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Brenzavvy
bexagliflozin
Adult Dosing .
Dosage forms: TAB: 20 mg
diabetes mellitus, type 2
- [20 mg PO qam]
- Info: do not crush/chew tab; hold tx at least 3 days before surgery/procedure if prolonged fasting
renal dosing
- [see below]
- eGFR <30: avoid use
- HD/PD: not defined
hepatic dosing
- [see below]
- Child-Pugh Class A or B: no adjustment; Child-Pugh Class C: not defined, caution advised
Peds Dosing .
Peds dosing is currently unavailable or not applicable for this drug.
Contraindications / Cautions .
- hypersensitivity to drug or ingredient
- pregnancy 2nd trimester
- pregnancy 3rd trimester
- breastfeeding
- eGFR <30
- diabetic ketoacidosis
- volume depletion
- caution: pregnancy 1st trimester
- caution: elderly patients
- caution: eGFR <60
- caution: hepatic impairment, Child-Pugh Class C
- caution: hypotension
- caution: ketoacidosis risk
- caution: pancreatic disorder
- caution: fasting
- caution: febrile illness, acute
- caution: surgery
- caution: ketogenic diet
- caution: alcohol abuse
- caution: genital mycotic infection history
- caution: uncircumcised penis
- caution: amputation history
- caution: PVD
- caution: neuropathy
- caution: diabetic foot ulcer
Drug Interactions .
Overview
bexagliflozin
SGLT2 inhibitor
- UGT1A9 substrate
- antidiabetic agent
- fluid/electrolyte loss
- hypotensive effects
Avoid/Use Alternative
- aldesleukin
- bexagliflozin
- canagliflozin
- dapagliflozin
- empagliflozin
- ertugliflozin
- lofexidine
- sotagliflozin
Monitor/Modify Tx
- acebutolol
- alclometasone topical
- alfentanil
- alfuzosin
- aliskiren
- aloe
- alpelisib
- alprostadil intracavernous
- amantadine
- amcinonide topical
- amifostine
- amiloride
- amitriptyline
- amlodipine
- amoxapine
- apomorphine
- apraclonidine ophthalmic
- aprocitentan
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- aripiprazole lauroxil
- aripiprazole monthly injection
- aripiprazole oral
- arsenic trioxide
- articaine
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- gymnema
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- lidocaine
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- lithium
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- loxapine
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- lumateperone
- lurasidone
- lutetium Lu 177 dotatate
- magnesium sulfate
- maraviroc
- mecasermin
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- megestrol
- meperidine
- mepivacaine
- methadone
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- methylene blue injection
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- methyltestosterone
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- metoprolol
- metreleptin
- midazolam
- milk thistle
- milrinone
- milsaperidone
- minoxidil
- mirtazapine
- moexipril
- molindone
- mometasone topical
- morphine
- moxifloxacin
- nadolol
- nalbuphine
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- nebivolol
- nelfinavir
- nevirapine
- niacin (vitamin B3)
- nicardipine
- nifedipine
- nimodipine
- nisoldipine
- nitric oxide
- nitrite
- nitroglycerin
- nitroprusside
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- norepinephrine
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- norgestrel (contraceptive)
- nortriptyline
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- ofloxacin
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- olmesartan medoxomil
- opicapone
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- oxycodone
- oxymorphone
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- pasireotide
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- peginterferon alfa 2a
- pegvisomant
- pentamidine
- pentazocine
- pentobarbital
- perindopril
- perphenazine
- phenelzine
- phenobarbital
- phenoxybenzamine
- phentolamine
- phenylephrine
- phenytoin
- pindolol
- plozasiran
- pramipexole
- prazosin
- prednicarbate topical
- prednisolone
- prednisone
- procarbazine
- prochlorperazine
- promethazine
- propafenone
- propofol
- propranolol
- protriptyline
- pseudoephedrine
- quetiapine
- quinapril
- quinine
- ramipril
- rasagiline
- remifentanil
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- repaglinide
- ribose
- rifampin
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- risperidone
- ritonavir
- ropinirole
- ropivacaine
- rotigotine transdermal
- sacrosidase
- sacubitril
- safinamide
- segesterone (contraceptive)
- selegiline
- selegiline transdermal
- sevoflurane
- sildenafil
- silodosin
- sirolimus albumin-bound
- sodium ferric gluconate complex
- somapacitan
- somatrogon
- somatropin
- sotalol
- sparsentan
- spironolactone
- sucralfate
- sufentanil
- sunitinib
- tadalafil
- tagraxofusp
- tamsulosin
- tapentadol
- taurine
- telmisartan
- temsirolimus
- teprotumumab
- terazosin
- tesamorelin
- testosterone
- thalidomide
- thioridazine
- thiothixene
- thyroid
- timolol
- timolol ophthalmic
- tipranavir
- tizanidine
- tolcapone
- torsemide
- tramadol
- trandolapril
- tranylcypromine
- trazodone
- treprostinil
- triamcinolone
- triamcinolone topical
- triamterene
- trifluoperazine
- trimipramine
- triptorelin
- turmeric
- valsartan
- vamorolone
- vardenafil
- verapamil
- vorinostat
- vosoritide
- yohimbe
- ziprasidone
Adverse Reactions .
Serious Reactions
- hypersensitivity reaction
- anaphylaxis
- acute kidney injury
- hypotension
- ketoacidosis
- UTI, serious
- sepsis
- fractures
- lower limb amputation risk
- Fournier gangrene
Common Reactions
- volume depletion
- urination incr.
- UTI
- genital mycotic infection
- rash
- thirst
- vulvovaginal pruritus
- lower limb amputation risk
- Cr incr.
- LDL-C incr.
- Hgb incr.
Safety/Monitoring .
Monitoring Parameters
Cr at baseline, then periodically; BP; consider urine ketones if ketoacidosis risk
Pregnancy/Lactation .
Pregnancy
Clinical Summary
avoid use in 2nd and 3rd trimester, weigh risk/benefit in 1st trimester; no human data available; possible risk of irreversible adverse effects on renal development and maturation in 2nd and 3rd trimesters based on animal data at 11x recommended human dose and drug's mechanism of action; no known risk of teratogenicity in 1st trimester based on animal data at 551x recommended human dose
Lactation
Clinical Summary
avoid use while breastfeeding; no human data available, though possible risk of adverse effects on infant renal development and maturation based on drug's mechanism of action; no human data available to assess effects on milk production
Pharmacology .
Metabolism: for bexagliflozin: liver; CYP450: 3A4 substrate; UGT: 1A9 (primary) substrate
Excretion: for bexagliflozin: feces 51% (29% unchanged), uring 41% (2% unchanged); Half-life: 12h
Subclass: Diabetes: SGLT2 Inhibitors
Mechanism of Action
for bexagliflozin: inhibits sodium-glucose cotransporter 2 (SGLT2), reducing glucose/sodium reabsorption, incr. urinary glucose excretion and sodium delivery to distal tubule
Formulary .
No Formulary Selected
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