Canagliflozin (Rx)

Canagliflozin Brand name: Invokana

Dea Class: Rx (Prescription drug)

Drug Class: Antidiabetics, SGLT2 Inhibitors

Dosage form: Tablet: 100mg, 300mg

In this post:

What is Canagliflozin and how does it work?

Canagliflozin is oral sodium-glucose co-transporter 2 (SGLT2) inhibitor
Used in adults with type 2 diabetes mellitus; also provides cardiovascular (CV) risk reduction if CV disease also present; if diabetic nephropathy with albuminuria is present, the drug reduces the risk of end-stage kidney disease, doubling of serum creatinine, CV death, and hospitalization for heart failure (HF)
Contraindicated in patients with severe renal impairment who are treated for glycemic control and any patient on dialysis


What are Canagliflozin uses?

Canagliflozin is used for the treatment of type 2 diabetes mellitus as an adjunct to diet and exercise.

Used for the reduction of cardiovascular mortality and major cardiovascular events (MACE) in T2DM patients with established cardiac disease; also to reduce the risk of end-stage kidney disease (ESKD), doubling of serum creatinine, and reduction of heart failure hospitalizations and CV death in adults with T2DM and diabetic nephropathy with albuminuria more than 300 mg/day.
 
 

How should I take Canagliflozin?

Canagliflozin comes as a tablet to take by mouth. It is usually taken once a day before breakfast or the first main meal of the day. Take canagliflozin at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take canagliflozin exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Your doctor may start you on a low dose of canagliflozin and gradually increase your dose.

Canagliflozin controls type 2 diabetes but does not cure it. Continue to take canagliflozin even if you feel well. Do not stop taking canagliflozin without talking to your doctor.


Canagliflozin Side Effects

The common side effects don’t need medical attention and will disappear as your body adjusts to the dosage. But if you are facing any serious or rare side effects, then immediately seek medical attention.

Female genital mycotic infections (10.4-11.4%)

Urinary tract infections (4.4-5.9%)

Increased urination (4.6-5.1%)

Male genital mycotic infections (3.8-4.2%)

Thirst (2.4-2.8%)

Constipation (1.8-2.4%)

Nausea (2.1-2.3%)

Volume depletion

  • Overall population (2.3-3.4%)
  • Age >75 yr (4.9-8.7%)
  • eGFR <60/mL/min/1.73 m³ (4.7-8.1%)
  • Use of loop diuretic (3.2-8.8%)

Ketoacidosis

Acute kidney injury

Anaphylaxis

Angioedema

Urosepsis

Pyelonephritis

Necrotizing fasciitis of the perineum (Fournier’s gangrene)


What Are Warnings and Precautions for Canagliflozin?

Warnings

Causes intravascular volume contraction and symptomatic hypotension and/or acute kidney injury can occur, particularly if eGFR <60 mL/min/1.73 m2, advance age, existing low systolic BP, or taking either diuretics or drugs that interfere with renin-angiotensin-aldosterone system (RAS) (eg, ACE inhibitors, ARBs); monitor for signs and symptoms during therapy

Increases in serum creatinine and decreases in estimated GFR also observed with initiation

Increases risk of urinary tract infections (UTIs), including life-threatening urosepsis and pyelonephritis that started as UTIs; evaluate patients for signs and symptoms of urinary tract infections and treat promptly, if indicated

Necrotizing fasciitis of the perineum (Fournier gangrene) reported with SGLT2 inhibitors; signs and symptoms include tenderness, redness, or swelling of the genitals or the area from the genitals back to the rectum, and have a fever >100.4ºF or a general feeling of being unwell; if suspected, discontinue SGLT2 inhibitor and start treatment immediately with broad-spectrum antibiotics and surgical debridement if necessary

Genital mycotic infections may occur, patients with history of genital mycotic infections and uncircumcised males are more susceptible

Increased risk of bone fracture, occurring as early as 12 weeks after treatment initiation, reported; consider factors that contribute to fracture risk before initiating therapy

Hypersensitivity reactions, including angioedema and anaphylaxis reported; reactions generally occurred within hours to days after initiation; if hypersensitivity reactions occur, discontinue therapy; treat and monitor until signs and symptoms resolve.

Before taking Canagliflozin, Cautions

Serious hypersensitivity reaction (eg, anaphylaxis, angioedema)

Patients on dialysis

Pregnancy and Lactation

Pregnancy

  • Based on animal data showing adverse renal effects, not recommended during the second and third trimesters of pregnancy

    Data are limited in pregnant women and are not sufficient to determine a drug associated risk for major birth defects or miscarriage

Lactation

  • No information regarding distribution in human milk or effects on the breastfed infant or milk production

What Are Dosages of Canagliflozin?

Dosage Forms & Strengths

Canagliflozin Tablet: 100mg, 300mg

Adults

300 mg/day PO.

Geriatric

300 mg/day PO.

Adolescents

Safety and efficacy have not been established.

Children

Safety and efficacy have not been established.

Infants

Not indicated.


Canagliflozin brand name

Canagliflozin brand name: INVOKANA 100mg, INVOKANA 300mg


Brand names of Canagliflozin combination products

  • Invokamet® (containing canagliflozin, metformin hydrochloride)
    • Invokamet 50mg/500mg
    • Invokamet 50mg/1000mg
    • Invokamet 150mg/500mg
    • Invokamet 150mg/1000mg
  • Invokamet-XR (containing canagliflozin, metformin hydrochloride)
    • Invokamet-XR 50mg/500mg
    • Invokamet-XR 50mg/1000mg
    • Invokamet-XR 150mg/500mg
    • Invokamet-XR 150mg/1000mg

Also Read:

Bromocriptine Uses, Side Effects, Dosage, Warnings

What is Canagliflozin and how does it work?

Canagliflozin is oral sodium-glucose co-transporter 2 (SGLT2) inhibitor
Used in adults with type 2 diabetes mellitus; also provides cardiovascular (CV) risk reduction if CV disease also present; if diabetic nephropathy with albuminuria is present, the drug reduces the risk of end-stage kidney disease, doubling of serum creatinine, CV death, and hospitalization for heart failure (HF)
Contraindicated in patients with severe renal impairment who are treated for glycemic control and any patient on dialysis


What are Canagliflozin uses?

Canagliflozin is used for the treatment of type 2 diabetes mellitus as an adjunct to diet and exercise.

Used for the reduction of cardiovascular mortality and major cardiovascular events (MACE) in T2DM patients with established cardiac disease; also to reduce the risk of end-stage kidney disease (ESKD), doubling of serum creatinine, and reduction of heart failure hospitalizations and CV death in adults with T2DM and diabetic nephropathy with albuminuria more than 300 mg/day.
 
 

How should I take Canagliflozin?

Canagliflozin comes as a tablet to take by mouth. It is usually taken once a day before breakfast or the first main meal of the day. Take canagliflozin at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take canagliflozin exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Your doctor may start you on a low dose of canagliflozin and gradually increase your dose.

Canagliflozin controls type 2 diabetes but does not cure it. Continue to take canagliflozin even if you feel well. Do not stop taking canagliflozin without talking to your doctor.


Canagliflozin Side Effects

The common side effects don’t need medical attention and will disappear as your body adjusts to the dosage. But if you are facing any serious or rare side effects, then immediately seek medical attention.

Female genital mycotic infections (10.4-11.4%)

Urinary tract infections (4.4-5.9%)

Increased urination (4.6-5.1%)

Male genital mycotic infections (3.8-4.2%)

Thirst (2.4-2.8%)

Constipation (1.8-2.4%)

Nausea (2.1-2.3%)

Volume depletion

  • Overall population (2.3-3.4%)
  • Age >75 yr (4.9-8.7%)
  • eGFR <60/mL/min/1.73 m³ (4.7-8.1%)
  • Use of loop diuretic (3.2-8.8%)

Ketoacidosis

Acute kidney injury

Anaphylaxis

Angioedema

Urosepsis

Pyelonephritis

Necrotizing fasciitis of the perineum (Fournier’s gangrene)


What Are Warnings and Precautions for Canagliflozin?

Warnings

Causes intravascular volume contraction and symptomatic hypotension and/or acute kidney injury can occur, particularly if eGFR <60 mL/min/1.73 m2, advance age, existing low systolic BP, or taking either diuretics or drugs that interfere with renin-angiotensin-aldosterone system (RAS) (eg, ACE inhibitors, ARBs); monitor for signs and symptoms during therapy

Increases in serum creatinine and decreases in estimated GFR also observed with initiation

Increases risk of urinary tract infections (UTIs), including life-threatening urosepsis and pyelonephritis that started as UTIs; evaluate patients for signs and symptoms of urinary tract infections and treat promptly, if indicated

Necrotizing fasciitis of the perineum (Fournier gangrene) reported with SGLT2 inhibitors; signs and symptoms include tenderness, redness, or swelling of the genitals or the area from the genitals back to the rectum, and have a fever >100.4ºF or a general feeling of being unwell; if suspected, discontinue SGLT2 inhibitor and start treatment immediately with broad-spectrum antibiotics and surgical debridement if necessary

Genital mycotic infections may occur, patients with history of genital mycotic infections and uncircumcised males are more susceptible

Increased risk of bone fracture, occurring as early as 12 weeks after treatment initiation, reported; consider factors that contribute to fracture risk before initiating therapy

Hypersensitivity reactions, including angioedema and anaphylaxis reported; reactions generally occurred within hours to days after initiation; if hypersensitivity reactions occur, discontinue therapy; treat and monitor until signs and symptoms resolve.

Before taking Canagliflozin, Cautions

Serious hypersensitivity reaction (eg, anaphylaxis, angioedema)

Patients on dialysis

Pregnancy and Lactation

Pregnancy

  • Based on animal data showing adverse renal effects, not recommended during the second and third trimesters of pregnancy

    Data are limited in pregnant women and are not sufficient to determine a drug associated risk for major birth defects or miscarriage

Lactation

  • No information regarding distribution in human milk or effects on the breastfed infant or milk production

What Are Dosages of Canagliflozin?

Dosage Forms & Strengths

Canagliflozin Tablet: 100mg, 300mg

Adults

300 mg/day PO.

Geriatric

300 mg/day PO.

Adolescents

Safety and efficacy have not been established.

Children

Safety and efficacy have not been established.

Infants

Not indicated.


Canagliflozin brand name

Canagliflozin brand name: INVOKANA 100mg, INVOKANA 300mg


Brand names of Canagliflozin combination products

  • Invokamet® (containing canagliflozin, metformin hydrochloride)
    • Invokamet 50mg/500mg
    • Invokamet 50mg/1000mg
    • Invokamet 150mg/500mg
    • Invokamet 150mg/1000mg
  • Invokamet-XR (containing canagliflozin, metformin hydrochloride)
    • Invokamet-XR 50mg/500mg
    • Invokamet-XR 50mg/1000mg
    • Invokamet-XR 150mg/500mg
    • Invokamet-XR 150mg/1000mg

Also Read:

Bromocriptine Uses, Side Effects, Dosage, Warnings

What is Canagliflozin and how does it work?

Canagliflozin is oral sodium-glucose co-transporter 2 (SGLT2) inhibitor
Used in adults with type 2 diabetes mellitus; also provides cardiovascular (CV) risk reduction if CV disease also present; if diabetic nephropathy with albuminuria is present, the drug reduces the risk of end-stage kidney disease, doubling of serum creatinine, CV death, and hospitalization for heart failure (HF)
Contraindicated in patients with severe renal impairment who are treated for glycemic control and any patient on dialysis


What are Canagliflozin uses?

Canagliflozin is used for the treatment of type 2 diabetes mellitus as an adjunct to diet and exercise.

Used for the reduction of cardiovascular mortality and major cardiovascular events (MACE) in T2DM patients with established cardiac disease; also to reduce the risk of end-stage kidney disease (ESKD), doubling of serum creatinine, and reduction of heart failure hospitalizations and CV death in adults with T2DM and diabetic nephropathy with albuminuria more than 300 mg/day.
 
 

How should I take Canagliflozin?

Canagliflozin comes as a tablet to take by mouth. It is usually taken once a day before breakfast or the first main meal of the day. Take canagliflozin at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take canagliflozin exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Your doctor may start you on a low dose of canagliflozin and gradually increase your dose.

Canagliflozin controls type 2 diabetes but does not cure it. Continue to take canagliflozin even if you feel well. Do not stop taking canagliflozin without talking to your doctor.


Canagliflozin Side Effects

The common side effects don’t need medical attention and will disappear as your body adjusts to the dosage. But if you are facing any serious or rare side effects, then immediately seek medical attention.

Female genital mycotic infections (10.4-11.4%)

Urinary tract infections (4.4-5.9%)

Increased urination (4.6-5.1%)

Male genital mycotic infections (3.8-4.2%)

Thirst (2.4-2.8%)

Constipation (1.8-2.4%)

Nausea (2.1-2.3%)

Volume depletion

  • Overall population (2.3-3.4%)
  • Age >75 yr (4.9-8.7%)
  • eGFR <60/mL/min/1.73 m³ (4.7-8.1%)
  • Use of loop diuretic (3.2-8.8%)

Ketoacidosis

Acute kidney injury

Anaphylaxis

Angioedema

Urosepsis

Pyelonephritis

Necrotizing fasciitis of the perineum (Fournier’s gangrene)


What Are Warnings and Precautions for Canagliflozin?

Warnings

Causes intravascular volume contraction and symptomatic hypotension and/or acute kidney injury can occur, particularly if eGFR <60 mL/min/1.73 m2, advance age, existing low systolic BP, or taking either diuretics or drugs that interfere with renin-angiotensin-aldosterone system (RAS) (eg, ACE inhibitors, ARBs); monitor for signs and symptoms during therapy

Increases in serum creatinine and decreases in estimated GFR also observed with initiation

Increases risk of urinary tract infections (UTIs), including life-threatening urosepsis and pyelonephritis that started as UTIs; evaluate patients for signs and symptoms of urinary tract infections and treat promptly, if indicated

Necrotizing fasciitis of the perineum (Fournier gangrene) reported with SGLT2 inhibitors; signs and symptoms include tenderness, redness, or swelling of the genitals or the area from the genitals back to the rectum, and have a fever >100.4ºF or a general feeling of being unwell; if suspected, discontinue SGLT2 inhibitor and start treatment immediately with broad-spectrum antibiotics and surgical debridement if necessary

Genital mycotic infections may occur, patients with history of genital mycotic infections and uncircumcised males are more susceptible

Increased risk of bone fracture, occurring as early as 12 weeks after treatment initiation, reported; consider factors that contribute to fracture risk before initiating therapy

Hypersensitivity reactions, including angioedema and anaphylaxis reported; reactions generally occurred within hours to days after initiation; if hypersensitivity reactions occur, discontinue therapy; treat and monitor until signs and symptoms resolve.

Before taking Vildagliptin, Cautions

Serious hypersensitivity reaction (eg, anaphylaxis, angioedema)

Patients on dialysis

Pregnancy and Lactation

Pregnancy

  • Based on animal data showing adverse renal effects, not recommended during the second and third trimesters of pregnancy

    Data are limited in pregnant women and are not sufficient to determine a drug associated risk for major birth defects or miscarriage

Lactation

  • No information regarding distribution in human milk or effects on the breastfed infant or milk production

What Are Dosages of Canagliflozin?

Dosage Forms & Strengths

Canagliflozin Tablet: 100mg, 300mg

Adults

300 mg/day PO.

Geriatric

300 mg/day PO.

Adolescents

Safety and efficacy have not been established.

Children

Safety and efficacy have not been established.

Infants

Not indicated.


Canagliflozin brand name

Canagliflozin brand name: INVOKANA 100mg, INVOKANA 300mg


Brand names of Canagliflozin combination products

  • Invokamet® (containing canagliflozin, metformin hydrochloride)
    • Invokamet 50mg/500mg
    • Invokamet 50mg/1000mg
    • Invokamet 150mg/500mg
    • Invokamet 150mg/1000mg
  • Invokamet-XR (containing canagliflozin, metformin hydrochloride)
    • Invokamet-XR 50mg/500mg
    • Invokamet-XR 50mg/1000mg
    • Invokamet-XR 150mg/500mg
    • Invokamet-XR 150mg/1000mg

Also Read:

Bromocriptine Uses, Side Effects, Dosage, Warnings

Acarbose Uses, Side Effects, Dosage, Warnings

Vildagliptin Uses, Side Effects, Dosage, Warnings

Colesevelam Hydrochloride Uses, Side Effects, Dosage, Warnings

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