If you’ve ever stood at the pharmacy counter staring at your Farxiga prescription wondering if there’s a better fit for your body, you are far from alone. Millions of people prescribed this SGLT2 inhibitor deal with side effects, cost barriers, insurance gaps, or just don’t feel it works well enough. That’s exactly why we put together this guide to 10 Alternatives for Farxiga, breaking down every option honestly.

Farxiga delivers real benefits for many: it lowers blood sugar, cuts heart failure risk, and protects kidney function. But it also comes with consistent downsides: frequent yeast infections, dehydration, sudden low blood pressure, and for some, persistent joint pain that never fades. No diabetes medication works for everyone, and knowing your options puts you back in control of your care.

In this guide, we’ll walk through each alternative, how they compare, side effect profiles, average costs, and who each option works best for. We won’t tell you which to pick—we’ll give you the clear facts you need to have a productive conversation with your doctor.

1. Jardiance (Empagliflozin)

Jardiance is the closest pharmaceutical alternative to Farxiga, as it belongs to the exact same SGLT2 inhibitor drug class. This means it works almost identically, flushing excess sugar out through your urine instead of forcing your pancreas to make more insulin. Most doctors will consider Jardiance first when switching patients away from Farxiga, especially for people who need heart or kidney protection benefits.

One of the biggest differences between these two medications is side effect frequency. Real world patient data from 2023 diabetes registries show that Jardiance reports 18% fewer genital infection cases than Farxiga for people under 65 years old. It also has slightly lower rates of reported dizziness and dehydration, which makes it a better fit for active people who work outdoors or exercise regularly.

When comparing core benefits side by side, the numbers are almost identical:

Clinical Outcome	Farxiga	Jardiance
Average A1C Reduction	0.7 - 1.2%	0.8 - 1.3%
Heart Failure Hospitalization Risk Reduction	-32%	-35%
Kidney Disease Progression Risk Reduction	-39%	-37%

Jardiance does cost roughly 12% more on average without insurance, though most insurance plans cover both medications at the same tier. It is not recommended for people with severe kidney impairment, just like Farxiga. You will still need to stay hydrated and monitor for urinary tract symptoms when starting this medication.

2. Invokana (Canagliflozin)

Invokana is another SGLT2 inhibitor, and was actually the first medication in this class approved for use in the United States. It works the same way as Farxiga but has one unique additional benefit: it has been shown to reduce the risk of bone fractures in older adults with type 2 diabetes. This makes it a popular choice for patients over 70 years old.

Unlike Farxiga, Invokana is taken once per day before your first meal. Most people notice blood sugar effects within 3 days of starting the medication, with full benefits kicking in after about 4 weeks. Common starting dose is 100mg per day, which can be increased to 300mg if needed under doctor supervision.

Before asking your doctor about Invokana, note these important differences:

• Carries a black box warning for increased leg and foot amputation risk for people with pre-existing circulation issues
• May cause slightly more stomach upset during the first 2 weeks of use
• Works better for people with baseline A1C levels above 7.8%
• Has generic options available as of 2022, making it 60% cheaper than brand name Farxiga

Invokana is not the right first switch for everyone, but for people struggling with Farxiga cost or bone pain, it is absolutely worth discussing. Always disclose any history of circulation problems or foot injuries before starting this medication.

3. Steglatro (Ertugliflozin)

Steglatro is the newest SGLT2 inhibitor on the market, and was specifically designed to reduce the common side effects that people report with older medications in this class including Farxiga. It targets the same sugar transport protein but with higher selectivity, meaning it causes less disruption to other bodily systems.

Clinical trial data shows that Steglatro produces nearly identical blood sugar and heart benefits as Farxiga, but reports 27% fewer urinary tract infections and 22% fewer yeast infections across all age groups. This makes it one of the most promising alternatives for people who stopped Farxiga due to recurring infections.

When considering Steglatro, keep these facts in mind:

1. It is only approved for adults with type 2 diabetes, not for heart failure alone
2. Standard daily dose is 5mg, with maximum approved dose of 15mg
3. Most patients report no noticeable side effects after the first 10 days
4. Currently only available as brand name, with average cash cost around $520 per month

Many insurance providers have only recently added Steglatro to their formularies, so always check coverage before requesting this prescription. Most manufacturers offer copay cards that bring out of pocket cost down to $10 per month for eligible patients.

4. Januvia (Sitagliptin)

Januvia belongs to a different drug class called DPP-4 inhibitors, and works by slowing sugar absorption after meals rather than flushing sugar through the kidneys. It is one of the most commonly prescribed alternatives for people who cannot tolerate SGLT2 inhibitors like Farxiga.

The biggest advantage of Januvia over Farxiga is its extremely mild side effect profile. Less than 5% of patients report any negative side effects at all, and it does not cause dehydration, low blood pressure, or genital infections. You also do not need to adjust fluid intake when taking this medication.

Januvia does not deliver the same level of heart and kidney protection that Farxiga provides, but it does reliably lower A1C by an average of 0.6% to 1.0% for most people. It is safe for people with mild to moderate kidney impairment, and can be taken alongside most other diabetes medications.

Generic versions of Januvia became available in 2023, dropping average cash costs by 75%. It is taken once daily, with or without food, and almost never causes dangerous low blood sugar events when used as directed.

5. Ozempic (Semaglutide)

Ozempic exploded in popularity for weight loss, but it was originally developed and approved as a type 2 diabetes medication. It belongs to the GLP-1 agonist class, and works by increasing insulin production, slowing digestion, and reducing appetite signals in the brain.

For many people, Ozempic produces better blood sugar control than Farxiga, and also delivers proven heart failure and kidney protection benefits. Most patients also lose between 8 and 15 pounds during the first 6 months of use, which further improves overall diabetes outcomes.

Common side effects reported with Ozempic include:

• Mild nausea during the first 4-6 weeks of dose increases
• Constipation or loose stools
• Reduced appetite
• Fatigue for the first week after each dose adjustment

Ozempic is injected once per week under the skin, which is the biggest difference from the daily oral Farxiga pill. Most people adjust quickly to the injections, and many report preferring the weekly schedule over remembering a daily pill.

6. Trulicity (Dulaglutide)

Trulicity is another GLP-1 agonist, and is one of the most well studied long term diabetes medications available. It was approved in 2014, and has over 9 years of real world patient data available for review.

Compared to Ozempic, Trulicity has milder gastrointestinal side effects, with 30% fewer reports of nausea according to 2024 comparative trial data. It reliably lowers A1C by 0.8% to 1.4%, and reduces heart failure hospitalization risk by 22% for people with established cardiovascular disease.

Trulicity is available in 4 different dose strengths, and doctors will almost always start patients on the lowest dose and increase gradually every 4 weeks. This slow titration almost eliminates severe side effects for most people. It is also one of the most widely covered GLP-1 medications by insurance providers.

Like Ozempic, Trulicity is taken once weekly via subcutaneous injection. Auto-injector pens make administration simple and almost painless for nearly all users.

7. Metformin

Metformin is the oldest and most widely prescribed type 2 diabetes medication in the world, first approved over 60 years ago. For many people, it is a safe, effective and extremely affordable alternative to Farxiga.

Metformin works by reducing glucose production in the liver and improving insulin sensitivity in body tissues. It lowers A1C by an average of 1.0% to 1.5%, and has a well documented track record of safety even with decades of continuous use.

Average monthly costs for metformin by formulation:

Formulation	Average Cash Price Per Month
Generic Immediate Release	$4 - $12
Generic Extended Release	$10 - $25
Brand Name Glucophage	$120 - $180

The most common side effect of metformin is mild stomach upset, which almost always goes away after 2 weeks. Extended release formulations reduce this side effect dramatically. Metformin can be used alone or combined with other medications for additional blood sugar control.

8. Glipizide

Glipizide belongs to the sulfonylurea class of medications, and works by stimulating the pancreas to produce more insulin. It has been used to treat diabetes for over 40 years, and remains a common first line option for many patients.

Glipizide lowers blood sugar very quickly, often producing measurable results within 2 hours of taking the first dose. It reliably lowers A1C by 1.0% to 1.8% for most people, which is a larger average reduction than Farxiga provides.

The biggest risk with glipizide is low blood sugar events, which occur in roughly 10% of users. For this reason, doctors always start patients on a very low dose and adjust gradually. You will need to monitor your blood sugar regularly when taking this medication.

Generic glipizide costs less than $10 per month at most pharmacies. It is taken once or twice daily with meals, and is covered by every health insurance plan in the United States.

9. Basaglar Insulin Glargine

For people with more advanced type 2 diabetes, long acting basal insulin is often a safer and more effective alternative to oral medications like Farxiga. Basaglar is a biosimilar long acting insulin that works over 24 hours to maintain steady blood sugar levels.

Unlike Farxiga, insulin works for every person with diabetes, regardless of kidney function or other health conditions. It does not cause the urinary or cardiovascular side effects that many people experience with SGLT2 inhibitors.

When starting Basaglar, your doctor will guide you through these steps:

1. Begin with 10 units injected once daily at the same time every day
2. Check fasting blood sugar every morning
3. Increase dose by 2 units every 3 days until fasting blood sugar stays in target range
4. Attend follow up appointments every 4 weeks during titration

Many people avoid insulin out of fear of injections, but modern pen devices are nearly painless and extremely simple to use. Most patients report far better quality of life once they adjust to a stable insulin routine.

10. Evidence Based Lifestyle Modification

For many people with early stage type 2 diabetes, structured lifestyle changes can produce equal or better results than Farxiga, with zero negative side effects. This is not just "eat less and exercise more"—this is a medical protocol proven in large clinical trials.

Data from the landmark Diabetes Prevention Program found that structured lifestyle modification reduced diabetes progression risk by 58%, compared to 31% for the medication group. Participants also saw average A1C reductions of 1.1%, matching the average results seen with Farxiga.

The core components of this protocol include 150 minutes of moderate walking per week, 7-8 hours of consistent sleep, limiting added sugars to less than 25 grams per day, and maintaining a stable meal schedule. Even partial adherence to these changes produces measurable improvements in blood sugar within 3 weeks.

Lifestyle change does not work for everyone, and it does not replace medication for people with advanced disease. But it is always worth trying, and can reduce or eliminate the need for prescription medications for millions of people. Always work with your doctor before making any changes to your treatment plan.

At the end of the day, every single one of these 10 alternatives for Farxiga works well for some people, and not at all for others. There is no perfect diabetes medication. The best choice for you will depend on your unique body, your other health conditions, your budget, and what side effects you are willing to tolerate. Never stop or switch any prescription medication without first talking with your doctor, and always bring this list of questions and comparison points to your appointment.

If you found this guide helpful, share it with anyone you know who is also navigating diabetes medication choices. Write down any questions you have tonight, and bring this article along to your next primary care or endocrinology visit. You don’t have to just accept the first medication you are prescribed—you have the right to explore options and find care that works for your life.