Meta Information
ID:bexagliflozin
Name:
Schema Version:AIM-2.0
Interactions
Target id:
/class/diuretics
Target name:
Diuretics (Water Pills)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Bexagliflozin causes fluid loss through urination; combining it with other diuretics significantly increases the risk of dehydration, low blood pressure, and acute kidney injury.
Actionable advice:
Avoid co-administration or use only under strict medical supervision with careful monitoring and potential dose adjustments.
Target id:
/class/antidiabetic-medications
Target name:
Insulin and Insulin Secretagogues (e.g., Sulfonylureas)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Combining bexagliflozin with insulin or drugs that stimulate insulin release (like sulfonylureas or glinides) dramatically increases the risk of dangerously low blood sugar (hypoglycemia).
Actionable advice:
Requires significant dose reduction of the insulin or secretagogue and frequent blood glucose monitoring when starting bexagliflozin.
Target id:
/condition/renal-impairment
Target name:
Renal Impairment
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Bexagliflozin's effectiveness and safety are dependent on kidney function. It is not recommended for individuals with an eGFR below 30 mL/min/1.73 m2 due to lack of efficacy and increased risk of adverse events.
Actionable advice:
Do not use if you have severe kidney disease (eGFR < 30); consult your doctor for use with mild to moderate impairment.
Target id:
/intervention/ketogenic-diet
Target name:
Ketogenic Diet
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
A ketogenic diet promotes the production of ketones, and bexagliflozin can also increase ketones, leading to a high risk of a serious condition called euglycemic diabetic ketoacidosis (DKA).
Actionable advice:
Avoid using bexagliflozin while following a strict ketogenic or very low-carbohydrate diet.
Target id:
/procedure/major-surgery
Target name:
Major Surgical Procedures
Severity:
major
Interaction type:
adverse
Nature:
temporal
Temporal spacing:
Hours before target:
72
Hours after target:
null
Description:
The metabolic stress of surgery, combined with fasting, significantly increases the risk of developing ketoacidosis. Bexagliflozin should be temporarily discontinued to mitigate this risk.
Actionable advice:
Stop taking bexagliflozin at least 3 days before any scheduled major surgery and consult your doctor on when to restart.
Target id:
/condition/pregnancy
Target name:
Pregnancy
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Bexagliflozin is not recommended during pregnancy, particularly in the second and third trimesters, due to potential risks to the developing fetus's kidneys.
Actionable advice:
Avoid completely during pregnancy.
Target id:
/condition/lactation
Target name:
Breastfeeding (Lactation)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
It is not known if bexagliflozin passes into breast milk, but due to the potential for serious adverse reactions in a breastfed infant, it is not recommended.
Actionable advice:
Avoid completely while breastfeeding.
Target id:
/class/ace-inhibitors
Target name:
ACE Inhibitors
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
The combination of bexagliflozin's diuretic effect with the blood pressure-lowering effect of ACE inhibitors can increase the risk of dehydration, hypotension, and acute kidney injury.
Actionable advice:
Use with caution and ensure adequate hydration; regular monitoring of blood pressure and kidney function is recommended.
Target id:
/class/arbs
Target name:
Angiotensin II Receptor Blockers (ARBs)
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
The combination of bexagliflozin's diuretic effect with the blood pressure-lowering effect of ARBs can increase the risk of dehydration, hypotension, and acute kidney injury.
Actionable advice:
Use with caution and ensure adequate hydration; regular monitoring of blood pressure and kidney function is recommended.
Target id:
/class/nsaids
Target name:
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
NSAIDs can reduce blood flow to the kidneys. When combined with the volume-depleting effect of bexagliflozin, the risk of acute kidney injury is significantly increased.
Actionable advice:
Avoid chronic use of NSAIDs; for occasional use, ensure you are well-hydrated and use the lowest effective dose.
Target id:
/class/broad-spectrum-inducers
Target name:
UGT Enzyme Inducers (e.g., Rifampin)
Severity:
moderate
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
null
Description:
Certain drugs, like the antibiotic rifampin, can accelerate the metabolism and clearance of bexagliflozin from the body, potentially reducing its effectiveness at lowering blood sugar.
Actionable advice:
If co-administration is necessary, your doctor may need to increase the dose of bexagliflozin and monitor glucose levels.
Target id:
/condition/dehydration
Target name:
Dehydration
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Bexagliflozin promotes fluid loss, which can worsen existing dehydration and lead to severe complications like low blood pressure, dizziness, and kidney failure.
Actionable advice:
Ensure you are well-hydrated before starting and maintain good fluid intake, especially during illness or hot weather.
Target id:
/condition/geriatric
Target name:
Geriatric (Older Adults)
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Older adults are more susceptible to the dehydrating effects of bexagliflozin, which increases their risk of low blood pressure (orthostatic hypotension), falls, and kidney problems.
Actionable advice:
Use with caution in older adults, ensuring adequate fluid intake and monitoring for dizziness upon standing.
Target id:
/intervention/alcohol-excessive
Target name:
Excessive Alcohol Consumption
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Heavy alcohol use can impair glucose production, increase the risk of dehydration, and elevate ketone levels, all of which can heighten the risk of hypoglycemia and ketoacidosis with bexagliflozin.
Actionable advice:
Limit alcohol intake and avoid binge drinking while taking this medication.
Target id:
/intervention/lithium
Target name:
Lithium
Severity:
moderate
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
null
Description:
Bexagliflozin can increase the kidneys' elimination of lithium, potentially lowering its concentration in the blood and reducing its therapeutic effect for conditions like bipolar disorder.
Actionable advice:
If taking lithium, your doctor should monitor your lithium levels closely after starting, stopping, or changing the dose of bexagliflozin.
Target id:
/biomarker/1-5-ag-assay
Target name:
1,5-Anhydroglucitol (1,5-AG) Assay
Severity:
major
Interaction type:
assay_interference
Nature:
absolute
Temporal spacing:
null
Description:
Bexagliflozin's mechanism of forcing glucose into the urine makes the 1,5-AG test, a marker of short-term glycemic control, completely unreliable for monitoring blood sugar.
Actionable advice:
Do not use the 1,5-AG test to monitor blood sugar control while taking this medication; use HbA1c or blood glucose monitoring instead.
Target id:
/biomarker/urine-glucose-test
Target name:
Urine Glucose Test
Severity:
major
Interaction type:
assay_interference
Nature:
absolute
Temporal spacing:
null
Description:
This medication works by causing glucose to be excreted in the urine, so urine glucose tests will always be positive and cannot be used to monitor for high blood sugar.
Actionable advice:
Do not rely on urine glucose tests for glycemic monitoring; use blood glucose tests instead.
Target id:
/circadian/wake
Target name:
Morning / Waking Up
Severity:
minor
Interaction type:
synergistic
Nature:
temporal
Temporal spacing:
Hours before target:
null
Hours after target:
2
Description:
Taking bexagliflozin in the morning helps align its diuretic (increased urination) effect with daytime hours, reducing the chance of sleep disruption from needing to urinate at night (nocturia).
Actionable advice:
Take your dose in the morning, with or without food, to minimize nighttime urination.
Target id:
/intervention/digoxin
Target name:
Digoxin
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Bexagliflozin may slightly increase the concentration of digoxin in the blood, which could potentially increase its effects and risk of side effects.
Actionable advice:
If taking both medications, your doctor may wish to monitor your digoxin levels when starting or adjusting bexagliflozin.