Canagliflozin (canagliflozin)

Canagliflozin (SGLT2 inhibitor (sodium-glucose co-transporter 2 inhibitor), originally Invokana (怡可安 in Chinese-language markets); Invokamet and Invokamet XR are the metformin combinations by Janssen Pharmaceuticals (Johnson & Johnson), licensed from Mitsubishi Tanabe Pharma) Canagliflozin blocks the SGLT2 protein in the kidney, so less glucose is taken back into the bloodstream and more is passed out in the urine, lowering blood sugar without relying on insulin. It also increases salt and water loss, which lowers the workload on the heart and slows the loss of kidney function in people with diabetic kidney disease. Start 100 mg orally once daily, taken before the first meal of the day. The dose may be increased to 300 mg once daily in patients who tolerate 100 mg, have an eGFR of 60 mL/min/1.73 m2 or greater, and need additional glycemic control.

Standard dosing for canagliflozin: Start 100 mg orally once daily, taken before the first meal of the day. The dose may be increased to 300 mg once daily in patients who tolerate 100 mg, have an eGFR of 60 mL/min/1.73 m2 or greater, and need additional glycemic control. Dose adjustments: Assess renal function before starting; do not initiate if eGFR is below 45 mL/min/1.73 m2. In patients with eGFR 45 to less than 60 mL/min/1.73 m2 the dose is limited to 100 mg once daily. Correct volume depletion first and assess volume status. Ongoing use may continue at 100 mg once daily as eGFR falls below 45 in patients already tolerating it, to reduce the risk of ESKD, worsening kidney function, CV death and heart failure hospitalization (per the 2019 diabetic kidney disease indication). No dose adjustment for hepatic impairment is specified for mild to moderate impairment.

Canagliflozin (SGLT2 inhibitor (sodium-glucose co-transporter 2 inhibitor), originally Invokana (怡可安 in Chinese-language markets); Invokamet and Invokamet XR are the metformin combinations by Janssen Pharmaceuticals (Johnson & Johnson), licensed from Mitsubishi Tanabe Pharma) Canagliflozin blocks the SGLT2 protein in the kidney, so less glucose is taken back into the bloodstream and more is passed out in the urine, lowering blood sugar without relying on insulin. It also increases salt and water loss, which lowers the workload on the heart and slows the loss of kidney function in people with diabetic kidney disease. Start 100 mg orally once daily, taken before the first meal of the day. The dose may be increased to 300 mg once daily in patients who tolerate 100 mg, have an eGFR of 60 mL/min/1.73 m2 or greater, and need additional glycemic control.

Canagliflozin (SGLT2 inhibitor (sodium-glucose co-transporter 2 inhibitor), originally Invokana (怡可安 in Chinese-language markets); Invokamet and Invokamet XR are the metformin combinations by Janssen Pharmaceuticals (Johnson & Johnson), licensed from Mitsubishi Tanabe Pharma) Canagliflozin blocks the SGLT2 protein in the kidney, so less glucose is taken back into the bloodstream and more is passed out in the urine, lowering blood sugar without relying on insulin. It also increases salt and water loss, which lowers the workload on the heart and slows the loss of kidney function in people with diabetic kidney disease. Start 100 mg orally once daily, taken before the first meal of the day. The dose may be increased to 300 mg once daily in patients who tolerate 100 mg, have an eGFR of 60 mL/min/1.73 m2 or greater, and need additional glycemic control.

Canagliflozin (SGLT2 inhibitor (sodium-glucose co-transporter 2 inhibitor), originally Invokana (怡可安 in Chinese-language markets); Invokamet and Invokamet XR are the metformin combinations by Janssen Pharmaceuticals (Johnson & Johnson), licensed from Mitsubishi Tanabe Pharma) Canagliflozin blocks the SGLT2 protein in the kidney, so less glucose is taken back into the bloodstream and more is passed out in the urine, lowering blood sugar without relying on insulin. It also increases salt and water loss, which lowers the workload on the heart and slows the loss of kidney function in people with diabetic kidney disease. Start 100 mg orally once daily, taken before the first meal of the day. The dose may be increased to 300 mg once daily in patients who tolerate 100 mg, have an eGFR of 60 mL/min/1.73 m2 or greater, and need additional glycemic control.

Canagliflozin (SGLT2 inhibitor (sodium-glucose co-transporter 2 inhibitor), originally Invokana (怡可安 in Chinese-language markets); Invokamet and Invokamet XR are the metformin combinations by Janssen Pharmaceuticals (Johnson & Johnson), licensed from Mitsubishi Tanabe Pharma) Canagliflozin blocks the SGLT2 protein in the kidney, so less glucose is taken back into the bloodstream and more is passed out in the urine, lowering blood sugar without relying on insulin. It also increases salt and water loss, which lowers the workload on the heart and slows the loss of kidney function in people with diabetic kidney disease. Start 100 mg orally once daily, taken before the first meal of the day. The dose may be increased to 300 mg once daily in patients who tolerate 100 mg, have an eGFR of 60 mL/min/1.73 m2 or greater, and need additional glycemic control.

Invokana (Janssen) is the reference product for canagliflozin 100 mg and 300 mg tablets. A proprietary boxed warning for lower limb amputation was added in 2017 and removed by the FDA on 26 August 2020; the amputation risk remains in Warnings and Precautions, so any generic leaflet must carry that warning. Canagliflozin generics in South Asia are locally approved products; verify on the local regulator's registered list (e.g. DGDA Bangladesh) before claiming interchangeability with Invokana. Note that many Bangladeshi listings show only the 100 mg strength. Manufacturers supplying canagliflozin generic versions include Cipla Ltd., Drug International Ltd., Incepta Pharmaceuticals Ltd., NIPRO JMI Pharma Ltd., Square Pharmaceuticals PLC, Steris Healthcare. Brands registered in Bangladesh include Canaglif, Canarol, Diacana, Glicana, Invokana.

Canagliflozin (SGLT2 inhibitor (sodium-glucose co-transporter 2 inhibitor), originally Invokana (怡可安 in Chinese-language markets); Invokamet and Invokamet XR are the metformin combinations by Janssen Pharmaceuticals (Johnson & Johnson), licensed from Mitsubishi Tanabe Pharma) Canagliflozin blocks the SGLT2 protein in the kidney, so less glucose is taken back into the bloodstream and more is passed out in the urine, lowering blood sugar without relying on insulin. It also increases salt and water loss, which lowers the workload on the heart and slows the loss of kidney function in people with diabetic kidney disease. Start 100 mg orally once daily, taken before the first meal of the day. The dose may be increased to 300 mg once daily in patients who tolerate 100 mg, have an eGFR of 60 mL/min/1.73 m2 or greater, and need additional glycemic control.

Standard dosing for canagliflozin: Start 100 mg orally once daily, taken before the first meal of the day. The dose may be increased to 300 mg once daily in patients who tolerate 100 mg, have an eGFR of 60 mL/min/1.73 m2 or greater, and need additional glycemic control. Dose adjustments: Assess renal function before starting; do not initiate if eGFR is below 45 mL/min/1.73 m2. In patients with eGFR 45 to less than 60 mL/min/1.73 m2 the dose is limited to 100 mg once daily. Correct volume depletion first and assess volume status. Ongoing use may continue at 100 mg once daily as eGFR falls below 45 in patients already tolerating it, to reduce the risk of ESKD, worsening kidney function, CV death and heart failure hospitalization (per the 2019 diabetic kidney disease indication). No dose adjustment for hepatic impairment is specified for mild to moderate impairment.

Canagliflozin (SGLT2 inhibitor (sodium-glucose co-transporter 2 inhibitor), originally Invokana (怡可安 in Chinese-language markets); Invokamet and Invokamet XR are the metformin combinations by Janssen Pharmaceuticals (Johnson & Johnson), licensed from Mitsubishi Tanabe Pharma) Canagliflozin blocks the SGLT2 protein in the kidney, so less glucose is taken back into the bloodstream and more is passed out in the urine, lowering blood sugar without relying on insulin. It also increases salt and water loss, which lowers the workload on the heart and slows the loss of kidney function in people with diabetic kidney disease. Start 100 mg orally once daily, taken before the first meal of the day. The dose may be increased to 300 mg once daily in patients who tolerate 100 mg, have an eGFR of 60 mL/min/1.73 m2 or greater, and need additional glycemic control.