Bexagliflozin

What is bexagliflozin?

Bexaglifozin (brand name Bexacat®, Brenzavvy®) is an oral glycemic control medication used in cats with diabetes mellitus. It is used to lower blood sugar levels in cats that have not been previously treated with insulin, are otherwise healthy, and weigh at least 6.6 lb (3 kg). 

Bexaglifozin is only approved for use in cats.

How do I give my pet bexagliflozin?

Bexagliflozin comes in tablet form. 

• Tablets are given orally (by mouth). 
• Give the medication at the same time every day.
• Give the medication with or without food.
• Give the medication to your cat for the entire time prescribed by your veterinarian. Do not stop giving this medication suddenly.

What if I miss giving my pet the medication?

Give the missed dose as soon as you remember and then continue with the regular dosing schedule. If it is almost time for the next dose, skip the missed dose and continue with the regular schedule. Do not give the pet 2 doses at once.

Are there any potential side effects from bexagliflozin?

Bexagliflozin may cause the following side effects:

• decreased or loss of appetite
• vomiting
• diarrhea
• decreased water intake
• changes in urination 
• decreased energy level

If stomach upset occurs, try giving the medication with food. If these signs continue, contact your veterinarian.

The following reactions are rare, but if they occur, contact your veterinarian immediately:

• an allergic reaction such as irregular breathing, rash, fever, puffiness and swelling around the face

Drug sensitivities can develop over time with repeated exposure. Your pet may have no reaction after the first few doses but may develop a sensitivity later. It is important to watch for signs of an allergic reaction over the entire course of treatment.

It is important to note that use of bexagliflozin may increase your cat’s risk for a potentially fatal condition called diabetic ketoacidosis (DKA). DKA is typically diagnosed based on clinical signs and lab results including high sugar levels (hyperglycemia); however, cats on bexagliflozin often have normal sugar levels, so the diagnosis could be missed. If your cat needs emergency assessment by someone other than their primary veterinarian, make sure they know that your cat has received this medication. 

Other side effects may occur. If you notice anything unusual, contact your veterinarian immediately. This short-acting medication should stop working within 24 hours, although effects can be longer in pets with liver disease.

Are there any risk factors for this medication?

This medication SHOULD BE AVOIDED in cats that:

• were previously (or currently) treated with insulin
• have insulin-dependent diabetes mellitus
• are allergic to bexagliflozin

This medication may cause an increased risk for potentially fatal diabetic ketoacidosis (DKA) or euglycemic DKA (DKA with normal sugar levels). 

Are there any drug interactions I should be aware of?

Certain medications should be USED WITH CAUTION when given with bexagliflozin, including but not limited to: 

• angiotensin-converting enzyme inhibitors
• antihypertensive agents
• beta-blockers
• corticosteroids
• diuretics
• estrogens

Be sure to tell your veterinarian about any medications (including vitamins, supplements, or herbal therapies) that your pet is taking before starting any new treatment.

Is any monitoring needed with this medication?

• When starting bexagliflozin, your veterinarian will monitor baseline bloodwork and urinalysis to check organ function and for urinary tract infections.
• Your veterinarian will give you specific monitoring parameters including checking urine or blood ketones, glucose curves, fructosamine, weight and physical examination. Be sure to follow your veterinarian’s recommendations closely to ensure the best care of your cat and help reduce the risk of your cat developing DKA.

How do I store bexagliflozin?

• Store tablets in a tightly sealed container, protected from light, at room temperature. 
• Leave tablets in the manufacturer’s packaging until needed to ensure they are protected from air. 
• Do not store this medicine in the bathroom, near the kitchen sink, or in damp places. The medicine may break down if exposed to heat or moisture. 
• Keep medication out of reach of children and pets.

What should I do in case of emergency?

If you suspect an overdose or an adverse reaction to the medication, call your veterinary office immediately. If they are not available, follow their directions in contacting an emergency facility.