What Is Bexagliflozin (Brenzavvy)? Uses, Dosage, and What You Need to Know in 2026

Bexagliflozin — brand name Brenzavvy — is a prescription medication approved by the FDA in January 2023 for adults with type 2 diabetes. It belongs to a class of drugs called SGLT2 inhibitors, which help lower blood sugar by causing the kidneys to excrete excess glucose through urine. This guide covers everything patients and caregivers need to know about bexagliflozin in 2026.

What Is Bexagliflozin Approved For?

The FDA approved bexagliflozin (Brenzavvy) on January 23, 2023, as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus.

What it is NOT approved for: Brenzavvy is not approved for type 1 diabetes, heart failure, chronic kidney disease without diabetes, or cardiovascular risk reduction — indications that Jardiance and Farxiga carry. Using it in type 1 diabetes significantly increases the risk of diabetic ketoacidosis.

Who Makes Brenzavvy?

Brenzavvy is manufactured by TheracosBio, a small pharmaceutical company founded with the mission of making new medications broadly accessible. Unlike Eli Lilly (Jardiance) and AstraZeneca (Farxiga), TheracosBio does not rely on a large sales force or direct-to-consumer advertising. Instead, they launched Brenzavvy at a dramatically lower price — around $50/month — through online and independent pharmacy partners.

How Does Bexagliflozin Work?

Bexagliflozin works by blocking a protein called SGLT2 (sodium-glucose co-transporter 2) in the kidneys. Normally, SGLT2 reabsorbs glucose from filtered blood back into the bloodstream. By blocking SGLT2, bexagliflozin allows excess glucose to pass out of the body through urine — effectively lowering blood sugar without relying on insulin.

For a detailed explanation of the mechanism, see our post on how bexagliflozin works.

Dosage and How to Take Bexagliflozin

Dose: 20 mg once daily (the only available dose)

When: In the morning, with or without food

How: Swallow whole; do not crush or chew

Missed dose: Take as soon as you remember. If close to the next dose, skip the missed dose — don't double up.

Storage: Room temperature (68°F–77°F), away from heat and moisture

Who Should NOT Take Bexagliflozin?

People with type 1 diabetes (increases DKA risk substantially)

People with severe kidney disease (eGFR < 30 mL/min/1.73 m²)

People on dialysis

People with a known allergy to bexagliflozin or any tablet ingredient

Pregnant women in the 2nd or 3rd trimester

How Effective Is Bexagliflozin?

The FDA approved bexagliflozin based on evidence from nine clinical trials with 4,462 adults. Key effectiveness data:

A1C reduction: 0.7–1.0% over 24 weeks

Fasting blood glucose reduction: ~35 mg/dL

Post-meal glucose reduction: >55 mg/dL

Weight reduction: ~6 lbs (2–3 kg) over 48 weeks

Systolic blood pressure reduction: ~2–3 mmHg

Bexagliflozin was shown to be non-inferior to glimepiride (a sulfonylurea) over 60 weeks and non-inferior to sitagliptin (a DPP-4 inhibitor) over 24 weeks. In the BEST trial, A1C levels decreased from an average of 8.3% to 7.45%.

How Is Brenzavvy Different From Jardiance or Farxiga?

All three are SGLT2 inhibitors with similar blood sugar-lowering effects. The main differences:

Cost: Brenzavvy ~$50/month vs. Jardiance ~$550/month and Farxiga ~$500/month

Indications: Jardiance and Farxiga are also approved for heart failure and CKD; Brenzavvy is not

Availability: Jardiance and Farxiga are at every major pharmacy; Brenzavvy is primarily through online pharmacies

Insurance: Most plans cover Jardiance and Farxiga; Brenzavvy is often not on formulary

Have your Brenzavvy prescription ready? Use medfinder to locate a pharmacy that has it in stock near you.