can't access Farxiga. Like Farxiga, Jardiance treats type 2 diabetes, reduces heart failure hospitalization risk, and protects kidney function. It's FDA-approved for reducing cardiovascular death in adults with T2DM and established cardiovascular disease.

Key differences from Farxiga:

Jardiance is currently brand-only (no FDA-approved generic as of 2026), which may affect cost

Jardiance is often preferred by many insurance plans, meaning lower copays for patients who qualify

The EMPA-REG OUTCOME trial demonstrated a strong reduction in cardiovascular mortality — Jardiance is often considered the strongest in-class for cardiovascular death prevention

Dosing: 10 mg or 25 mg once daily (slightly different dosing range than Farxiga)

Manufacturer copay card: Eli Lilly offers a savings card that allows eligible commercially insured patients to pay as little as $0 per month for Jardiance.

Alternative #2: Invokana (Canagliflozin)

Invokana was the first SGLT2 inhibitor approved by the FDA (2013) and is still widely available. It treats type 2 diabetes and has FDA-approved indications for reducing cardiovascular events and kidney disease progression in adults with T2DM. Available as 100 mg and 300 mg tablets taken once daily.

Important warning: Invokana carries an FDA boxed warning for increased risk of lower limb amputations (primarily toe and foot amputations). Patients with peripheral vascular disease, neuropathy, or diabetic foot ulcers should discuss this risk carefully with their doctor before switching.

Alternative #3: Steglatro (Ertugliflozin)

Steglatro (ertugliflozin) is FDA-approved for improving blood sugar control in adults with type 2 diabetes. Available as 5 mg and 15 mg tablets once daily. Unlike Farxiga and Jardiance, Steglatro does not have FDA-approved indications for heart failure or CKD — so it is a suitable alternative only for the T2DM indication.

Its cardiovascular trial data (VERTIS CV) showed efficacy in blood glucose control but did not demonstrate the same magnitude of cardiovascular mortality benefit as Jardiance or Farxiga.

Alternative #4: Brenzavvy (Bexagliflozin)

Brenzavvy (bexagliflozin) is a newer SGLT2 inhibitor approved for type 2 diabetes in adults. Available as 20 mg tablets once daily. It's an option if other SGLT2 inhibitors are unavailable or not covered, though it has less long-term clinical trial data than Farxiga, Jardiance, or Invokana.

What About Non-SGLT2 Alternatives?

If SGLT2 inhibitors are not accessible or appropriate, your doctor may consider:

GLP-1 receptor agonists (Ozempic, Trulicity, Victoza): Excellent for T2DM and cardiovascular outcomes, often combined with SGLT2 inhibitors

DPP-4 inhibitors (Januvia/sitagliptin, Tradjenta/linagliptin): Well-tolerated, generally cheaper, but less cardiovascular/renal benefit

Metformin: First-line T2DM drug; inexpensive and widely available but does not have the cardiorenal benefits of SGLT2 inhibitors

Comparison Table: SGLT2 Inhibitor Alternatives to Farxiga

Here's a quick side-by-side comparison for T2DM, heart failure, and CKD indications:

Farxiga (dapagliflozin): T2DM ✓ | Heart Failure ✓ | CKD ✓ | Generic available (2026) | ~$288/month with GoodRx

Jardiance (empagliflozin): T2DM ✓ | Heart Failure ✓ | CKD ✓ | Brand-only | Often preferred by insurers

Invokana (canagliflozin): T2DM ✓ | HF hospitalization risk reduction ✓ | CKD ✓ (T2DM only) | Amputation risk warning

Steglatro (ertugliflozin): T2DM ✓ | Heart Failure ✗ | CKD ✗ | Limited cardiovascular data

How to Make the Switch Safely

Never switch diabetes or heart medications without talking to your doctor first. Even within the same drug class, dosing, monitoring requirements, and your specific medical history matter. Bring this article to your appointment and ask your provider which alternative is best for your situation — including which one your insurance plan will cover at the lowest cost tier.

Still hoping to stick with Farxiga? Read our guide on how to find Farxiga in stock near you or use medfinder.com to have pharmacies near you checked on your behalf.