An SGLT2 inhibitor for type 2 diabetes
Bexagliflozin
An SGLT2 inhibitor that lowers blood sugar in type 2 diabetes by removing excess glucose in the urine.
What is Bexagliflozin?
Bexagliflozin is an SGLT2 inhibitor used to help control blood sugar in adults with type 2 diabetes, usually alongside diet, exercise and sometimes other diabetes medicines. It works in the kidneys to remove excess sugar (glucose) from the body in the urine. The most serious risk is diabetic ketoacidosis, a dangerous build-up of acids that, with this class, can occasionally occur even when blood sugar is near normal. It can also cause genital and urinary infections, dehydration, and very rarely a serious infection of the genital area (Fournier's gangrene). It is taken by mouth.
Education and reference only. This is a plain-language guide to Bexagliflozin — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Bexagliflozin is a medicine from the SGLT2 inhibitor group, used to help lower blood sugar in adults with type 2 diabetes. It is usually taken alongside healthy eating and physical activity, and sometimes together with other diabetes medicines, to improve blood-sugar control. It works in the kidneys to remove excess glucose from the body in the urine. It is taken by mouth as a tablet. The SGLT2 inhibitor class is well established in the UK, though bexagliflozin itself is mainly a United States product; this page is for general understanding of how it works and its key risks.
How it works
The kidneys normally filter glucose out of the blood and then reabsorb it back into the body using a transporter called SGLT2. Bexagliflozin blocks SGLT2, so less glucose is reabsorbed and more is passed out in the urine, which lowers the level of sugar in the blood. Because it works on the kidneys rather than by making more insulin, it carries a low risk of causing low blood sugar on its own. Removing glucose in the urine also draws water out with it, which is why staying hydrated matters and why it can have a mild effect on blood pressure and weight.
Company & origin
Originated / developed by: Specialist manufacturer.
An SGLT2 inhibitor used to help control blood sugar in type 2 diabetes; this class is well established, though this particular medicine is mainly a US product.
What it treats
Conditions Bexagliflozin is used for
Practical use
How to take Bexagliflozin
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Take it by mouth once a day as prescribed, with or without food, at about the same time each day.
- Drink enough fluids to stay hydrated, as it makes you pass more urine.
- Seek urgent help if you feel very unwell with nausea, vomiting, tummy pain or fast breathing, which can be signs of ketoacidosis.
- Follow any sick-day advice to pause it during illness with vomiting, diarrhoea or dehydration.
- Take care with genital hygiene and report any genital pain, swelling or redness urgently.
Weighing it up
Advantages & disadvantages of Bexagliflozin
Advantages
- Lowers blood sugar in type 2 diabetes by removing excess glucose in the urine.
- Has a low risk of causing low blood sugar on its own, as it does not work by making more insulin.
- Taken by mouth once a day and can be combined with other diabetes treatments.
Disadvantages
- Can cause diabetic ketoacidosis, which may occur even when blood sugar is near normal.
- Increases the chance of genital thrush and urinary infections, and can cause dehydration.
- Very rarely can cause a serious infection of the genital area (Fournier's gangrene).
Practical use
Good to know
The most important safety point with bexagliflozin, as with all SGLT2 inhibitors, is diabetic ketoacidosis: a dangerous build-up of acids in the blood that needs urgent treatment and that, unusually for this class, can sometimes happen even when blood sugar is near normal. Warning signs include feeling very unwell, nausea and vomiting, tummy pain, fast breathing and unusual tiredness, and these should be acted on urgently. Because it makes you pass more sugar in the urine, genital thrush and urinary infections are more common, and good genital hygiene helps; very rarely a serious infection of the genital area called Fournier's gangrene can occur, which needs emergency care. It can also cause dehydration, so it may be paused during illness with vomiting or diarrhoea (sometimes called sick-day rules). It is taken by mouth and reviewed regularly by your diabetes team.
Who should not take it / use with caution
- People who have had a serious allergic reaction to bexagliflozin should not take it.
- It is not suitable for type 1 diabetes unless a specialist decides otherwise, because of the ketoacidosis risk.
- It is used with caution, or avoided, in people with poor kidney function or who are prone to dehydration.
- It is used with care in pregnancy and breastfeeding, with medical advice.
Monitoring
- Regular reviews of blood-sugar control and kidney function.
- Watching for signs of ketoacidosis, dehydration and genital or urinary infections.
- Reviewing fluid intake and sick-day advice during illness.
Side effects
- Genital thrush and urinary infections, because more sugar passes in the urine.
- Dehydration, dizziness or feeling faint, especially if fluid intake is low.
- Rarely but seriously, diabetic ketoacidosis or a serious genital infection (Fournier's gangrene), both needing urgent care.
Key interactions
- Water tablets (diuretics) can add to the risk of dehydration, so this is reviewed.
- When used with insulin or some other diabetes medicines, the risk of low blood sugar can rise, so doses may be adjusted.
- Tell your team about all your medicines so they can be reviewed together.
Available as: Tablets taken by mouth.
Answers
Bexagliflozin: frequently asked questions
What is bexagliflozin used for?
It is an SGLT2 inhibitor used to help control blood sugar in adults with type 2 diabetes, by removing excess glucose from the body in the urine.
What is its most serious risk?
The most serious risk is diabetic ketoacidosis, a dangerous build-up of acids that can sometimes occur even when blood sugar is near normal and needs urgent treatment.
Why does it cause infections?
Because it makes you pass more sugar in the urine, genital thrush and urinary infections are more common; very rarely a serious genital infection can occur, needing emergency care.
Should I drink more fluids?
Yes, staying well hydrated is important because it makes you pass more urine, which can otherwise lead to dehydration.
Does it cause low blood sugar?
On its own it has a low risk of causing low blood sugar, but the risk can rise when it is used with insulin or some other diabetes medicines.
The wider class
About SGLT2 inhibitor
Bexagliflozin belongs to the sglt2 inhibitor class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.
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Authoritative sources
- BNF
- NICE CKS
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