How Baxfendy Works to Help Lower Blood Pressure

Written by Patricia Weiser, PharmD
Medically Reviewed by Beth Johnston, BCPS, PharmD on May 20, 2026

High blood pressure (hypertension) is a common condition that can raise the risk of serious health problems over time, including heart attack, stroke, heart failure, and kidney disease. Many people need more than one blood pressure medicine to help keep their blood pressure within a healthy range.

Many prescription medicines are available to help lower blood pressure. One option is Baxfendy (baxdrostat). Baxfendy is different from many older blood pressure medicines. It works by targeting a hormone that can raise blood pressure.

The FDA approved Baxfendy in May 2026 to treat high blood pressure in people for whom other blood pressure medicines don’t work well. Baxfendy is typically used together with other blood pressure medicines. 

Continue reading this article to learn how Baxfendy works for high blood pressure, how to take it, and its benefits as seen in studies. You may also want to read about Baxfendy side effects and Baxfendy interactions.

Baxfendy works by lowering the body’s production of a hormone called aldosterone.

Aldosterone helps control blood pressure by telling the kidneys to retain salt (sodium) and water. When the body keeps extra salt and water, the amount of fluid in the bloodstream increases. This raises blood pressure.

In some people with high blood pressure, the body makes too much aldosterone. High aldosterone levels can also damage blood vessels over time by causing:

  • Blood vessel stiffness and poor function
  • Inflammation
  • Scarring (fibrosis)

Baxfendy blocks an enzyme called aldosterone synthase. This enzyme is needed to make aldosterone. By blocking it, Baxfendy lowers aldosterone levels in the blood, which can help lower blood pressure.

Older blood pressure medicines that affect aldosterone pathways can sometimes interact with other hormone receptors. Baxfendy works differently by blocking aldosterone production more selectively, without affecting other hormones in the body. In studies, Baxfendy lowered aldosterone levels while allowing the body to continue making normal amounts of important hormones such as cortisol and testosterone. 

Before starting Baxfendy, your health care provider will order blood tests to check your potassium and sodium levels. Baxfendy can sometimes cause potassium levels to become too high or sodium levels to become too low. Your health care provider may also continue checking these levels during treatment. It is important to attend all recommended blood test appointments while taking Baxfendy.

The typical Baxfendy dose is 2 milligrams (mg) taken once daily. Some people may start with a lower dose (1 mg once daily) if they have a higher risk of changes in potassium or sodium levels. You can take Baxfendy with or without food. Swallow the tablet whole — do not cut, crush, or chew it.

Take Baxfendy exactly as prescribed by your health care provider. Baxfendy is typically used in combination with other blood pressure medicines. Your health care provider can let you know the best time of day to take each of your blood pressure medicines.

Many people need more than one medicine to help reach their blood pressure goals. Along with taking medicines as prescribed, lifestyle changes such as regular exercise, limiting salt intake, not smoking, and managing other conditions (like diabetes or high cholesterol) can also help support blood pressure control and heart health.

Researchers conducted a large clinical trial called BaxHTN involving adults whose hypertension remained hard to control despite already taking multiple blood pressure medicines. They checked whether adding Baxfendy to existing blood pressure treatment could help lower blood pressure in such adults.

The BaxHTN study included 794 adults with high blood pressure who were already taking multiple blood pressure medicines. Here are some key details about the participants at the start of the study:

  • Their average age was 61 years, and there were more men (62% of participants) than women.
  • 63% were White, 26% were Asian, 7% were Black or African American, and 4% were other races; 13% reported being of Hispanic or Latino ethnicity.
  • The average systolic blood pressure (SBP), which is the top number, was about 149, while the average diastolic blood pressure (DBP), which is the bottom number, was about 86-88.
  • The average body mass index (BMI) of participants was 31, which falls within the obesity range. 
  • Some participants also had other health conditions, including type 2 diabetes (37%), heart failure (6%), previous heart attack (5%), or previous stroke (4%).
  • Most participants were living with resistant hypertension, meaning their blood pressure stayed high despite taking at least three blood pressure medicines, including a diuretic (“water pill”). Other participants had uncontrolled hypertension while taking at least two blood pressure medicines.

Participants were randomly assigned to take Baxfendy 1 mg, Baxfendy 2 mg, or a placebo (a pill with no active medicine) for 12 weeks. Neither the participants nor the researchers knew who received Baxfendy or a placebo. All participants continued taking their usual blood pressure medicines during the study.

Participants’ blood pressure was measured regularly over 12 weeks. Blood tests were also done throughout the study to monitor potassium, sodium, kidney function, aldosterone levels, and other safety measures.

The main goal of the study was to measure how much Baxfendy lowered SBP, which is the top number in a blood pressure reading.

After 12 weeks:

  • People taking Baxfendy 1 mg had an average SBP reduction of about 14.5 points.
  • People taking Baxfendy 2 mg had an average SBP reduction of about 15.7 points.
  • People taking a placebo had an average SBP reduction of about 5.8 points.

Compared with placebo, Baxfendy lowered SBP by an additional:

  • 8.7 points with the 1-mg dose
  • 9.8 points with the 2-mg dose

The blood pressure-lowering effects were seen in both participants with uncontrolled hypertension and those with resistant hypertension.

Your results may differ from what was seen in clinical trials.

The study also looked at several other results along with the main blood pressure results.

After 12 weeks:

  • About 39%-40% of people taking Baxfendy reached an SBP below 130.
  • About 19% of people taking a placebo reached this goal.

Baxfendy also lowered DBP, which is the bottom number in a blood pressure reading. On average, compared with placebo:

  • The 1-mg dose lowered DBP by an additional 3.3 points.
  • The 2-mg dose lowered DBP by an additional 3.9 points.

Ask your health care provider about what benefits to expect with Baxfendy. They can also let you know how often to monitor your blood pressure at home and what a healthy blood pressure goal looks like for you.

The main part of the BaxHTN trial that compared Baxfendy to a placebo lasted 12 weeks.

However, the study also included extended phases that lasted up to 52 weeks total. Some participants continued taking Baxfendy during longer open-label study periods, allowing researchers to collect additional safety information over time. (Open-label means the participants knew they were taking Baxfendy, and no one was given a placebo.)

Later parts of the study suggested that blood pressure reductions with Baxfendy continued over time. In one part of the study, some participants stopped Baxfendy and switched to a placebo. Their blood pressure started to rise again over the following weeks, while blood pressure remained lower in people who stayed on Baxfendy.

In the BaxHTN trial, many participants had blood pressure reductions within four weeks after starting Baxfendy. Blood pressure continued to improve over the 12-week study period.

This suggests some people may notice improvements within the first month of treatment, although it may take several weeks to see the full blood pressure-lowering effects

Baxfendy requires a prescription from a health care provider.

A copay savings program is available from AstraZeneca, the maker of Baxfendy. It may reduce the amount you pay. Whether you qualify to enroll may depend on what type of insurance you have or if you are uninsured. Visit this website to learn more about copay savings. You can also call 800-236-9933 to speak to a representative at AstraZeneca.

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