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Dec 5, 2023



Differences Between Brenzavvy and Januvia

Choosing the right medication for type 2 diabetes can be challenging due to the variety of options available. BRENZAVVY and JANUVIA are two commonly considered medications, each with distinct differences. But which one is the better choice for you?

Get Brenzavvy for $59.95 exclusively through Marley Drug

Understanding Type 2 Diabetes Mellitus

Type 2 diabetes is a condition where your body struggles to use dietary sugars effectively. Normally, insulin, a hormone, helps your body use and store sugars. In type 2 diabetes, your body doesn't respond well to insulin, leading to high blood sugar levels after meals. This causes the typical symptoms of diabetes. Monitoring diabetes involves checking your blood sugar, which indicates the current sugar level in your blood, and your A1C, which reflects longer-term blood sugar control.

BRENZAVVY vs. JANUVIA: Understanding Your Options

Both BRENZAVVY and JANUVIA are FDA-approved treatments designed to help adults with type 2 diabetes. These medications are most effective when combined with a healthy diet and regular exercise. It's important to note that they are not suitable for those with type 1 diabetes or for individuals experiencing diabetic ketoacidosis, a serious complication of uncontrolled diabetes.

While BRENZAVVY and JANUVIA share the same goal, they differ in how they work, their side effects, rare risks, and cost.

How They Work

BRENZAVVY (bexagliflozin)

BRENZAVVY (generic name: bexagliflozin) works in a unique way within the body. It targets a process that involves the kidneys, an essential organ in managing blood sugar levels.

Normally, when blood is filtered through the kidneys, sugar is reabsorbed back into the bloodstream. BRENZAVVY, however, interferes with this process. It acts on the kidneys to block a specific protein called SGLT2 (sodium-glucose co-transporter 2). This protein usually helps in reabsorbing sugar from the kidneys back into the blood.

When BRENZAVVY inhibits this protein, less sugar is reabsorbed by the kidneys and more is excreted in the urine. This results in a reduction of overall blood sugar levels in the body. By preventing the reabsorption of sugar, BRENZAVVY effectively lowers blood sugar levels and A1C levels.

JANUVIA (sitagliptin)

JANUVIA (generic name: sitagliptin) is a dipeptidyl peptidase-4 (DPP-4) inhibitor. DPP-4 enzymes typically break down hormones that are involved in blood sugar regulation.

When food is consumed, the body naturally produces hormones that help regulating blood sugar levels. These hormones signal the pancreas to produce insulin and also prevent the liver from producing excess sugar.

However, in individuals with type 2 diabetes, these hormones are rapidly broken down by DPP-4 enzymes, reducing their effectiveness. JANUVIA works by inhibiting this enzyme (dipeptidyl peptidase-4), allowing these hormones to remain active in the body for a longer duration. As a result, the pancreas is able to produce more insulin, and the liver's sugar production is moderated.

By understanding the differences between BRENZAVVY and JANUVIA, you can have a more informed discussion with your healthcare provider about which medication might be best for your diabetes management plan.

Side Effects of BRENZAVVY and JANUVIA

Both BRENZAVVY and JANUVIA, medications for type 2 diabetes, can cause side effects, but these effects vary due to how each medication works in the body

Common Side Effects

Both BRENZAVVY and JANUVIA can cause side effects, but these effects vary due to how each medication works in the body.

  • Genital yeast infections, more common in women
  • Urinary tract infections
  • Needing to urinate more often
  • Nausea
  • Diarrhea
  • Headaches
  • Constipation

Understanding Serious Risks

While serious side effects are rare, it's important to know what they are.

Both medication can cause low blood sugar, especially if taken with other diabetes medications that lower insulin.
BRENZAVVY's rare risks include:
  • Ketoacidosis: A serious condition where the body uses fat for energy instead of sugar, leading to acidic blood
  • Lower limb amputations: Particularly for those with heart disease or previous foot issues
  • Decrease in body fluids: Can lead to low blood pressure, especially in older adults or those with kidney issues
  • Necrotizing Fasciitis: : A serious infection around the genital area. Immediate medical attention is needed if you notice redness, swelling, or tenderness
JANUVIA's rare risks include:
  • Pancreatitis: Inflammation of the pancreas, causing severe abdominal pain and fever. Medical help should be sought immediately
  • Kidney Damage: Mainly in those with existing kidney problems. Kidney function tests are recommended before starting JANUVIA

Knowing these side effects can help you make informed decisions and seek medical advice if needed.

Comparing the Retail Price of BRENZAVVY and JANUVIA

When considering medications for type 2 diabetes, the cost can be a significant factor. Here's a comparison of the prices for BRENZAVVY and JANUVIA:

  • JANUVIA: The price for JANUVIA varies slightly depending on the pharmacy. On average, a one-month supply (30 tablets) costs between $540 and $650 depending on the pharmacy and coupons they offer.
  • Kidney Damage: In contrast, BRENZAVVY is significantly more affordable. The cost for a one-month supply (30 tablets of 20 mg) is around $59. This price is also for cash-paying customers and is 95 exclusively available at Marley Drug.

Head-to-Head Medication Comparison

A study conducted in 2019 compared BRENZAVVY and JANUVIA directly. The key findings were:

  • Efficacy in Reducing A1C: The study concluded that BRENZAVVY was "non-inferior" to JANUVIA. This means BRENZAVVY was found to be not worse than JANUVIA in lowering A1C levels, a measure of long-term blood sugar control.
  • Impact on Blood Sugar and Body Weight: BRENZAVVY showed some significant advantages over JANUVIA in reducing blood sugar levels and aiding in weight loss.
  • Side Effects: Both medications had a similar overall incidence of side effects, though the specific side effects varied between the two.

Which Medication to Choose?

Deciding which medication is best for you depends on various factors, including personal health, response to the medication, and cost considerations. While BRENZAVVY offers a more budget-friendly option with some additional benefits in blood sugar and weight management, JANUVIA has its own set of advantages and a longer track record. It's important to discuss these options with a healthcare provider to determine the most suitable choice for your diabetes management.

Prices mentioned in this article are based on average retail price at major box chain pharmacy in the U.S. as of November 9, 2023.


  1. JANUVIA® (sitagliptin) Tablets. Food and Drug Administration. (2006; Revised 04/2011). Retrieved November 9, 2023, from
  2. BRENZAVVY (bexagliflozin) tablets, for oral use. Food and Drug Administration. (2023; Revised 01/2023). Retrieved November 9, 2023, from
  3. Halvorsen, Y. et al. (2019) ‘A 24‐week, randomized, double‐blind, active‐controlled clinical trial comparing bexagliflozin with sitagliptin as an adjunct to metformin for the treatment of type 2 diabetes in adults’, A 24-week, randomized, double-blind, active-controlled clinical trial comparing bexagliflozin with sitagliptin as an adjunct to metformin for the treatment of type 2 diabetes in adults, 21(10), pp. 2248–2256. doi:10.1111/dom.13801.
  4. JANUVIA (empagliflozin). GoodRx. (n.d.). November 9, 2023, from:
  5. Farxiga (dapagliflozin). GoodRx. (n.d.). November 9, 2023, from:

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