Canagliflozin is indicated as an adjunct to diet and exercise to improve glycemic control in patients with type 2 diabetes mellitus.
Sodium-glucose Cotransporter-2 (SGLT2) Inhibitors
Canagliflozin is an inhibitor of subtype-2 sodium-glucose co-transport protein (SGLT2), which is responsible for at least 90% of the glucose reabsorption in the kidney. Blocking this transporter reduces the reabsorption of glucose from renal tubules, leading to more excretion of glucose in urine.
The recommended starting dose of Canagliflozin is 100 mg once daily, taken before the first meal of the day. Dose can be increased to 300 mg once daily in patients tolerating Canagliflozin 100 mg once daily who have an eGFR of 60 ml/min/1.73 m2 or greater and require additional glycemic control. If the eGFR of Patients is 45 to 60 ml/min/1.73 m2,the dose of Canagliflozin should be 100 mg once daily.
UGT inducers (e.g. rifampin, phenytoin): Canagliflozin exposure is reduced. Consider increasing dose from 100 mg to 300 mg.
Digoxin: Canagliflozin may slightly increase the concentration of digoxin in the body when both drugs are being taken.
History of a serious hypersensitivity reaction to Canagliflozin, Severe renal impairment (eGFR less than 30 mL/min/1.73 m2), end stage renal disease or patients on dialysis.
Dehydration, Vaginal yeast infection, Yeast infection of the penis (balanitis or balanoposthitis).
Pregnancy Category C. There are no adequate and well-controlled studies in pregnant women. Canagliflozin should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is not known if Canagliflozin passes into breast milk. Discontinue drug or nursing.
Keep in a dry place away from light and heat. Keep out of the reach of children.
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