Canagliflozin

Canagliflozin treats type 2 diabetes. Canagliflozin can cause yeast infections and urinary tract infections.

Canagliflozin Overview

Reviewed: July 9, 2014

Updated: September 10, 2015

Canagliflozin is a prescription medication used to treat type 2 diabetes. It belongs to a group of drugs called sodium-glucose co-transporter 2 (SGLT2) inhibitors. Canagliflozin lowers blood sugar by causing the kidneys to get rid of more glucose in the urine.

This medication comes in tablet form. It is taken by mouth, usually once daily before breakfast.

Common side effects include yeast infections and urinary tract infections.

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Canagliflozin Cautionary Labels

Uses of Canagliflozin

Canagliflozin is a prescription medication used to treat type 2 diabetes.

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Canagliflozin Brand Names

Canagliflozin may be found in some form under the following brand names:

Canagliflozin Drug Class

Canagliflozin is part of the drug class:

Other blood glucose lowering drugs, excl. insulins

Side Effects of Canagliflozin

Serious side effects have been reported. See "Precautions" section.

Common side effects include:

vaginal yeast infections and yeast infections of the penis
urinary tract infection
changes in urination, including urgent need to urinate more often, in larger amounts, or at night

This is not a complete list of canagliflozin side effects. Ask your doctor or pharmacist for more information.

Canagliflozin Interactions

Tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

diuretics (water pills)
rifampin (used to treat or prevent tuberculosis)
phenytoin or phenobarbital (used to control seizures)
ritonavir (Norvir, Kaletra, Lopinavir) (used to treat HIV infection)
digoxin (Lanoxin) (used to treat heart problems)

This is not a complete list of canagliflozin drug interactions. Ask your doctor or pharmacist for more information.

Canagliflozin Precautions

Do not take canagliflozin if you:

are allergic to canagliflozin or any of the ingredients in canagliflozin. Symptoms of allergic reaction to canagliflozin may include:
- rash
- raised red patches on your skin (hives)
- swelling of the face, lips, tongue, and throat that may cause difficulty in breathing or swallowing
have severe kidney problems or are on dialysis.

Canagliflozin can cause side effects, including:

Dehydration. Canagliflozin can cause some people to have dehydration (the loss of body water and salt). Dehydration may cause you to feel dizzy, faint, lightheaded, or weak, especially when you stand up (orthostatic hypotension).
You may be at higher risk of dehydration if you:
- have low blood pressure
- take medicines to lower your blood pressure, including diuretics (water pill)
- are on low sodium (salt) diet
- have kidney problems
- are 65 years of age or older
Vaginal yeast infection. Women who take canagliflozin may get vaginal yeast infections. Symptoms of a vaginal yeast infection include:
- vaginal odor
- white or yellowish vaginal discharge (discharge may be lumpy or look like cottage cheese)
- vaginal itching
Yeast infection of the penis (balanitis or balanoposthitis). Men who take canagliflozin may get a yeast infection of the skin around the penis. Certain men who are not circumcised may have swelling of the penis that makes it difficult to pull back the skin around the tip of the penis. Other symptoms of yeast infection of the penis include:
- redness, itching, or swelling of the penis
- rash of the penis
- foul smelling discharge from the penis
- pain in the skin around penis

Talk to your doctor about what to do if you get symptoms of a yeast infection of the vagina or penis. Your doctor may suggest you use an over-the-counter antifungal medicine. Talk to your doctor right away if you use an over-the-counter antifungal medication and your symptoms do not go away.

kidney problems
a high amount of potassium in your blood (hyperkalemia)
low blood sugar (hypoglycemia). If you take canagliflozin with another medicine that can cause low blood sugar, such as a sulfonylurea or insulin, your risk of getting low blood sugar is higher. The dose of your sulfonylurea medicine or insulin may need to be lowered while you take canagliflozin.
Signs and symptoms of low blood sugar may include:

headache
drowsiness
weakness
dizziness
confusion
irritability
hunger
fast heart-beat
sweating
shaking or feeling jittery

serious allergic reaction. If you have any symptoms of a serious allergic reaction, stop taking canagliflozin and call your doctor right away or go to the nearest hospital emergency room. Your doctor may give you a medicine for your allergic reaction and prescribe a different medicine for your diabetes.
bone fractures. Patients taking canagliflozin are at an increased risk of bone fractures. In addition, this medication may decrease bone mineral density.

Do not take canagliflozin if you:

are allergic to canagliflozin or any of its ingredients. Symptoms of allergic reaction to canagliflozin may include:
- rash
- raised red patches on your skin (hives)
- swelling of the face, lips, tongue, and throat that may cause difficulty in breathing or swallowing
have severe kidney problems or are on dialysis.

Canagliflozin Food Interactions

Medications can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of canagliflozin, there are no specific foods that you must exclude from your diet when receiving this medication.

Inform MD

Before you take canagliflozin, tell your doctor if you:

have kidney problems
have liver problems
are on a low sodium (salt) diet. Your doctor may change your diet or your dose of canagliflozin.
have ever had an allergic reaction to canagliflozin
have other medical conditions
are pregnant or plan to become pregnant. It is not known if canagliflozin will harm your unborn baby. If you are pregnant, talk with your doctor about the best way to control your blood sugar while you are pregnant.
are breastfeeding or plan to breastfeed. It is not known if canagliflozin passes into your breast milk. Talk with your doctor about the best way to feed your baby if you are taking canagliflozin.

Tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements.

Canagliflozin and Pregnancy

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

Canagliflozin falls into catagory C. In animal studies, pregnant animals were given this medication and had some babies born with problems. No well-controlled studies have been done in humans. Therefore, this medication may be used if the potential benefits to the mother outweigh the potential risks to the unborn child.

Canagliflozin and Lactation

It is not known if canagliflozin crosses into human milk. Because many medications can cross into human milk and because of the possibility for serious adverse reactions in nursing infants with use of this medication, a choice should be made whether to stop nursing or stop the use of this medication. Your doctor and you will decide if the benefits outweigh the risk of using canagliflozin.

Canagliflozin Usage

Take canagliflozin by mouth 1 time each day exactly as your doctor tells you to take it.
Your doctor will tell you how much canagliflozin to take and when to take it. Your doctor may change your dose if needed.
It is best to take canagliflozin before the first meal of the day.
Your doctor may tell you to take canagliflozin along with other diabetes medicines. Low blood sugar can happen more often when canagliflozin is taken with certain other diabetes medicines.
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take two doses of canagliflozin at the same time. Talk to your doctor if you have questions about a missed dose.
If you take too much canagliflozin, call your doctor or go to the nearest hospital emergency room right away.
When your body is under some types of stress, such as fever, trauma (such as a car accident), infection, or surgery, the amount of diabetes medicine you need may change. Tell your doctor right away if you have any of these conditions and follow your doctor's instructions.
Stay on your prescribed diet and exercise program while taking canagliflozin.
Check your blood sugar as your doctor tells you to.
Canagliflozin will cause your urine to test positive for glucose.
Your doctor may do certain blood tests before you start canagliflozin and during treatment as needed. Your doctor may change your dose of canagliflozin based on the results of your blood tests.
Your doctor will check your diabetes with regular blood tests, including your blood sugar levels and your hemoglobin A1C.

Canagliflozin Dosage

The recommended starting dose of canagliflozin is 100 mg once daily, taken before the first meal of the day. If necessary, the dose can be increased to 300 mg once daily.