Home Drug Guide Bexagliflozin

Drug Guide

Generic Name

Bexagliflozin

Brand Names Brenzavvy

Classification

Therapeutic: Antidiabetic agent

Pharmacological: SGLT2 inhibitor

FDA Approved Indications

  • Type 2 diabetes mellitus

Mechanism of Action

Bexagliflozin inhibits the sodium-glucose co-transporter 2 (SGLT2) in the proximal renal tubules, reducing glucose reabsorption and increasing urinary glucose excretion, thereby lowering blood glucose levels.

Dosage and Administration

Adult: Typically, 20 mg once daily, with or without food. Dose adjustments may be necessary based on renal function.

Pediatric: Not approved for pediatric use.

Geriatric: Use with caution; consider renal function and overall health status.

Renal Impairment: Adjust dose or use with caution in patients with impaired renal function; contraindicated in severe renal impairment.

Hepatic Impairment: Limited data; use caution and monitor closely.

Pharmacokinetics

Absorption: Rapid absorption with peak plasma concentrations in approximately 1-2 hours.

Distribution: Moderate volume of distribution; highly protein-bound.

Metabolism: Primarily metabolized via glucuronidation.

Excretion: Excreted mainly in urine (as unchanged drug and metabolites).

Half Life: Approximately 10-13 hours.

Contraindications

  • Severe renal impairment (eGFR <30 mL/min/1.73 m²)
  • End-stage renal disease
  • Dialysis

Precautions

  • Monitor renal function regularly.
  • Risk of diabetic ketoacidosis (DKA).
  • Use with caution in elderly, dehydrated patients, or those with hypotension.

Adverse Reactions - Common

  • Urinary tract infections (Common)
  • Genital mycotic infections (Common)
  • Increased urination (Common)

Adverse Reactions - Serious

  • Diabetic ketoacidosis (DKA) (Uncommon but serious)
  • Serious urinary tract infections or pyelonephritis (Rare)
  • Hypotension (Uncommon)

Drug-Drug Interactions

  • Diuretics (potentiation of hypotension)
  • Insulin and other antidiabetics (risk of hypoglycemia)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor blood glucose, renal function, volume status, and signs of DKA.

Diagnoses:

  • Risk for hypoglycemia
  • Risk for infection
  • Risk for dehydration

Implementation: Administer once daily, monitor renal function periodically, educate patient on signs of DKA and infections.

Evaluation: Assess blood glucose control, renal function, and for any adverse reactions.

Patient/Family Teaching

  • Take medication exactly as prescribed.
  • Report symptoms of urinary tract infections, genital infections, or DKA.
  • Maintain hydration.
  • Monitor blood glucose regularly.

Special Considerations

Black Box Warnings:

  • Risk of ketoacidosis, which can be life-threatening.

Genetic Factors: No specific genetic considerations currently recognized.

Lab Test Interference: May affect serum blood glucose measurements; use appropriate testing methods.

Overdose Management

Signs/Symptoms: Severe dehydration, hypotension, ketoacidosis.

Treatment: Discontinue medication, provide supportive care, rehydrate with intravenous fluids, and monitor blood glucose and acid-base status.

Storage and Handling

Storage: Store at room temperature, protect from moisture and light.

Stability: Stable up to the expiration date when stored properly.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.