Applies to the following strength(s): 100 mg ; 300 mg
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Usual Adult Dose for:
Additional dosage information:
Usual Adult Dose for Diabetes Type 2
Initial dose: 100 mg orally once daily
Maximum dose: May increase to 300 mg orally once daily in patients with an eGFR of 60 mL/min/1.73 m2 or greater, tolerating therapy with 100 mg, and requiring additional glycemic control
-Do not initiate in patients with an eGFR less than 45 mL/min/1.73 m2 as this drug will not be effective.
-If used in combination with insulin or an insulin secretagogue, a lower dose of insulin or the insulin secretagogue should be considered to reduce the risk of hypoglycemia.
Use: As an adjunct to diet and exercise to improve glycemic control in patients with type 2 diabetes mellitus.
Renal Dose Adjustments
Mild renal dysfunction (eGFR of 60 mL/min/1.73 m2 or greater): No adjustment recommended.
Moderate renal dysfunction (eGFR of 45 to less than 60 mL/min/1.73 m2): Limit to 100 mg orally once daily
Severe renal dysfunction (eGFR less than 45 mL/min/1.73 m2): Initiation of therapy is not recommended
Severe renal dysfunction (eGFR less than 30 mL/min/1.73 m2): Use is contraindicated
If during therapy, eGFR is persistently less than 45 mL/min/1.73 m2: Use is not recommended
Liver Dose Adjustments
Mild to moderate liver dysfunction: No adjustment recommended
Severe liver dysfunction: Not recommended
Patients Concomitantly Receiving Uridine 5-diphospho (UDP)-glucuronosyl transferase (UGT) Enzyme Inducers and Requiring Additional Glycemic Control:
-For eGFR greater than 60 mL/min/1.73 m2: Consider increasing the canagliflozin dose to 300 mg orally once a day
-For eGFR of 45 to less than 60 mL/min/1.73 m2: Consider an alternative antihyperglycemic agent
Safety and efficacy have not been established in patients younger than 18 years.
Consult WARNINGS section for additional precautions.
-Take before the first meal of the day, swallow whole.
-If a dose is missed, it should be taken as soon as it is remembered; however, double dosing to make up for a missed dose is not recommended.
-Correct volume depletion prior to initiating treatment.
-Not recommended for patients with type 1 diabetes mellitus or for the treatment of diabetic ketoacidosis.
-Assess fluid status prior to initiation and monitor for signs and symptoms of volume depletion during therapy.
-Verify renal function at baseline, and monitor periodically during therapy.
-Monitor potassium in patients at risk for hyperkalemia.
-Evaluate for the presence of acidosis, including ketoacidosis in symptomatic patients.
-Monitor legs and feet for any new pain, tenderness, sore, ulcer, or infection.
-Patients experiencing symptoms of ketoacidosis such as difficulty breathing, nausea, vomiting, abdominal pain, confusion, and unusual fatigue, or sleepiness should be instructed to seek immediate medical attention.
-This drug will cause the urine to test positive for glucose.
-Ensure adequate fluid intake to avoid adverse reactions related to volume depletion such as orthostatic hypotension.
-Seek medical advice during periods of stress as medical management of glycemic control may change.
-Inform patients that genital mycotic infections, urinary tract infections, and hypersensitivity reactions may occur; patients should be instructed to contact their health care professional.
-Inform patients that use of this drug may increase their risk of bone fractures.
-Patients should be instructed to report any new pain, tenderness, sore, ulcer, or infection of legs or feet.
-Patients should be instructed to seek medical attention promptly for signs and symptoms of acute kidney injury such as decreased urine, swelling in the legs or feet.
More about canagliflozin
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- Drug class: SGLT-2 inhibitors
Other brands: Invokana