Patients with hypovolemia may be more susceptible to these changes. Renal function abnormalities can occur after initiating canagliflozin. Hyperkalemia Canagliflozin can lead to hyperkalemia. Patients with moderate renal impairment who are taking medications that interfere with potassium excretion, such as potassium-sparing diuretics, or medications that interfere with the RAAS are more likely to develop hyperkalemia.
Serum potassium levels should be monitored after initiating canagliflozin in patients with impaired renal function and in patients who are predisposed to hyperkalemia as a result of medications or other medical conditions. Hypoglycemia Associated with Concomitant Use of Insulin and Insulin Secretagogues Insulin and insulin secretagogues are known to cause hypoglycemia.
Canagliflozin can increase the risk of hypoglycemia when combined with insulin or an insulin secretagogue. Therefore, a lower dose of insulin or of insulin secretagogue may be required to minimize the risk of hypoglycemia when used in combination with canagliflozin. Genital Mycotic Infections Canagliflozin increases the risk for genital mycotic infections. Patients with a history of genital mycotic infections and uncircumcised males are more likely to develop genital mycotic infections.
Patients should be monitored and treated appropriately. Hypersensitivity Reactions Hypersensitivity reactions eg, generalized urticaria , some serious, were reported with treatment with canagliflozin; these reactions generally occurred within hours to days after initiating canagliflozin.
If hypersensitivity reactions occur, canagliflozin should be discontinued, and patients should be treated according to the standard of care and monitored until the signs and symptoms resolve. Increases in Low-Density Lipoprotein Cholesterol Dose-related increases in low-density lipoprotein cholesterol occur with canagliflozin.
Low-density lipoprotein cholesterol should be monitored and patients should be treated per standard of care after initiating canagliflozin.
Macrovascular Outcomes No clinical studies have established conclusive evidence of macrovascular risk reduction with canagliflozin or with any other antidiabetic drug.
Conclusion In March , canagliflozin, an oral SGLT2 inhibitor, became the first member in this drug class to receive FDA approval for the management of patients with type 2 diabetes.
Canagliflozin is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes. This medication has a novel mode of action: by inhibiting the SGLT2 in the proximal renal tubules, canagliflozin reduces glucose reabsorption in the kidney and increases the amount of glucose excreted in the urine.
Canagliflozin was evaluated for safety and efficacy in 9 clinical trials involving more than 10, patients with type 2 diabetes. In these studies, canagliflozin was shown to improve HbA 1c levels and fasting plasma glucose. Stay up to date on the latest information you need to devise benefit designs, make coverage decisions, and further value-based healthcare! Sign up for our newsletter or print publications today by entering your contact information below and clicking "Subscribe".
Loretta Fala. Download PDF. Table 3 Contraindications Canagliflozin is contraindicated in patients with a serious hypersensitivity reaction to canagliflozin, as well as in patients with severe renal impairment, patients with end-stage renal disease, or patients on dialysis. You can help slow this increased spending by working with your HCPs to make sure that your care is "personalized" to what you need.
Take a look at our patient guide diaTribe. The issue features a learning curve about SGLT-2 inhibitor medications. It also includes our interview with Dr. The FDA approval for Invokana is also good news for people with type 1 diabetes — it is thought that they may benefit from this therapy, and there is work from various companies to see if SGLT-2 inhibitors might help treat type 1 diabetes.
Skip to main content. Published: Oct 01, By Alex Keown. On Monday, the U. Specifically, the FDA approved Invokana canagliflozin as a treatment to reduce the risk of end-stage kidney disease ESKD , worsening of kidney function, cardiovascular death, and hospitalization for heart failure in adults with type 2 diabetes and diabetic kidney disease nephropathy with a certain amount of protein in the urine.
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