Canagliflozin
About Canagliflozin
Canagliflozin is an oral prescription medication used to lower blood sugar levels in adults with type 2 diabetes. As a treatment that helps manage glucose levels, its primary medical purpose is to prevent serious complications associated with diabetes. It is also prescribed to reduce the risk of major cardiovascular events like heart attacks and to protect kidney health in certain individuals.
To achieve the best results, you should take Canagliflozin consistently once daily, preferably before your first meal of the day. It is taken orally and can be taken with or without food, but taking it before breakfast is highly recommended to manage blood sugar spikes after eating. To maximise its effectiveness, you should combine this treatment with a balanced diet, reduced sugar intake, and a regular exercise routine.
While using Canagliflozin, you may experience common side effects like increased urination, mild thirst, or genital yeast infections. While these are usually manageable, you must consult your doctor immediately if you face serious side effects such as severe stomach pain, persistent vomiting, or extreme dizziness, which can point to a serious metabolic issue.
Talk to your doctor before starting this medicine if you have a history of kidney disease, liver damage, low blood pressure, or a history of leg or foot amputations. Do not take this if you have type 1 diabetes, severe kidney failure, are on dialysis, or have had a severe allergic reaction to this medication in the past.
This medication can interact with other drugs like insulin, water pills, or blood pressure medicines, which may increase your risk of low blood sugar or dehydration. It is also important to limit alcohol intake and avoid smoking to protect your cardiovascular and metabolic health while on this treatment. If you are pregnant, breastfeeding, or are an older adult, you should consult your healthcare provider before taking this medicine.
Uses of Canagliflozin
• Blood Sugar Control: Canagliflozin is primarily used to manage type 2 diabetes by lowering blood sugar levels when combined with a suitable diet and exercise regimen.
• Weight Loss Aid: Canagliflozin medication may support weight loss in individuals with type 2 diabetes by reducing calorie absorption and food intake.
• Cardiovascular Benefits: Canagliflozin has shown potential in lowering the risk of cardiovascular events in diabetic patients, making it particularly beneficial for those prone to heart-related conditions.
• Kidney Health: Canagliflozin helps protect kidney function in individuals with type 2 diabetes, reducing the likelihood of developing diabetic nephropathy.
• Improvement in Glycemic Control: Canagliflozin enhances glycemic control by enabling the body to excrete excess glucose through urine, effectively lowering overall blood sugar levels.
Medicinal Benefits
Canagliflozin helps manage blood sugar levels while providing additional protection for the heart and kidneys. By improving glucose control and supporting the health of vital organs, it contributes to better overall wellbeing and may help reduce the risk of long-term diabetes-related complications.
- Helps Control Blood Sugar Levels: By reducing rises in blood sugar after meals, Canagliflozin helps maintain more stable glucose levels throughout the day. This supports effective diabetes management and may help lower the risk of complications associated with uncontrolled blood sugar.
- Supports Heart Health: Canagliflozin helps reduce the risk of hospitalisation due to heart failure and supports better cardiovascular health. This may contribute to improved stamina, reduced shortness of breath, and greater comfort during everyday activities.
- Helps Protect Kidney Function: In addition to managing blood sugar, Canagliflozin supports kidney health and may help slow the progression of diabetes-related kidney damage, promoting better long-term kidney function and overall health outcomes.
Directions for Use
- Canagliflozin can be taken with or without food, but it is best to take it before the first meal of the day.
- It is usually taken once daily or as prescribed by your doctor.
- Swallow Canagliflozin as a whole with a glass of water.
- Do not crush, chew, or break it.
Storage
Side Effects of Canagliflozin
Common Side Effects (Usually mild)
- Increased urination or needing to urinate more frequently
- Mild yeast infections in the genital area
- Increased thirst or dry mouth
- Mild nausea or constipation
Serious Side Effects (Call a doctor right away)
- Signs of diabetic ketoacidosis, such as nausea, vomiting, severe stomach pain, confusion, or unusual tiredness
- Severe dehydration, indicated by extreme dizziness, feeling lightheaded, or fainting
- Signs of a severe genital infection, including pain, redness, swelling, or itching accompanied by a fever
- An allergic reaction, such as swelling of the face, lips, tongue, or throat, severe rash, or difficulty breathing
- Severe pain, tenderness, redness, or swelling of the genital or perineal area, especially when accompanied by fever or feeling unwell, as this may indicate Fournier's gangrene, a rare but serious infection requiring urgent medical attention
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Drug Warnings
- Monitor your fluid intake carefully, especially during hot weather or physical exercise, to avoid severe dehydration.
- Check your blood sugar levels regularly as directed by your healthcare team, especially during periods of stress, illness, or changes in your diet.
- Pay close attention to genital hygiene to help reduce the risk of yeast or urinary tract infections.
- Inform your surgeon or dentist that you are taking this medication well in advance of any scheduled surgeries, as you may need to pause treatment.
- Always keep a quick source of sugar, like fruit juice or glucose tablets, nearby in case you experience sudden low blood sugar.
- Do not take Canagliflozin unless specifically advised by your healthcare provider if you have type 1 diabetes, severe kidney failure or are receiving dialysis or had a serious allergic reaction to canagliflozin or any of its ingredients or are in the second or third trimester of pregnancy, unless your doctor determines otherwise
- Canagliflozin has been associated with an increased risk of lower-limb amputations, particularly involving the toes, feet, or legs. Inform your doctor if you have a history of amputation, peripheral vascular disease, diabetic foot ulcers, or neuropathy. Seek medical attention promptly if you develop new foot pain, sores, ulcers, tenderness, infection, or changes in skin colour.
Drug Interactions
Drug-Drug Interactions
- Diuretics (water pills): Taking these alongside Canagliflozin can significantly increase your risk of dehydration and low blood pressure.
- Insulin or sulfonylureas: Combining these medications with Canagliflozin may lower your blood sugar too much, increasing the risk of hypoglycaemia.
Drug-Food Interactions
- Taking this medication before your first meal of the day is recommended to help control the rise in blood sugar that occurs after eating.
Drug-Disease Interactions
- Severe kidney disease: This medicine is not effective and should not be used if you have severe kidney failure or are on dialysis.
- Low blood pressure (hypotension): This medication can lower blood pressure further due to increased fluid loss.
- History of diabetic ketoacidosis: Individuals with a history of this serious condition may have an increased risk of developing it again.
Drug-Drug Interactions Checker List:
Safety Advice
Alcohol
unsafeYou should avoid consuming alcohol with Canagliflozin as it may alter your blood sugar levels or lead to serious side effects.
Pregnancy
consult your doctorCanagliflozin is not recommended during pregnancy. However, your doctor may prescribe it for you during pregnancy if he/she feels the benefit outweighs the risk. You should not take Canagliflozin without a doctor's advice.
Breast Feeding
consult your doctorThere is no sufficient data on how Canagliflozin affects breastfeeding. It is safe to seek medical advice before you start Canagliflozin if you are breastfeeding.
Driving
cautionCanagliflozin should not affect your ability to drive or operate machinery/tools.
Liver
cautionCanagliflozin to be taken with caution, especially if you have a history of liver diseases/conditions. The dose may have to be adjusted by your doctor.
Kidney
cautionCanagliflozin to be taken with caution, especially if you have a history of Kidney diseases/conditions. The dose may have to be adjusted by your doctor depending on your renal functions. Canagliflozin is not recommended in severe kidney disease. Regular monitoring of kidney function tests is therefore important if you're taking Canagliflozin.
Children
cautionCanagliflozin is not recommended for children below 18 years of age, as the safety and effectiveness were not established.
Habit Forming
Diet & Lifestyle Advise
- Drink plenty of water throughout the day to stay well-hydrated, as this medicine naturally increases fluid loss through urination.
- Follow a balanced meal plan focusing on vegetables, lean proteins, and fibre-rich carbohydrates to help maintain stable blood sugar levels.
- Engage in regular physical activity, such as walking, swimming, or cycling, as recommended by your doctor to help your body use insulin more effectively.
- Take extra care of your feet by checking them daily for cuts, sores, or redness, and wear comfortable, protective footwear.
Special Advise
You should have a test of glycated haemoglobin (HbA1C) every 3 months to check your blood glucose level control.
Patients Concern
Disease/Condition Glossary
Type 2 diabetes: It is a chronic or lifelong condition in which the body's cells fail to respond to insulin and, in later stages, the body fails to produce enough insulin. It accounts for roughly 90% of all diabetes cases. Because of this condition, the body must rely on various energy sources in muscles, tissues, and organs. Early symptoms of this disease include constant hunger, lack of energy, fatigue, weight loss, excessive thirst, frequent urination, dry mouth, itchy skin, and blurry vision. Type 2 diabetes, also known as adult-onset diabetes, is most common in people in their forties and fifties. The risks of uncontrolled type 2 diabetes include retinal damage or blindness, limb loss, nerve problems, kidney problems, sexual dysfunction, and an increased risk of heart attack or stroke.
FAQs
Canagliflozin is used to treat type 2 diabetes, also called 'non-insulin-dependent diabetes.
Canagliflozin is a type of medicine known as a sodium-glucose cotransporter-2 (SGLT2) inhibitor used for the treatment of type -2 diabetes. It lowers blood sugar levels by blocking the action of SGLT-2 in the kidney and removing excess sugar from your body through urination.
Take the missed dose as soon as possible. However, if it is time for the next dose, skip the missed dose and go back to your regular dosing schedule.
Do not stop taking Canagliflozin until your prescribed course is finished, even if you feel better.
Once blood sugar goes below the normal range (70mg/dl), it is called hypoglycemia or low blood sugar. If you feel your sugar level is going down and feel weak, immediately eat sugar candies. It will help to balance the blood sugar level in your body. So, it is advisable to keep sugar candies with you if you have diabetes.
Type 2 diabetes mellitus is a chronic (long-lasting) condition that keeps the body away from properly utilizing insulin. Hence, people affected with type 2 diabetes either do not produce enough insulin, or there is resistance to the action of insulin. Middle-aged or older are most likely to suffer from type 2 diabetes, so it is also known as adult-onset diabetes. The symptoms include frequent urination at night, increased thirst, slow wound healing, increased hunger, fatigue, and blurred vision.
During the treatment with Canagliflozin, maintain a healthy diet and do regular exercise to control blood sugar levels. Avoid skipping any dose of Canagliflozin, as it may cause fluctuations in your blood sugar levels. Tell your doctor about all of your medical conditions and any other medications that you are taking.
No, Invokana tablet and metformin are not the same. Though, both the medicines are used to treat Type 2 diabetes mellitus, their mechanisms of action are different.
Take Canagliflozin with or without food as prescribed by your doctor. Try to take it at the same time every day. Swallow it as whole with a glass of water. Do not crush, break or chew it.
Record your blood sugar levels, either daily or on a regular basis so that you can show them to your doctor on your next visit. Your doctor will examine these reports and let you know whether Canagliflozin is working or not.
Patients with a history of amputation are more prone to lower limb amputation. Patients with foot ulcers or sores, as well as those who have or had heart disease, are also at high risk. Additionally, patients who have or have suffered from neuropathy (nerve damage that causes numbness, tingling, and pain, usually in your hands and feet) and peripheral vascular disease (narrowing of blood vessels in feet, legs, or arms causing numbness, pain, or coldness) are also at high risk of lower limb amputation.
Canagliflozin usually causes loss of fat mass which typically results in weight loss. However, this may differ from person to person depending upon the doses and whether it is being used alone or with other diabetes medications.
The serious side effects of Canagliflozin are sudden kidney impairment, ketoacidosis (increased ketones in your blood or urine), low blood sugar, some allergic reaction, and serious urinary tract infections. Although it is rare, Canagliflozin may also cause a severe bacterial infection that may damage the tissue beneath the skin in the perineum (area between and around the anus and genitals). Canagliflozin may weaken your bones, increasing the risk of fractures, especially in the wrists, upper arms, or hands.
No, Canagliflozin is only approved to treat type 2 diabetes and should not be used by individuals with type 1 diabetes. Talk to your doctor.
It is best to avoid or limit alcohol, as it can increase your risk of dehydration and a dangerous medical condition called diabetic ketoacidosis. Talk to your doctor.
Because this medication increases sugar in your urine, genital yeast infections can occur. Mild cases can often be treated easily, but you should seek guidance on how to manage them. Talk to your doctor.
Yes, you may need to temporarily stop taking this medication several days before a scheduled surgery to lower the risk of ketoacidosis. Talk to your doctor.
This medication is generally not recommended during the second and third trimesters of pregnancy because it may affect the developing kidneys of the unborn child. Talk to your doctor.
Canagliflozin works in the kidney tubules by blocking the SGLT2 transporter, which helps remove excess glucose through the urine. Because its effectiveness depends on adequate kidney function, your doctor will check your kidney function using tests such as eGFR before starting treatment and during follow-up visits. Dose adjustments or treatment restrictions may be necessary if kidney function declines. Talk to your doctor.
