| Heart failure
Samsca vs Farxiga
Side-by-side clinical, coverage, and cost comparison for heart failure.Deep comparison between: Samsca vs Farxiga with Prescriber.AI
AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.Safety signalsFarxiga has a higher rate of injection site reactions vs Samsca based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Farxiga but not Samsca, including UnitedHealthcare
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Category
Samsca
Farxiga
At A Glance
Oral
Daily
Vasopressin V2-receptor antagonist
Oral
Once daily
SGLT2 inhibitor
Indications
- Hyponatremia
- Heart failure
- Inappropriate ADH Syndrome
- Chronic Kidney Diseases
- Heart failure
- Diabetes Mellitus, Non-Insulin-Dependent
Dosing
Hyponatremia, Heart failure, Inappropriate ADH Syndrome Start at 15 mg once daily; titrate at intervals >=24 hours to 30 mg once daily, then to a maximum of 60 mg once daily as needed; initiate and re-initiate in a hospital; do not administer for more than 30 days.
Chronic Kidney Diseases, Heart failure 10 mg orally once daily.
Diabetes Mellitus, Non-Insulin-Dependent Starting dose 5 mg orally once daily; may be increased to 10 mg orally once daily for additional glycemic control. Not recommended when eGFR is less than 45 mL/min/1.73 m2 for glycemic control.
Contraindications
- Autosomal dominant polycystic kidney disease (ADPKD) outside of FDA-approved REMS
- Unable to sense or respond to thirst
- Hypovolemic hyponatremia
- Concomitant use of strong CYP3A inhibitors
- Anuria
- Hypersensitivity to tolvaptan or any components of the product
- Previous serious hypersensitivity reaction to dapagliflozin or any excipient in FARXIGA
Adverse Reactions
Most common (>=5%) Thirst, dry mouth, asthenia, constipation, pollakiuria or polyuria, hyperglycemia
Serious Disseminated intravascular coagulation, intracardiac thrombus, ventricular fibrillation, ischemic colitis, diabetic ketoacidosis, rhabdomyolysis, cerebrovascular accident, pulmonary embolism, respiratory failure, deep vein thrombosis
Postmarketing Osmotic demyelination syndrome, hypernatremia, hypersensitivity reactions including anaphylactic shock and generalized rash
Most common (>=2%) Female genital mycotic infections, nasopharyngitis, urinary tract infections, back pain, increased urination, male genital mycotic infections, nausea, influenza, dyslipidemia, constipation, discomfort with urination, pain in extremity
Serious Diabetic ketoacidosis, volume depletion, urosepsis and pyelonephritis, hypoglycemia with concomitant insulin or insulin secretagogues, necrotizing fasciitis of the perineum (Fournier's Gangrene), hypersensitivity reactions including anaphylaxis and angioedema
Postmarketing Necrotizing fasciitis of the perineum (Fournier's Gangrene), urosepsis and pyelonephritis, ketoacidosis, acute kidney injury, rash
Pharmacology
Tolvaptan is a selective vasopressin V2-receptor antagonist that blocks vasopressin's renal effect, promoting free water excretion (aquaresis) and raising serum sodium concentrations without significantly affecting urinary sodium or potassium excretion.
SGLT2 inhibitor; dapagliflozin inhibits sodium-glucose cotransporter 2 in the proximal renal tubules, reducing glucose reabsorption and promoting urinary glucose excretion, while also reducing sodium reabsorption to lower cardiac pre- and afterload, suppress sympathetic activity, and decrease intraglomerular pressure via tubuloglomerular feedback.
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Most Common Insurance
Anthem BCBS
Samsca
- Covered on 5 commercial plans
- PA (9/12) · Step Therapy (0/12) · Qty limit (9/12)
Farxiga
- Covered on 5 commercial plans
- PA (9/12) · Step Therapy (9/12) · Qty limit (11/12)
UnitedHealthcare
Samsca
- Covered on 4 commercial plans
- PA (1/8) · Step Therapy (0/8) · Qty limit (1/8)
Farxiga
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (4/8)
Humana
Samsca
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (2/3)
Farxiga
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (1/3) · Qty limit (3/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
$0
Otsuka Patient Assistance Foundation (OPAF)Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
Cost estimate not availableAccessia Health: Heart Failure - Private Insurance
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
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SamscaView full Samsca profile
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.