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Can you take Canagliflozin with Trovafloxacin?

1 drug interaction and 15 additional warnings found for the following 2 drugs:

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Drug interactions

Moderate drug interactions

Moderate:

trovafloxacin canagliflozin

Applies to: trovafloxacin and canagliflozin

Medications like trovafloxacin can sometimes affect blood glucose levels. Both hyperglycemia (high blood glucose) and, less frequently, hypoglycemia (low blood glucose) have been reported. Severe cases of hypoglycemia have resulted in coma and even death, especially in the elderly and patients with kidney problems or severe infections using insulin or other diabetes medications that can commonly cause hypoglycemia. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring of your blood glucose levels to safely use both medications. Let your doctor know if you experience hypoglycemia or hyperglycemia, or if you notice a loss of blood glucose control. Symptoms of hypoglycemia include headache, dizziness, drowsiness, nervousness, confusion, tremor, nausea, hunger, weakness, perspiration, palpitation, and rapid heartbeat. Symptoms of hyperglycemia may include increased thirst, increased hunger, and increased urination. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Food/lifestyle interactions

Moderate food/lifestyle interactions

Moderate:

canagliflozin Food/Lifestyle

Applies to: canagliflozin

Alcohol may affect blood glucose levels in patients with diabetes. Both hypoglycemia (low blood sugar) and hyperglycemia (high blood sugar) may occur, depending on how much and how often you drink. You should avoid using alcohol if your diabetes is not well controlled or if you have high triglycerides, neuropathy (nerve damage), or pancreatitis. Moderate alcohol consumption generally does not affect blood glucose levels if your diabetes is under control. However, it may be best to limit alcohol intake to one drink daily for women and two drinks daily for men (1 drink = 5 oz wine, 12 oz beer, or 1.5 oz distilled spirits) in conjunction with your normal meal plan. Avoid drinking alcohol on an empty stomach or following exercise, as it may increase the risk of hypoglycemia. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Disease interactions

14 potential interactions Applies to: 11 conditions, including Rheumatoid Arthritis, Peripheral Neuropathy, Hypotension, Myasthenia Gravis, and Tendonitis.

Biliary Obstruction

Major:

trovafloxacin

Trovafloxacin has a major potential interaction with Biliary Obstruction.

Trovafloxacin undergoes metabolism by the liver as well as excretion by the hepatobiliary system. Patients with hepatic impairment or biliary obstruction may be at greater risk for adverse effects from trovafloxacin due to decreased drug clearance. Therapy with trovafloxacin should be administered cautiously in these patients. The manufacturer recommends a dosage reduction in mild to moderate cirrhosis. Periodic assessment of hepatic function is advised, especially during prolonged therapy (>= 21 days), since trovafloxacin can also cause elevations of liver enzymes.

Central Nervous System Disorders

Major:

trovafloxacin

Trovafloxacin has a major potential interaction with Central Nervous System Disorders.

Quinolones may cause CNS stimulation manifested as tremors, agitation, restlessness, anxiety, confusion, hallucinations, paranoia, insomnia, toxic psychosis, and/or seizures. Benign intracranial hypertension has also been reported. Therapy with quinolones should be administered cautiously in patients with or predisposed to seizures or other CNS abnormalities. In addition, these patients should be advised to avoid the consumption of caffeine-containing products during therapy with some quinolones, most notably ciprofloxacin, enoxacin, and cinoxacin, since these agents can substantially reduce the clearance of caffeine and other methylxanthines, potentially resulting in severe CNS reactions.

Hypotension

Moderate:

canagliflozin

Canagliflozin has a moderate potential interaction with Hypotension.

Sodium-glucose cotransporter 2 (SGLT2) inhibitors cause intravascular volume contraction which may lead to symptomatic hypotension after treatment initiation, especially in older adult patients, patients with impaired renal function, patients with low systolic blood pressure, or those using diuretics. Volume status should be assessed and corrected before starting treatment and patients should be monitored during therapy.

Infection

Moderate:

canagliflozin

Canagliflozin has a moderate potential interaction with Infection.

Sodium-glucose cotransporter 2 (SGLT2) inhibitors increase the risk of genital mycotic infections. Care should be exercised when using an SGLT2 inhibitor in patients who have a history of chronic or recurrent genital mycotic infections or who are uncircumcised as these patients are more likely to develop genital mycotic infections. Patients should be monitored and treated appropriately.

Liver Disease

Major:

canagliflozin

Canagliflozin has a major potential interaction with Liver Disease.

Sodium-glucose cotransporter 2 (SGLT2) inhibitors ertugliflozin and canagliflozin are not recommended for use in patients with severe hepatic impairment due to lack of clinical data. Sotagliflozin is not recommended for use in patients with moderate to severe hepatic impairment. Dapagliflozin has not been studied in patients with severe hepatic impairment and caution is recommended. The manufacturer's product labeling should be consulted for specific dosing of SGLT2 inhibitors in patients with hepatic impairment.

Major:

trovafloxacin

Trovafloxacin has a major potential interaction with Liver Disease.

Trovafloxacin undergoes metabolism by the liver as well as excretion by the hepatobiliary system. Patients with hepatic impairment or biliary obstruction may be at greater risk for adverse effects from trovafloxacin due to decreased drug clearance. Therapy with trovafloxacin should be administered cautiously in these patients. The manufacturer recommends a dosage reduction in mild to moderate cirrhosis. Periodic assessment of hepatic function is advised, especially during prolonged therapy (>= 21 days), since trovafloxacin can also cause elevations of liver enzymes.

Myasthenia Gravis

Major:

trovafloxacin

Trovafloxacin has a major potential interaction with Myasthenia Gravis.

Fluoroquinolones have neuromuscular blocking activity and may exacerbate muscle weakness in persons with myasthenia gravis. Postmarketing serious adverse events, including deaths and requirement for ventilatory support, have been associated with fluoroquinolones use in persons with myasthenia gravis. Fluoroquinolones should be avoided in patients with history of myasthenia gravis.

Organ Transplant

Major:

trovafloxacin

Trovafloxacin has a major potential interaction with Organ Transplant.

Tendonitis and ruptures of the shoulder, hand, and Achilles tendons have been reported in patients receiving quinolones, both during and after treatment. Avoid the use of these agents in patients who have a history of tendon disorders or have experienced tendinitis or tendon rupture. Therapy with quinolones should be administered cautiously in patients with patients with kidney, heart, and lung transplant, since it may delay the recognition or confound the diagnosis of a quinolone-induced musculoskeletal effect. Factors that may independently increase the risk of tendon rupture include strenuous physical activity, renal failure, and previous tendon disorders such as rheumatoid arthritis. It is recommended to discontinue these agents if, at any time during therapy, pain, inflammation or rupture of a tendon develops and institute appropriate treatment.

Peripheral Neuropathy

Major:

trovafloxacin

Trovafloxacin has a major potential interaction with Peripheral Neuropathy.

The use of quinolones has been associated with an increased risk of peripheral neuropathy. Monitor closely and discontinue their use in patients experiencing symptoms of peripheral neuropathy. It is recommended to avoid these agents in patients who have previously experienced peripheral neuropathy.

Renal Dysfunction

Major:

canagliflozin

Canagliflozin has a major potential interaction with Renal Dysfunction.

The glucose lowering effects of sodium-glucose cotransporter 2 (SGLT2) inhibitors are decreased in patients with worsening renal function. Additionally, patients with impaired renal function (estimated GFR less than 60 mL/min/1.73 m2), older adult patients, and patients on loop diuretics may be more likely to experience adverse reactions related to volume depletion such as hypotension and acute kidney injury during therapy. Renal function should be evaluated prior to treatment initiation and monitored regularly in at-risk patients. Volume status should be assessed and volume depletion corrected before initiating therapy. The use of SGLT2 inhibitors in patients undergoing dialysis is either contraindicated or not recommended. The manufacturer product information should be consulted for contraindications and indication specific renal dosing.

Major:

trovafloxacin

Trovafloxacin has a major potential interaction with Renal Dysfunction.

Tendonitis and ruptures of the shoulder, hand, and Achilles tendons have been reported in patients receiving quinolones, both during and after treatment. Avoid the use of these agents in patients who have a history of tendon disorders or have experienced tendinitis or tendon rupture. Therapy with quinolones should be administered cautiously in patients with patients with kidney, heart, and lung transplant, since it may delay the recognition or confound the diagnosis of a quinolone-induced musculoskeletal effect. Factors that may independently increase the risk of tendon rupture include strenuous physical activity, renal failure, and previous tendon disorders such as rheumatoid arthritis. It is recommended to discontinue these agents if, at any time during therapy, pain, inflammation or rupture of a tendon develops and institute appropriate treatment.

Moderate:

canagliflozin

Canagliflozin has a moderate potential interaction with Renal Dysfunction.

Sodium-glucose cotransporter 2 (SGLT2) inhibitors cause intravascular volume contraction which may lead to symptomatic hypotension after treatment initiation, especially in older adult patients, patients with impaired renal function, patients with low systolic blood pressure, or those using diuretics. Volume status should be assessed and corrected before starting treatment and patients should be monitored during therapy.

Rheumatoid Arthritis

Major:

trovafloxacin

Trovafloxacin has a major potential interaction with Rheumatoid Arthritis.

Tendonitis and ruptures of the shoulder, hand, and Achilles tendons have been reported in patients receiving quinolones, both during and after treatment. Avoid the use of these agents in patients who have a history of tendon disorders or have experienced tendinitis or tendon rupture. Therapy with quinolones should be administered cautiously in patients with patients with kidney, heart, and lung transplant, since it may delay the recognition or confound the diagnosis of a quinolone-induced musculoskeletal effect. Factors that may independently increase the risk of tendon rupture include strenuous physical activity, renal failure, and previous tendon disorders such as rheumatoid arthritis. It is recommended to discontinue these agents if, at any time during therapy, pain, inflammation or rupture of a tendon develops and institute appropriate treatment.

Tendonitis

Major:

trovafloxacin

Trovafloxacin has a major potential interaction with Tendonitis.

Tendonitis and ruptures of the shoulder, hand, and Achilles tendons have been reported in patients receiving quinolones, both during and after treatment. Avoid the use of these agents in patients who have a history of tendon disorders or have experienced tendinitis or tendon rupture. Therapy with quinolones should be administered cautiously in patients with patients with kidney, heart, and lung transplant, since it may delay the recognition or confound the diagnosis of a quinolone-induced musculoskeletal effect. Factors that may independently increase the risk of tendon rupture include strenuous physical activity, renal failure, and previous tendon disorders such as rheumatoid arthritis. It is recommended to discontinue these agents if, at any time during therapy, pain, inflammation or rupture of a tendon develops and institute appropriate treatment.

More resources

canagliflozin

A total of 436 drugs are known to interact with canagliflozin.

trovafloxacin

A total of 314 drugs are known to interact with trovafloxacin.

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.