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Canagliflozin

Molecule Description

Canagliflozin is used to treat Type 2 diabetes in adults and also to reduce the risk of heart disease in these patients. It belongs to the ‘SGLT-2 (Sodium-Glucose co-Transporter 2) inhibitor’ class of ‘anti-diabetic medicines.’
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Uses of Canagliflozin

  • Treatment of Type 2 diabetes along with lifestyle modifications such as changes in diet and exercise
  • A patient can use Canagliflozin alone or in combination with other diabetic medicines (e.g., Glipizide, Glimepiride, Pioglirazone, Sitagliptin, Vildagliptin, Teneligliptin, etc.) to treat Type 2 diabetes
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Contraindications of Canagliflozin

When should one not use Canagliflozin

Allergy to Canagliflozin or any other components of this medicine.

Side effects of Canagliflozin

Common side effects of this drug are:

  • Low blood sugars (hypoglycemia) – blurry vision, sweating, trembling, looking pale, tingling of lips, anxiety or confusion
  • Fungal infections of the vagina, penis or foreskin (redness or rashes)
  • Urinary tract infections, or increased urination
  • Excessive thirst, constipation, feeling sick (nausea) changes in blood cholesterol levels
  • Increased red blood cells
  • Rashes, itching, blisters, kidney problems

Precautions and Warnings of Canagliflozin

Pregnancy

Q:
Can I take Canagliflozin during pregnancy?
A:
Canagliflozin should not be used in pregnancy as it has the potential to harm the unborn baby.

Breast Feeding

Q:
Can I take Canagliflozin while breastfeeding?
A:
Canagliflozin secretes in breast milk, and mothers who breast-feed should not intake this medicine in order to prevent any harm to their babies.

Driving

Q:
Can I drive if I have consumed Canagliflozin?
A:
Canagliflozin does not directly affect your ability to drive. But if you have or you are at risk for side effects such as low blood sugar, dehydration or low blood pressure (dizziness), etc., caution is advised.

Alcohol

Q:
Can I consume alcohol with Canagliflozin?
A:
Alcohol lowers blood sugar levels and also increases the risk of dehydration and other complication in patients taking Canagliflozin. Hence, these patients are advised to avoid excessive intake of alcohol (occasional drinking is permitted).

Other General Warnings

Talk to your doctor if
  • You have Type I diabetes
  • You have severe kidney or liver disease
  • You have or are at risk of heart attacks or any heart disease or brain stroke
  • You have low blood pressure or are on medicines for high blood pressure
  • You had your lower leg cut-off (amputated) below the knee
  • A complication of poorly controlled diabetes (diabetic ketoacidosis) can occur with Canagliflozin. Symptoms include high blood sugars, rapid weight loss, vomiting, nausea, excessive thirst, fast and deep breathing, mental confusion, sweet or metallic taste, and breath, smelly sweat, or urine. This condition usually follows inadequate water intake or fluid loss (dehydration), excess alcohol intake, insufficient insulin dose (following any significant surgeries), etc.
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  • Pain, swelling, redness of the genitals or the skin between the genitals and anus due to uncontrolled blood sugars (necrotizing fasciitis or Fournier's gangrene) is a serious condition which can occur and requires immediate medical attention
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  • Irritation, itching or discharge from genital organs (due to yeast or fungal infections)

Mode of Action of Canagliflozin

How Does It Work?

Canagliflozin works by causing the kidneys to increase the excretion of glucose via urine. For this reason, it is beneficial for patients with heart disease, as it decreases fluid levels in the body and reduces the load on the heart. Maintaining adequate fluid levels is vital while taking this medicine.
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Interactions of Canagliflozin

Interactions with other medicines

  • Antidiabetic medicines like Insulin, Glipizide, Glimepiride, Sitagliptin, Teneligliptin etc.
  • Medicines used to treat high blood pressure (Ramipril, Captopril, Losartan, Amlodipine, Nifedipine, Atenolol, water pills such as Hydrochlorothiazide, etc.)
  • Carbamazepine, Phenytoin or Phenobarbital (anti-seizure medications)
  • Ritonavir or Efavirenz (HIV/AIDs medicines)
  • Rifampicin (used to treat TB)
  • Cholestyramine (lowers blood cholesterol), Digoxin or Digitoxin (to treat heart problems)
  • Dabigatran (blood thinner)

Interactions with food items

It is preferred to take Canagliflozin on an empty stomach, before the first meal of the day.

Dietary Restrictions of Canagliflozin

  • It is advisable to have a diabetic diet as advised by your doctor or dietician
  • This medicine works best along with a proper diet and exercise
  • Maintain adequate hydration by speaking to your doctor about your water intake

Dosage of Canagliflozin

Overdose

Unintentional overdose with Canagliflozin may not be harmful. Consult your doctor if you experience any signs of low blood sugar (hypoglycemia), like dizziness, excess sweating, anxiety, headache, or irritation.
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Missed a Dose

Do not take a higher or a double dose to compensate for the missed dose.

Frequently Asked Questions (FAQs)

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Q: Is Canagliflozin an effective medicine to treat diabetes?

  • Adults with Type II diabetes should not use Canagliflozin, which is not dependent on Insulin injections. It is recommended to use along with lifestyle changes such as modifications in diet and increasing exercise
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  • It is also approved to use in Type 2 diabetic patients who are at risk for heart diseases (heart attack, stroke, presence of blood clots, etc.) or those who are at risk for kidney disease due to uncontrolled blood sugars (diabetic nephropathy)
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  • Canagliflozin is most beneficial to patients who have Type 2 diabetes and associated heart disease or kidney disease or both or who are at risk of developing these complications
  • The efficacy of Canagliflozin in the control and maintenance of blood sugars (fasting and after-meals), body weight, cholesterol levels, and blood pressure has been demonstrated in various clinical trials. It is preferable in patients with Type 2 diabetes with other associated conditions
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Q: Is there anything else I need to know before using Canagliflozin?

  • Canagliflozin causes fluid loss from the body, by way of more glucose excretion by increasing urination. Hence, it is essential to maintain proper hydration while using this medicine. Severe exercise or excess alcohol can cause dehydration and should be avoided
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  • The intake of fluids also depends on your associated conditions. If you have high blood pressure, decreased heart efficiency, or kidney disease, taking excess fluids can cause more harm. Hence discuss with your doctor about your fluid intake
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  • Canagliflozin must be in use with caution in patients with kidney disease. For patients with mild kidney disease, regular dosing may continue. But, in patients with moderate kidney failure, dosage must be adjusted as per the patient’s tolerability and should be discontinued if the patient’s kidney function is not improving or is worsening
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  • Patients with severe kidney (end-stage kidney disease), liver disease and patients with Type 1 diabetes must avoid the use of Canagliflozin
  • Tests for kidney function are mandatory before starting this medicine
  • Patients below 18 years of age should not use Canagliflozin
Last Updated on: 05 Oct 2020 | 10:47 PM (IST)

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The information provided herein is accurate, updated and complete as per the best practices of the Company. Please note that this information should not be treated as a replacement for physical medical consultation or advice. We do not guarantee the accuracy and the completeness of the information so provided. The absence of any information and/or warning to any drug shall not be considered and assumed as an implied assurance of the Company. We do not take any responsibility for the consequences arising out of the aforementioned information and strongly recommend you for a physical consultation in case of any queries or doubts. Please click here for detailed T&C.
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