Before taking any medication, including Brenzavvy, it is crucial to consult with a healthcare professional. Information provided here is for general knowledge and should not be considered medical advice.
What is Brenzavvy (Bexagliflozin)?
Brenzavvy, with the generic name bexagliflozin, is an oral prescription medication approved by the FDA in January 2023. It is used alongside diet and exercise to improve glycemic control in adults with type 2 diabetes. Brenzavvy belongs to a class of drugs known as sodium-glucose co-transporter 2 (SGLT2) inhibitors. It is important to note that this medication is not for use in patients with type 1 diabetes, as it may increase the risk of diabetic ketoacidosis (DKA) in that population. It is typically taken once daily.
How Brenzavvy Works
The mechanism of action for Brenzavvy involves the kidneys. SGLT2 is a transporter protein responsible for reabsorbing most of the glucose filtered by the kidneys back into the bloodstream. By selectively inhibiting SGLT2, Brenzavvy prevents this reabsorption. This action lowers the renal threshold for glucose, leading to increased excretion of excess sugar in the urine, which in turn lowers blood sugar levels in the body.
Benefits and Efficacy
Clinical trials have demonstrated Brenzavvy's effectiveness in managing type 2 diabetes.
- A1c Reduction: Multiple Phase 3 studies have shown that Brenzavvy significantly reduces hemoglobin A1c (HbA1c) levels. For instance, one study showed an average A1c reduction. In other studies, about a third of participants achieved a specific A1c level after six months.
- Weight Loss: While not an FDA-approved indication, modest weight loss has been observed in clinical studies. Patients taking Brenzavvy have shown weight loss over a period of time, a benefit that was sustained.
- Blood Pressure Reduction: Modest decreases in systolic blood pressure were also noted in clinical trials, though it is not specifically approved for this purpose.
Potential Side Effects and Warnings
Like all medications, Brenzavvy has potential side effects and important warnings.
Common Side Effects:
- Genital yeast infections in both women and men.
- Urinary tract infections (UTIs).
- Increased urination.
Serious Warnings:
- Ketoacidosis (DKA): A serious condition where the body produces high levels of blood acids called ketones. It can be life-threatening and requires immediate hospitalization. It may occur even with certain blood glucose levels.
- Lower Limb Amputations: Brenzavvy may increase the risk of lower limb amputations, primarily involving the toe or foot. Patients should practice routine preventative foot care and report any new pain, sores, or infections to their doctor immediately.
- Volume Depletion (Dehydration): The drug can cause dehydration, which may lead to symptomatic hypotension (low blood pressure) or acute kidney injury. The risk is higher in the elderly, those with kidney problems, or patients on loop diuretics.
- Necrotizing Fasciitis (Fournier’s Gangrene): A rare but very serious bacterial infection of the tissue under the skin of the perineum has been reported with SGLT2 inhibitors.
- Urosepsis and Pyelonephritis: Serious urinary tract infections that spread to the kidneys can occur.
Comparison with Other SGLT2 Inhibitors
Brenzavvy is one of several SGLT2 inhibitors on the market. Its main distinction has been its lower price point, making it a more accessible option.
| Feature | Brenzavvy (bexagliflozin) | Jardiance (empagliflozin) | Farxiga (dapagliflozin) | Invokana (canagliflozin) |
|---|---|---|---|---|
| Primary Use | Type 2 Diabetes | Type 2 Diabetes | Type 2 Diabetes | Type 2 Diabetes |
| Additional FDA-Approved Indications | None currently. | Reduce risk of CV death in adults with T2D and CVD; reduce risk of CV death and hospitalization for Heart Failure. | Reduce risk of hospitalization for Heart Failure in adults with T2D and CVD; treat Heart Failure; treat Chronic Kidney Disease. | Reduce risk of major CV events in adults with T2D and CVD; reduce risk of end-stage kidney disease in adults with T2D and diabetic nephropathy. |
| Amputation Risk Warning | Yes, included in prescribing information. | Not listed as a primary warning. | Not listed as a primary warning. | Yes, boxed warning in the past, though since removed. Risk is a class consideration. |
| Cost | Significantly lower without insurance through specific pharmacies. | Higher brand-name price, often hundreds of dollars per month. | Higher brand-name price; generic available. | Higher brand-name price. |
Conclusion
Brenzavvy (bexagliflozin) represents an effective and notably more affordable option within the SGLT2 inhibitor class for managing type 2 diabetes. Its mechanism of promoting glucose excretion through urine helps lower A1c, and it offers secondary benefits like modest weight and blood pressure reduction. However, patients and healthcare providers must be vigilant about its potential serious side effects, including the risks of ketoacidosis, lower limb amputations, and dehydration. As with any prescription medication, a thorough discussion with a healthcare provider is essential to determine if Brenzavvy is the right choice for an individual's treatment plan.
For more detailed information, you can review the official FDA Prescribing Information.
