Alternatives to Bexagliflozin (Brenzavvy) if You Can't Fill Your Prescription

Brenzavvy (bexagliflozin) is a highly affordable SGLT2 inhibitor — but its unconventional distribution means some patients can't easily access it. If you've tried and failed to fill your Brenzavvy prescription, or if your doctor wants to switch you to a more readily available option, this guide covers the best alternatives in 2026.

Note: Before switching, it's worth trying to find Brenzavvy through its partner pharmacies — read our guide on why Brenzavvy is hard to find and how to locate it. Many patients are able to access it for $47–$50/month through online pharmacies.

What Makes a Good Bexagliflozin Alternative?

Bexagliflozin belongs to the SGLT2 inhibitor drug class. Medications in the same class work via the same mechanism — blocking glucose reabsorption in the kidneys — so they are direct alternatives. Other drug classes for type 2 diabetes work differently but may be appropriate depending on your situation.

When choosing an alternative, your doctor will consider:

Your kidney function (eGFR)

Heart failure or cardiovascular disease history

Insurance coverage and cost

Other medications you are taking

Current A1C level and glycemic control needs

SGLT2 Inhibitor Alternatives to Brenzavvy

1. Jardiance (Empagliflozin)

Jardiance is the most widely prescribed SGLT2 inhibitor in the US, holding over 50% of the market. It is FDA-approved for type 2 diabetes, heart failure (HFpEF and HFrEF), cardiovascular risk reduction, and chronic kidney disease — broader indications than Brenzavvy.

Available at: All major chain pharmacies

Cash price: ~$550/month list price; manufacturer copay card available for eligible patients

Best for: Patients with heart failure, established cardiovascular disease, or CKD; patients whose insurance covers it

2. Farxiga (Dapagliflozin)

Farxiga is another top-tier SGLT2 inhibitor with FDA approvals for type 2 diabetes, heart failure (HFrEF and HFpEF), and chronic kidney disease. It has a strong cardiovascular outcomes data set. Generic dapagliflozin entered the market in 2025, which is bringing the cost down significantly.

Available at: All major chain pharmacies

Cash price: Brand ~$500/month; generic dapagliflozin available at significantly lower cost in 2025-2026

Best for: Patients needing heart failure or CKD benefit; those wanting a generic option

3. Invokana (Canagliflozin)

Invokana was the first SGLT2 inhibitor approved in the US (2013). It's indicated for type 2 diabetes and reducing the risk of cardiovascular events in adults with established cardiovascular disease. Important note: canagliflozin has higher data on lower limb amputation risk than other SGLT2 inhibitors — your doctor will weigh this for your specific case.

Available at: Most major pharmacies

Best for: Patients with established cardiovascular disease who cannot access Farxiga or Jardiance

4. Steglatro (Ertugliflozin)

Steglatro is an SGLT2 inhibitor approved for type 2 diabetes only. It has a smaller market share and less outcomes data compared to Jardiance or Farxiga. Available in 5 mg and 15 mg doses, taken once daily in the morning.

Non-SGLT2 Alternatives for Type 2 Diabetes

If an SGLT2 inhibitor is not appropriate for you (e.g., kidney function is too low), your doctor may recommend:

Metformin — First-line therapy, very low cost, widely available

GLP-1 agonists (Ozempic, Trulicity, Victoza) — Injectable or oral options with strong A1C lowering and weight loss benefits

DPP-4 inhibitors (Januvia, generic sitagliptin) — Well-tolerated oral agents; generic sitagliptin now available

Sulfonylureas (glimepiride, glipizide) — Inexpensive generics; effective but may cause weight gain and hypoglycemia

Comparison Table: Brenzavvy vs. Other SGLT2 Inhibitors

Here's a quick comparison of the major SGLT2 inhibitors available in the US in 2026:

Brenzavvy (bexagliflozin): T2DM only | ~$47–$50/month cash | Limited distribution

Jardiance (empagliflozin): T2DM, HF, CKD, CV risk | ~$550/month | Widely available; insurance often covers

Farxiga (dapagliflozin): T2DM, HF, CKD | ~$500/month brand; generic available | Widely available

Invokana (canagliflozin): T2DM, CV risk | Variable cost | Widely available; amputation risk counseling needed

Before You Switch: Try Finding Brenzavvy First

If the cost savings of Brenzavvy matter to you, it's worth trying medfinder before switching. medfinder contacts pharmacies in your area to check which ones can fill your prescription — no hold music required. The drug is available nationwide; you just need to find the right pharmacy.