Home Drug Guide Bexagliflozin

Drug Guide

Generic Name

Bexagliflozin

Brand Names Brenzavvy

Classification

Therapeutic: Antidiabetic agent

Pharmacological: SGLT2 inhibitor

FDA Approved Indications

Type 2 diabetes mellitus

Mechanism of Action

Bexagliflozin inhibits the sodium-glucose co-transporter 2 (SGLT2) in the proximal renal tubules, reducing glucose reabsorption and increasing urinary glucose excretion, thereby lowering blood glucose levels.

Dosage and Administration

Adult: Typically, 20 mg once daily, with or without food. Dose adjustments may be necessary based on renal function.

Pediatric: Not approved for pediatric use.

Geriatric: Use with caution; consider renal function and overall health status.

Renal Impairment: Adjust dose or use with caution in patients with impaired renal function; contraindicated in severe renal impairment.

Hepatic Impairment: Limited data; use caution and monitor closely.

Pharmacokinetics

Absorption: Rapid absorption with peak plasma concentrations in approximately 1-2 hours.

Distribution: Moderate volume of distribution; highly protein-bound.

Metabolism: Primarily metabolized via glucuronidation.

Excretion: Excreted mainly in urine (as unchanged drug and metabolites).

Half Life: Approximately 10-13 hours.

Contraindications

Severe renal impairment (eGFR <30 mL/min/1.73 m²)
End-stage renal disease
Dialysis

Precautions

Monitor renal function regularly.
Risk of diabetic ketoacidosis (DKA).
Use with caution in elderly, dehydrated patients, or those with hypotension.

Adverse Reactions - Common

Urinary tract infections (Common)
Genital mycotic infections (Common)
Increased urination (Common)

Adverse Reactions - Serious

Diabetic ketoacidosis (DKA) (Uncommon but serious)
Serious urinary tract infections or pyelonephritis (Rare)
Hypotension (Uncommon)

Drug-Drug Interactions

Diuretics (potentiation of hypotension)
Insulin and other antidiabetics (risk of hypoglycemia)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor blood glucose, renal function, volume status, and signs of DKA.

Diagnoses:

Risk for hypoglycemia
Risk for infection
Risk for dehydration

Implementation: Administer once daily, monitor renal function periodically, educate patient on signs of DKA and infections.

Evaluation: Assess blood glucose control, renal function, and for any adverse reactions.

Patient/Family Teaching

Take medication exactly as prescribed.
Report symptoms of urinary tract infections, genital infections, or DKA.
Maintain hydration.
Monitor blood glucose regularly.

Special Considerations

Black Box Warnings:

Risk of ketoacidosis, which can be life-threatening.

Genetic Factors: No specific genetic considerations currently recognized.

Lab Test Interference: May affect serum blood glucose measurements; use appropriate testing methods.

Overdose Management

Signs/Symptoms: Severe dehydration, hypotension, ketoacidosis.

Treatment: Discontinue medication, provide supportive care, rehydrate with intravenous fluids, and monitor blood glucose and acid-base status.

Storage and Handling

Storage: Store at room temperature, protect from moisture and light.

Stability: Stable up to the expiration date when stored properly.