Canaflo

Indications

Canagliflozin is used together with diet and exercise to improve blood sugar control in adults with type 2 diabetes. In people with type 2 diabetes who also have heart disease or diabetic kidney disease, it also helps lower the risk of heart attack, stroke, heart-related death and worsening of kidney disease. It can be used alone or with other diabetes medicines such as Metformin.

How It Works

Canagliflozin belongs to a group called SGLT2 inhibitors. Normally the kidneys take sugar back from the urine into the blood. Canagliflozin blocks a transporter in the kidney (SGLT2) that does this, so extra sugar leaves the body in the urine and blood sugar falls. It also causes a small loss of salt and water, which may slightly lower blood pressure and weight.

Dosage and Administration

The usual starting dose for adults is 100 mg once a day, taken before the first meal of the day. If needed and kidney function allows, the doctor may increase it to 300 mg once a day. The dose is limited in people with reduced kidney function, so follow your doctor's instructions. Swallow the tablet whole with water.

Interactions

Using it with Insulin or sulfonylureas such as Gliclazide or Glimepiride raises the risk of low blood sugar, so their dose may need lowering. Diuretics (water tablets) such as Furosemide may increase dehydration and dizziness. Rifampicin, Phenytoin, Carbamazepine and Ritonavir can reduce its effect. It may raise Digoxin levels slightly.

Contraindications

Do not use if you are allergic to Canagliflozin, are on dialysis, or have type 1 diabetes. It is not used to treat diabetic ketoacidosis.

Side Effects

Common side effects are genital fungal infections (itching, discharge or redness of the genital area), urinary tract infections, passing more urine, thirst and constipation. Dizziness or light-headedness on standing can happen, especially in older people or those on water tablets. A higher risk of lower-limb amputation and bone fractures has been reported in some studies.

Get urgent medical help if you have nausea, vomiting, stomach pain, unusual tiredness or fast breathing (possible ketoacidosis, which can occur even when blood sugar is not very high), pain, tenderness or swelling of the genital or anal area with fever, sores or infection on the feet or legs, signs of kidney infection such as fever and back pain, fainting, or a serious allergic reaction.

Pregnancy and Lactation

Not recommended during pregnancy, especially in the second and third trimesters; other treatments such as Insulin are preferred. It is not recommended while breastfeeding.

Precautions and Warnings

Kidney function should be checked before starting and regularly afterwards. Drink enough fluid and tell your doctor if you are vomiting, have diarrhoea or cannot eat, as the medicine may need to be paused. It is usually stopped a few days before planned surgery. Check your feet daily and keep the genital area clean. Avoid heavy alcohol use.

Overdose

Overdose may cause dehydration, dizziness and low blood pressure. Contact a doctor or the nearest hospital; supportive treatment is given.

Therapeutic Class

Antidiabetic, sodium glucose co-transporter 2 (SGLT2) inhibitor.

Storage

Store below 30°C in a dry place, away from light and out of the reach of children.