When Brenzavvy Isn't Available, You Still Have Options

Brenzavvy (Bexagliflozin) has become a popular choice for people with type 2 diabetes — especially those looking for an affordable SGLT2 inhibitor. But if you can't find it at your pharmacy or your insurance won't cover it, you're not stuck. There are several alternatives in the same drug class that work in a very similar way.

Before we get into the alternatives, let's quickly cover what Brenzavvy is and how it works — so you can understand what you'd be switching to.

What Is Brenzavvy?

Brenzavvy is the brand name for Bexagliflozin, a prescription medication approved by the FDA in January 2023. It's made by TheracosBio and is used alongside diet and exercise to improve blood sugar control in adults with type 2 diabetes.

Brenzavvy comes as a single-strength 20 mg tablet taken once daily in the morning. For a full overview, read our guide on what Brenzavvy is, its uses, and dosage.

How Does Brenzavvy Work?

Brenzavvy belongs to the SGLT2 inhibitor class. It works by blocking the SGLT2 protein in your kidneys, which normally reabsorbs glucose back into your bloodstream. By blocking this process, Brenzavvy causes excess sugar to be flushed out through your urine — lowering your blood sugar levels.

All SGLT2 inhibitors share this same basic mechanism, which means alternatives in the class work in a very similar way. The differences come down to additional approved uses, dosing, side effect profiles, and — often most importantly — cost and insurance coverage.

For more detail, check out how Brenzavvy works: mechanism of action explained.

SGLT2 Inhibitor Alternatives to Brenzavvy

1. Jardiance (Empagliflozin)

Manufacturer: Boehringer Ingelheim / Eli Lilly

Doses: 10 mg and 25 mg tablets, taken once daily

Approved for: Type 2 diabetes, heart failure (with reduced and preserved ejection fraction), and cardiovascular risk reduction in adults with type 2 diabetes and established cardiovascular disease.

How it compares: Jardiance is the most widely prescribed SGLT2 inhibitor and has the broadest set of FDA-approved indications. It's been studied extensively for cardiovascular and kidney benefits. The downside? It's significantly more expensive — retail prices can exceed $550/month without insurance. However, most insurance plans cover it as a preferred SGLT2 inhibitor, so your out-of-pocket cost with insurance may be manageable.

2. Farxiga (Dapagliflozin)

Manufacturer: AstraZeneca

Doses: 5 mg and 10 mg tablets, taken once daily

Approved for: Type 2 diabetes, heart failure, and chronic kidney disease (CKD).

How it compares: Farxiga is the only SGLT2 inhibitor approved for CKD regardless of diabetes status, making it a strong option if you have kidney concerns. Like Jardiance, retail pricing is high ($500+/month) but insurance coverage is generally good. It's often a first-line choice on commercial and Medicare formularies.

3. Invokana (Canagliflozin)

Manufacturer: Janssen (Johnson & Johnson)

Doses: 100 mg and 300 mg tablets, taken once daily before the first meal

Approved for: Type 2 diabetes, cardiovascular risk reduction, and diabetic kidney disease.

How it compares: Invokana was the first SGLT2 inhibitor approved in the US (2013). It's effective but carries a stronger warning about lower limb amputation risk compared to some newer options. Retail pricing is similar to Jardiance and Farxiga. Insurance coverage varies — some plans prefer it, while others favor Jardiance or Farxiga.

4. Steglatro (Ertugliflozin)

Manufacturer: Merck / Pfizer

Doses: 5 mg and 15 mg tablets, taken once daily in the morning

Approved for: Type 2 diabetes only.

How it compares: Steglatro is the least prescribed SGLT2 inhibitor. It lacks the cardiovascular and kidney indications of Jardiance and Farxiga. It's typically less expensive than those two but is also less likely to be on preferred formulary tiers. It may be an option if your doctor wants to keep you on an SGLT2 inhibitor and other options aren't accessible.

Quick Comparison Table

Here's how these alternatives stack up against Brenzavvy:

• Brenzavvy: 20 mg once daily | Type 2 diabetes | $43–$69/month cash | Limited formulary coverage
• Jardiance: 10–25 mg once daily | Diabetes + heart failure + CV risk | $550+/month retail | Widely covered by insurance
• Farxiga: 5–10 mg once daily | Diabetes + heart failure + CKD | $500+/month retail | Widely covered by insurance
• Invokana: 100–300 mg once daily | Diabetes + CV risk + kidney disease | $500+/month retail | Variable coverage
• Steglatro: 5–15 mg once daily | Diabetes only | $400+/month retail | Less commonly covered

What to Consider When Switching

If you're thinking about switching from Brenzavvy to an alternative, keep these factors in mind:

• Insurance coverage: Check whether the alternative is on your formulary. Jardiance and Farxiga are most commonly covered.
• Additional health conditions: If you have heart failure or kidney disease, Jardiance or Farxiga may offer additional benefits that Brenzavvy doesn't have specific FDA approval for.
• Cost: If you're paying cash, Brenzavvy is by far the cheapest SGLT2 inhibitor. Alternatives can cost 5–10x more without insurance.
• Side effects: All SGLT2 inhibitors share similar side effects, but individual responses vary. Read about Brenzavvy side effects and discuss with your doctor.

Final Thoughts

Brenzavvy stands out for its affordability, but if you can't get it, there are solid alternatives in the same drug class. The best choice depends on your health needs, insurance coverage, and budget. Talk with your doctor or pharmacist about which SGLT2 inhibitor makes the most sense for you.

Still want to try finding Brenzavvy? Use Medfinder to search pharmacies near you, or read our guide on how to find Brenzavvy in stock.