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Why is this medication prescribed?

Canagliflozin is used to lower blood sugar levels in persons with type 2 diabetes together with diet, exercise, and occasionally additional drugs (condition in which blood sugar is too high because the body does not produce or use insulin normally). Canagliflozin is also prescribed to persons with type 2 diabetes who also have heart and blood vessel disease in order to lower their risk of stroke, heart attack, or death. In persons with type 2 diabetes and severe renal disease, canagliflozin is also used to lower the risk of end-stage kidney disease, worsening kidney function, needing hospitalisation for heart failure, and cardiovascular death. A group of drugs known as sodium-glucose co-transporter 2 (SGLT2) inhibitors includes canagliflozin. By encouraging the kidneys to excrete more glucose through urine, it reduces blood sugar levels. There is no treatment for type 1 diabetes with canagliflozin (condition in which the body does not produce insulin and, therefore, cannot control the amount of sugar in the blood).

Those with diabetes and high blood sugar over time may experience serious or fatal complications, such as heart disease, stroke, kidney issues, nerve damage, and vision issues. It may be possible to control your diabetes and enhance your health by taking medication(s), making lifestyle changes (such as diet, exercise, and quitting smoking), and monitoring your blood sugar frequently. This treatment may also lower your risk of heart attack, stroke, kidney failure, nerve damage (resulting in numb, cold legs or feet and diminished sex capacity in both men and women), eye issues, such as changes in eyesight or blindness, or gum disease, which are all symptoms of diabetes. The optimal strategy to manage your diabetes will be discussed with you by your doctor and other healthcare professionals.

How should this medicine be used?

An oral tablet is available for canagliflozin. It is typically taken once day, preferably before breakfast or the morning meal. Take canagliflozin every day at roughly the same time. Ask your doctor or pharmacist to explain any instructions on your prescription label that you are unsure about following. Follow the canagliflozin directions exactly. Never take it in larger or less amounts or more frequently than directed by your doctor.

Your doctor might prescribe you a low dose of canagliflozin and then gradually raise it.

Although not curing type 2 diabetes, canagliflozin manages the condition. Even if you feel well, keep taking canagliflozin. Without consulting your doctor, do not discontinue taking canagliflozin.

Other uses for this medicine

Ask your doctor or pharmacist for more details if you believe this drug should be used for something else.

What special precautions should I follow?

Before taking canagliflozin,

  • Inform your doctor and pharmacist if you have any symptoms of a canagliflozin, other medicine, or canagliflozin tablet ingredient allergy (rash, hives, swelling of your face, lips, tongue, or throat, or trouble breathing). For a list of the ingredients, consult the Medication Guide or speak with your pharmacist.
  • Inform your doctor and pharmacist about any additional prescription and over-the-counter medications, vitamins, herbal items, nutritional supplements, and any drugs you are now taking or intend to take. Any of the following should be mentioned: ACE inhibitors, such as benazepril, suppress the angiotensin-converting enzyme (Lotensin, in Lotrel), perindopril (Aceon, in Prestalia), quinapril (Accupril, in Accuretic, in Quinaretic), ramipril (Altace), and trandolapril (Mavik, in Tarka); captopril, enalapril (Vasotec, in Vaseretic), fosinopril, and lisinopril (in Zestoretic), moexipril (Univasc, in Uniretic); Digoxin (Lanoxin); angiotensin receptor blockers such as olmesartan (Benicar, in Azor, in Benicar HCT, in Tribenzor); telmisartan (Micardis, in Micardis HCT, in Twynsta); azilsartan (Edarbi, in Edarbyclor); candesartan (Atacand, in Atacand HCT); eprosartan (Teveten); insulin, various diabetes drugs, phenobarbital, phenytoin (Dilantin, Phenytek), rifampin (Rifadin, Rimactane, in Rifamate, in Rifater), diuretics (‘water pills,’) and ritonavir (Norvir, in Kaletra). Your doctor might need to adjust your medication doses or keep a close eye out for any negative side effects.
  • If you receive dialysis, let your doctor know. You could be advised by your doctor not to take canagliflozin.
  • If you routinely consume alcohol, occasionally consume significant amounts of alcohol quickly (binge drinking), or follow a low sodium diet, let your doctor know. Inform your doctor if you have ever had an amputation, heart disease, peripheral vascular disease (a narrowing of the blood arteries in the feet, legs, or arms that results in numbness, pain, or coldness in that area of the body), neuropathy, or any other medical conditions (nerve damage that causes tingling, numbness, and pain, usually in your hands and feet), yeast infections in the vaginal area, pancreatic disease, including pancreatitis (pancreatic swelling), osteoporosis (a condition in which the bones grow thin and weak and break easily), kidney or liver disease, low blood pressure, urinary tract infections, or urinary issues. If you’ve never had your manhood circumcised, let your doctor know whether you’re a male. Inform your doctor if you are eating less owing to an illness, surgery, dietary change, or if you are unable to eat or drink normally due to nausea, vomiting, diarrhoea, or if you become dehydrated after spending too much time in the sun.
  • Inform your physician if you are nursing a baby, intend to get pregnant, or are already pregnant. While using canagliflozin, refrain from breastfeeding. Call your doctor if you become pregnant while taking canagliflozin.
  • Inform your doctor or dentist that you are taking canagliflozin if you are having surgery, including dental surgery.
  • Alcohol may alter blood sugar levels. Inquire with your doctor if drinking alcohol is okay for you to do while taking canagliflozin.
  • You should be aware that canagliflozin may result in fainting, lightheadedness, and dizziness if you stand up suddenly from a laying position. Call your doctor if you are experiencing this issue. When using canagliflozin for the first time, this issue is more prevalent. To avoid this issue, slowly get out of bed and sit up after a few minutes of resting your feet on the floor.
  • In the event that you become ill, encounter exceptional stress, a feverish infection, or an injury, consult your doctor for advice. Your blood sugar levels and potential canagliflozin dosage may be impacted by these situations.

What special dietary instructions should I follow?

Don’t forget to abide by your doctor’s or dietitian’s advice regarding diet and exercise. Eating a balanced diet and exercising frequently are vital.

While taking this medication, make sure to hydrate properly throughout the day as directed by your doctor.

What should I do if I forget a dose?

If you miss a dosage, take it as soon as you recall. If the next dose is soon due, skip the missed one and carry on with your regular dosing plan. To make up for a missing dose, do not take a second one.

What side effects can this medication cause?

Your blood sugar levels may alter as a result of this drug. You should be aware of the signs of low and high blood sugar as well as what to do if you experience these signs.

Canagliflozin could have unwanted effects. If any of these symptoms are severe or do not go away, let your doctor know right once:

  • A lot of urination, including at night
  • Heightened thirst
  • Constipation
  • Mouth ache

Certain adverse effects can be very harmful. Call your doctor right away if any of these symptoms occur to you:

  • Frequent, throbbing, painful, or urgent urinating
  • Reduction in urine production
  • Hazy, red, pink, or brown urine
  • Unpleasant-smelling urine
  • Rectal or pelvic pain
  • Vaginal odour, white or yellowish vaginal discharge that may be lumpy or resemble cottage cheese, or vaginal irritation are all common in women
  • Redness, rash, itching, or swelling of the penis; discharge from the penis that smells bad; or soreness in the area of skin around the penis (in men)
  • Feeling exhausted, weak, or uneasy; fever; and genital discomfort, soreness, redness, or swelling; or the region between the genitalia and the rectum

You should stop taking canagliflozin and contact your doctor right away if you have any of the following symptoms, or seek emergency medical attention:

  • Rash
  • Hives
  • Itching
  • Having trouble swallowing
  • Face, throat, tongue, lips, mouth, or eyes swelling
  • Hoarseness

Stop taking canagliflozin and seek emergency medical attention if you suffer any of the following symptoms of ketoacidosis, a hazardous disease that may arise if high blood sugar is not managed. If you experience any of the following symptoms, even if your blood sugar is less than 250 mg/dL, try to check for ketones in your urine:

  • Nausea
  • Vomiting
  • Abdominal pain
  • Tiredness
  • Having trouble breathing

You should be aware that canagliflozin may raise your chance of needing to amputate a lower limb (toe, foot, or leg). To help prevent infections and other problems that could result in an amputation, your doctor will instruct you on how to properly take care of your legs and feet. If you experience any pain, soreness, sores, ulcers, swollen, warm, reddened areas in your leg or foot, fever or chills, or other signs and symptoms of infection, pay close attention to the doctor’s instructions and call them straight once.

Canagliflozin may make it more likely to break a bone, especially in the hands, wrists, or upper arms. The dangers of using this drug should be discussed with your doctor.

Further negative effects of canagliflozin are possible. If you experience any strange issues while taking this medicine, contact your doctor right away.

You or your doctor can submit a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting programme online or by phone if you have a serious side event (1-800-332-1088).

What should I know about storage and disposal of this medication?

Keep this medication tightly closed in the original container and out of the reach of children. Keep it away from excessive heat and moisture at room temperature (not in the bathroom).

Although many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and are simple for young children to open, it is crucial to keep all medications out of sight and out of reach of children. Always lock safety caps and promptly stash medication up and away from young children where it is out of their sight and reach to prevent poisoning.

Unused prescriptions must be disposed of carefully to prevent pets, kids, and other people from ingesting them. You should not, however, dispose of this medication in the toilet. Instead, utilising a medicine take-back programme is the easiest approach to get rid of your medication. To find out about take-back programmes in your area, speak with your pharmacist or the garbage/recycling department in your city. If you do not have access to a take-back programme, see the FDA’s Safe Disposal of Medications website at for additional information.

In case of emergency/overdose

Call the poison control hotline at 1-800-222-1222 in the event of an overdose. Moreover, information can be found online at Call 911 right once if the person has collapsed, experienced a seizure, is having difficulty breathing, or cannot be roused.

What other information should I know?

Keep all of your appointments with your physician and the lab. Before and during your canagliflozin medication, your doctor will request a lab test to assess how well your kidneys are functioning. You should routinely check your blood sugar levels to see how canagliflozin is impacting you. To monitor your response to canagliflozin, your doctor will often request additional blood tests, including as the glycosylated haemoglobin (HbA1c) test. Your doctor will also instruct you on how to measure your blood sugar levels at home in order to monitor your reaction to this medicine. Pay close attention to these directions.

Inform the lab staff and your doctor that you are taking canagliflozin prior to any laboratory test. Your urine may test positive for glucose because of the way this drug functions.

Wearing a diabetes identity bracelet will ensure that you receive the right care in an emergency.

No one else should take your medication. Any queries you may have regarding medication refills should be directed to your pharmacist.

You should keep a written record of every medication you take, including any over-the-counter (OTC) items, prescription drugs, and dietary supplements like vitamins and minerals. This list should be brought with you whenever you see a doctor or are admitted to the hospital. You should always have this information with you in case of emergencies.

Brand names

  • Invokana®
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