Bexagliflozin is a sodium-glucose cotransporter 2 (SGLT2) inhibitor. It works by blocking the reabsorption of glucose in the kidneys, which causes excess glucose to be excreted in the urine. This mechanism effectively lowers blood sugar levels and has shown secondary benefits for cardiovascular and renal health in diabetic populations.
Verdict
Effective for T2D glycemic control under strict medical supervision.
HEALTHSPAN IMPACT
High Value
RISK LEVEL
Moderate
EVIDENCE GRADE
A
MONTHLY COST
$50 - $550
Protocol
- The standard clinical dose is 20 mg taken orally once daily in the morning.
Flags
- Increased risk of genital mycotic infections (yeast infections) and urinary tract infections.
- Risk of dehydration and hypotension, especially when combined with diuretics or in the elderly.
- Rare but serious risk of diabetic ketoacidosis (DKA), even with near-normal blood glucose.
- Associated with a rare but life-threatening bacterial infection of the perineum (Fournier's gangrene).
- Not recommended for patients with severe renal impairment (e.g., eGFR < 30).