Doctor in a white labcoat choosing medicament between two drug packagings

Farxiga vs. Entresto

Authored by The Rx Advocates, / Medically Reviewed by Dr. Conor Sheehy, PharmD, BCPS
Last Updated: March 18, 2022

Farxiga and Entresto are brand name prescriptions that have been FDA approved for multiple uses. Both have been approved to help treat Type 2 diabetes and heart failure.

Many people in the United States have been diagnosed with one of these diseases.

There is not a cure for Type 2 diabetes or heart failure. Lifestyle changes and medication can help treat the symptoms that people with these conditions are dealing with.

 

What is Type 2 Diabetes?

Diabetes is a disease that results from consistently high glucose levels in the bloodstream. When someone eats a meal, the food turns into glucose and acts as the primary fuel for the cells in the body. 

When glucose levels are high in the bloodstream, the pancreas releases the hormone insulin. Insulin moves the glucose into the body’s cells and uses it as energy.

When someone has Type 2 diabetes, the cells do not respond to insulin properly. This stops the glucose from getting into the cells to be used for energy. At some point the pancreas could also stop producing enough insulin.

Symptoms of Type 2 diabetes include:

  • Blurred vision
  • Frequent urination
  • Fatigue
  • Increased thirst and hunger
  • Frequent infections
  • Numbness or tingling in the hands or in the feet
  • Areas of darkened skin

 

What is Heart Failure?

Heart failure happens when the heart muscle is not working as well as it should be. It does not mean that a heart has stopped beating, as this disease is often misinterpreted. 

When the heart muscle is not pumping enough blood into the rest of the body, the cells are not getting enough oxygen and nutrients. When the body is not getting enough oxygen and nutrients, then other systems are affected. Heart failure can lead to liver and kidney problems.

Symptoms of heart failure can include:

  • Fatigue and weakness
  • Rapid or irregular heartbeat
  • Swelling in the legs, ankles, feet, or abdomen
  • Coughing and wheezing
  • Shortness of breath
  • Difficulty concentrating or decreased alertness

 

Farxiga

Farxiga was originally FDA approved to treat Type 2 diabetes in 2014. Farxiga is an SGLT-2 inhibitor.

SGLT-2 inhibitors stop SGLT-2 proteins in the renal tubules of the kidneys from working. The SGLT-2 proteins send glucose back into the bloodstream. This means that the body will send glucose out through urine. 

SGLT-2 inhibitors have also been noted to reduce hemoglobin A1c levels and lower blood pressure.

In May 2020, the FDA approved Farxiga for the treatment of heart failure in adults. The news release says there was a clinical trial showing a reduced rate of hospitalization for heart failure. There was also a reduced rate of death from heart failure in the clinical trial time frame.

Farxiga Side Effects

There are some possible side effects for people taking Farxiga, which can include:

  • Sore throat
  • Runny or stuffy nose
  • Urinating more than normal
  • Genital yeast infections (vagina or penis)
  • Dehydration
  • Kidney problems
  • Ketoacidosis
  • Bladder infection

 

Entresto

The FDA originally approved Entresto for the treatment of heart failure in 2015. It is a combination of two medications in one, sacubitril and valsartan. Each medicine works in a different way to help the heart pump blood efficiently.

Valsartan is a type of angiotensin receptor blocker. It works by stopping the hormone angiotensin 2 from narrowing blood vessels.

Angiotensin 2 also encourages the body to hold onto salt and water. Excess salt and water in the body and narrow blood vessels make it harder for the heart to work right.

Sacubitril can only be found in Entresto. It is a neprilysin inhibitor. Sacubitril stops neprilysin enzymes from breaking down natriuretic peptides. Natriuretic peptides tell the body to move extra sodium out of the blood, helping to lower blood pressure.

After Entresto was approved for treating heart failure, researchers found another benefit for patients who also had Type 2 diabetes. A study showed that A1c levels were lowered and stayed lower over a three-year period.  

Researchers also noted that insulin therapy and oral diabetes drugs dosages were reduced in those patients taking Entresto.

However, the effect on A1C was small and Entresto is not approved for lowering blood sugar in people with diabetes.

Side Effects of Entresto

Entresto has some mild side effects of cough and dizziness. Additionally, some uncommon but significant side effects are possible, including:

  • Kidney failure
  • Low blood pressure
  • High blood potassium levels
  • Fetal toxicity (harm to an unborn baby)

 

Farxiga or Entresto?

Type 2 diabetes and heart failure are lifelong diseases. There is not a cure for either one. Patients need to make lifestyle changes and find the medication that will work best to relieve their symptoms. 

Each patient needs to discuss the pros and cons of Farxiga and Entresto with their doctor. Patients and doctors need to look at how each medication could affect other health issues the patient may be experiencing before making a decision. 

It is important to remember that a better option for Patient A may not be the best fit for Person B.

Both prescription drugs can benefit patients with Type 2 diabetes and heart failure. The FDA has officially approved Farxiga to treat both conditions.

 

Get Help With Farxiga and Entresto Costs

Name brand prescription medications are expensive. There is no generic alternative for Farxiga or Entresto. The Rx Advocates can help.

At The Rx Advocates, we connect people with patient assistance programs. These are programs offered by pharmaceutical companies that make name-brand prescriptions.

These programs provide patients with medication for no cost; however, being accepted into the programs requires a lot of paperwork and phone calls.

The Rx Advocates do all of that work for just one low monthly rate.

The Rx Advocates can help a patient get Farxiga or Entresto for only $60 per month. This is a significant savings over paying out-of-pocket or even the cost with some insurance programs.

We can help people save money on additional prescription medications they also need each month. Each additional medication only raises the monthly fee by $10, but no one will pay more than $90.

Please contact us today for more information.

 

Sources:

MedlinePlus. Diabetes.
https://medlineplus.gov/diabetes.html November 4, 2021.

Mayo Clinic. Type 2 Diabetes.
https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/symptoms-causes/syc-20351193 2021.

American Heart Association. What is Heart Failure?
https://www.heart.org/en/health-topics/heart-failure/what-is-heart-failure 2021.

Mayo Clinic.Heart Failure.
https://www.mayoclinic.org/diseases-conditions/heart-failure/symptoms-causes/syc-20373142 2021.

Farxiga (dapagliflozin). Welcome to Farxiga.
https://www.farxiga.com/?source=&umedium=cpc&uadpub=GOOGLE&ucampaign=71700000083533839&ucreative=58700007054859404&uplace=43700063515523918&outcome=&cmpid=1&gclid=CjwKCAiAs92MBhAXEiwAXTi2585Pqbd3R3-5GrhclOI65josmHYcsppnmtL3k1RFOdbVAUyhVQC7hhoCX-AQAvD_BwE&gclsrc=aw.ds September 2021.

Drugs.com. SGLT-2 inhibitors. https://www.drugs.com/drug-class/sglt-2-inhibitors.html 2021.

U.S. Food & Drug Administration. FDA Approves New Treatment for a Type of Heart failure.
https://www.fda.gov/news-events/press-announcements/fda-approves-new-treatment-type-heart-failure May 5, 2020.

Drugs.com. Farxiga. https://www.drugs.com/farxiga.html#side-effects 2021.

Heart Failure Society of America. FDA Approves Entresto. https://hfsa.org/fda-approves-entresto 2015.

Circulation. Angiotensin Receptor Blockers.
https://www.ahajournals.org/doi/full/10.1161/01.CIR.0000072344.12827.13 June 24, 2003.

PubMed. Natriuretic peptides: their structure, receptors, physiologic functions and therapeutic applications.
https://pubmed.ncbi.nlm.nih.gov/19089336/ 2009.

Diabetes Daily. New Drug Entresto May Benefit Type 2 Diabetes Patients’ Hearts and Blood Sugars.
https://www.diabetesdaily.com/blog/new-drug-entresto-may-benefit-type-2-diabetes-patients-hearts-and-blood-sugars-381223/ March 31, 2017.

Medical News Today. Entresto (sacubitril/valsartan).
https://www.medicalnewstoday.com/articles/327055#side-effects November 18, 2019.

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