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Bexagliflozin FDA Approved for Diabetes: TheracosBio Brenzavvy

Bexagliflozin FDA Approval

On 20th January, the FDA approved a new SGLT2 inhibitor, Bexagliflozin for the treatment of adults with Type 2 Diabetes [Ref].

The drug is a brand of TheracosBio by the name of Brenzavvy.

Bexagliflozin is the 5th SGLT2 inhibitor that the FDA approved for the treatment of adults with Diabetes Type 2. The other SGLT2 inhibitors that have been approved and are very commonly used are:

Bexagliflozin was approved in December 2022 for the treatment of Diabetes in cats.

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How effective is Brenzavvy Vs other SGLT2 Inhibitors?

According to the ADA 2023 guidelines, SGLT2 inhibitors are classified as “intermediate to highly potent” diabetes medicines.

The following table summarizes diabetes drugs based on their potency:

Efficacy of Type 2 Diabetes Medications (in descending order)



IntermediateDPP-IV Inhibitors
  • Sitagliptin
  • Vildagliptin
  • Linagliptin
  • Alogliptin
  • Saxagliptin
Intermediate to highSGLT2 Inhibitors
  • Dapagliflozin
  • Empagliflozin
  • Canagliflozin
  • Ertugliflozin
  • Metformin
  • Pioglitazone
2nd Generation Sulfonylureas
  • Glyburide
  • Gliclazide
  • Glimepiride
High to very highly effectiveGLP-1 Receptor agonists
  • Dulaglutide
  • Liraglutide
  • Semaglutide
  • Exenatide
  • Insulin analogs
  • Human Insulin
Very high potencyGIP and GLP-1 Receptor agonists
  • Tirzepatide

Among the SGLT2 inhibitors, Canagliflozin is the most potent, followed by Ertugliflozin, Empagliflozin, and Dapagliflozin.

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The A1C reduction of different SGLT2 inhibitors is tabulated below:

SGLT2 Inhibitor


Percentage A1C reduction

Canagliflozin100 mg0.91%
300 mg↓ 1.16%
Empagliflozin10 mg↓ 0.7%
25 mg↓ 0.8%
Ertugliflozin5 mg↓0.6%
15 mg↓ 0.7%
Dapagliflozin5 mg↓0.6%
10 mg↓ 0.7%
Bexagliflozin20 mg↓ 0.5%

SGLT2 inhibitors are categorized based on their potency (Data is taken from the FDA-prescribing information of each drug):

SGLT2 Inhibitor


Percentage A1C reduction

Canagliflozin300 mg↓ 1.16%
Canagliflozin100 mg↓ 0.9%
Empagliflozin25 mg↓ 0.8%
Empagliflozin10 mg↓ 0.7%
Ertugliflozin15 mg↓ 0.7%
Dapagliflozin10 mg↓ 0.7%
Ertugliflozin5 mg↓ 0.6%
Dapagliflozin5 mg↓ 0.6%
Bexagliflozin20 mg↓ 0.5%

Since Bexagliflozin (Brenzavvy) is one of the least potent SGLT2 inhibitors, it might not be able to compete with other SGLT2 inhibitors.

In addition, Bexagliflozin (Brenzavvy) is contraindicated in patients with kidney disease and not recommended in patients with a CrCl of less than 30 ml/minute.

Thus, although approved by the FDA for the treatment of diabetes, it may not win the markets.

Additional studies may be needed to see the full therapeutic response of the drug.

Lastly, if the price is kept the lowest, it may be utilized by physicians for their patients who are paying from their pockets or in low-income countries.

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What do you think?

Written by Dr. Ahmed

I am Dr. Ahmed (MBBS; FCPS Medicine), an Internist and a practicing physician. I am in the medical field for over fifteen years working in one of the busiest hospitals and writing medical posts for over 5 years.

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