Choosing Wisely: Brenzavvy vs. Jardiance for Diabetes Control

Diabetes management can be challenging, and choosing the right medication for you is an important decision.

Whether you're contemplating a change in your current medication or have recently received a diabetes diagnosis, this article is designed to guide you through a comparison of Brenzavvy and Jardiance. The purpose is to assist you in navigating toward effective diabetes care tailored for your needs.

Overview of Type 2 Diabetes

According to the Centers for Disease Control and Prevention (CDC), around 34.2 million Americans have diabetes. Of these, approximately 90-95% have type 2 diabetes.

Type 2 diabetes is a chronic medical condition characterized by your body's inability to properly use insulin, leading to elevated blood sugar (glucose) levels.

Insulin is generally used in facilitating the absorption of glucose into cells for energy. However, with type 2 diabetes, your body either doesn’t use insulin properly, doesn't produce enough insulin, or becomes resistant to its effects.

Some symptoms of type 2 diabetes may include the following:

• Increased thirst and hunger
• Frequent urination
• Fatigue
• Blurred vision
• Slow wound healing

It’s important to keep in mind that early detection and management are vital to prevent complications and promote overall well-being.

To learn more about diabetes read our blog Understanding Diabetes.

Brenzavvy and Jardiance are both SGLT2 Inhibitors

Brenzavvy (bexagliflozin) and Jardiance (empaglilozin) are both part of a drug class of medications called SGLT2 inhibitors, or sodium-glucose co-transporter 2 inhibitors.

What are SGLT2 Inhibitors?

SGLT2 inhibitors are a class of medications that assist in reducing blood sugar levels. They achieve this by increasing the excretion of sugar in your urine through the inhibition of a specific molecule known as SGLT2, which is typically responsible for reabsorbing sugar in the kidney tubules. By blocking this molecule, these medications encourage the elimination of glucose in the urine.

Medication that belong to SGLT2 Inhibitors typically end with "-gliflozin".

Here is a list of FDA-approved SGLT2 inhibitors, including combination options:

• Brenzavvy (bexagliflozin)
• Inpefa (sotagliflozin)
• Jardiance (empaglilozin)
• Invokana (canagliflozin)
• Farxiga (dapagliflozin)
• Steglatro (ertugliflozin)

Additionally, Jardiance, Invokana, Steglatro and Farxiga are available in combination pills that include metformin, metformin ER, or linagliptin, marketed under various brand names.

Cost of SGLT2 Inhibitors

Despite their effectiveness, this class of medications is quite expensive. Their steep retail prices often place them beyond the financial means of those in need.

The one exception is Brenzavvy, which costs $59.95 for 30 tablets through our pharmacy. We are able to offer this great price because of our agreement with the manufacturer.

Prices listed above from October 2023 in Princeton, NJ

Brenzavvy vs. Jardiance

There is limited clinical data that specifically compares Brenzavvy to Jardiance. As a result, it is difficult for us to make a comparison between these 2 medications in terms of effectiveness.

Jardiance and Brenzavvy share a common mechanism of action. Both medications function by inhibiting the SGLT2 protein located in the kidneys. As mentioned earlier, this protein's role is to reabsorb glucose into the bloodstream. By blocking the activity of SGLT2, both Brenzavvy and Jardiance promote the excretion of glucose through urine, decreasing blood sugar levels. This mechanism helps individuals with type 2 diabetes manage their glucose levels.

Similarities:

• Lower blood sugar levels in adults with type 2 diabetes
• Share the same mechanism of action as both are SGLT2 inhibitors
• Used alongside other diabetes medications, such as metformin
• Taken orally once daily in the morning with or without food
• Neither should be used for type 1 diabetes

Differences:

• Brenzavvy is available in a 20mg tablet, whereas Jardiance comes in 10mg or 25mg tablets
• Jardiance is approved for reducing blood sugar levels in children aged 10 or older with type 2 diabetes
• Jardiance has shown, in clinical trials, a reduction in the risk of cardiovascular death in people with type 2 diabetes
• Brenzavvy is the first SGLT2 inhibitor proven effective in adults with type 2 diabetes and stage 3 (3a + 3b) chronic kidney disease
• Jardiance has been studied in adults with heart failure and demonstrated a reduction in the risk of hospitalization and death
• Brenzavvy is more cost-effective, costing 90% less than Jardiance

It's important to note that there have been no head-to-head clinical trials comparing Brenzavvy and Jardiance, so the superiority or safety of one over the other cannot be determined.

Brenzavvy

Efficacy

In clinical trials, approximately one-third of individuals undergoing Brenzavvy treatment achieved an A1C (which is a metric that’s used to reflect the average blood sugar level) level below 7% within roughly 6 months. Additionally, findings indicate that when this medication is used in conjunction with Metformin, it leads to notable reductions in A1C, blood pressure, fasting blood glucose, and weight.

Doses and Administration

Brenzavvy is available in a tablet form in 20 mg dose, taken by mouth, once a day, in the morning, with or without food. However, it’s important to remember that it's not recommended to crush or chew the tablet.

Side effects

Common side effects of Brenzavvy may include the following:

• Changes in urination, including urinating more often, in larger amounts, or at night
• Urinary tract infections (UTIs)
• Vaginal yeast infection in women
• Genital yeast or fungal infections in men
• Increased thirst

Serious side effects of this medication may include the following:

• Serious urinary tract infections that may lead to hospitalization
• Hypoglycemia or low blood sugar levels, especially when taken together with other diabetes medications, such as insulin.
  Symptoms: headache, drowsiness, dizziness, increased hunger, confusion, sweating, or weakness
• Ketoacidosis (high levels of ketone in the blood)
  Symptoms: dry mouth, fruity breath, increased thirst, difficulty breathing, an upset stomach, nausea
• Increased risk of lower limb amputations (rare)
  Your risk is elevated, particularly if you have a history of amputation, blood circulation issues, or nerve problems. Research indicates that leg infections and damage to leg tissue were the predominant reasons for amputations among individuals who were prescribed Brenzavvy.
  In a study involving patients at an elevated risk of cardiovascular disease, there was a higher occurrence of lower limb amputations among those who were administered this medication in comparison to those who received a placebo. However, some research also indicates that leg infections and damage to leg tissue were the predominant reasons for amputations among individuals who were prescribed Brenzavvy.

If you’re experiencing any of these serious side effects, immediately call your doctor and stop taking this medication.

Jardiance

Jardiance has been studied in additional patient populations which Benzavvy has not been studied, including those living with heart failure and in children 10 years and older. Jardiance is now a prescribed for treating heart failure even in those without diabetes, and it has become one of the preferred treatment options for certain types of heart failure.

Efficacy

Jardiance is effective in treating type 2 diabetes by significantly reducing A1C levels. Clinical studies have shown that those with type 2 diabetes who take Jardiance experience a notable decrease in their A1C levels over time.

In a 24-week clinical trial involving adults diagnosed with type 2 diabetes, 13% of individuals who were administered a placebo experienced a reduction in their A1C levels below 7%. However, 38% for those taking Jardiance 10 mg and 39% for those taking Jardiance 25 mg, achieved the target A1C level during this study period.

However, it’s important to keep in mind that individual responses to medications may vary, and the use of Jardiance should be part of a comprehensive diabetes management plan tailored by healthcare professionals.

Doses and Administration

Jardiance is available in tablet form in 10 mg, generally taken in the morning, and 25 mg and this medication can be taken once a day, by mouth, with or without food.

Side effects

Common side effects of Jardiance may include the following:

• Urinary tract infections (UTIs)
• Vaginal yeast infection in women
• Genital yeast or fungal infections in men
• Upper respiratory tract infection, which may include a common cold
• Increased thirst
• Increased urination
• Joint pain

Serious side effects of this medication may include the following:

• Having a light-headed feeling, or feeling like you may faint
• Hypoglycemia or low blood sugar levels, especially when taken together with other diabetes medications, such as insulin.
  Symptoms: headache, drowsiness, dizziness, increased hunger, confusion, sweating, or weakness
• Ketoacidosis (high levels of ketone in the blood)
  Symptoms: dry mouth, fruity breath, increased thirst, difficulty breathing, an upset stomach, nausea
• Dehydration
  Symptoms: dizziness, confusion, increased thirst, and/or decreased urination
• Bladder infection
  Symptoms: pain or burning when you urinate, blood in your urine, and pain in your pelvis and/or back

Cost Difference Between Brenzavvy and Jardiance

Jardiance and Brenzavvy are both branded medications and currently there are no generics available. Regrettably, the high retail price for Jardiance of over $500 places this life-saving medication out of reach for many. If you are having trouble accessing Jardiance due to cost, Brenzavvy may be a great option for you. Our price is just $59.95 for 30-tablets.

To learn more about Jardiance and Brenzavvy feel free to give our pharmacy team a call at 800-810-7790.