৳ 40/unit
Pack: ৳ 400
৳ 40/unit
Pack: ৳ 400
At a glance
Canagliflozin is an SGLT2 inhibitor used as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus. It reduces glucose reabsorption in the kidney, leading to increased urinary glucose excretion.
Indications
- Type 2 diabetes mellitus (as an adjunct to diet and exercise)
Pharmacology
Canagliflozin is an SGLT2 inhibitor that blocks the SGLT2 transporter responsible for glucose reabsorption in the proximal renal tubule. This reduces the renal glucose threshold and increases urinary glucose excretion, lowering blood glucose levels.
Dosage
Adults (≥18 years): Recommended dose: 100 mg once daily before the first meal of the day. May increase to 300 mg once daily in patients tolerating 100 mg/day with eGFR >60 mL/min/1.73 m² and requiring additional glycemic control.
Elderly (>75 years): Starting dose: 100 mg once daily.
Renal impairment:
eGFR >60 mL/min/1.73 m²: No dose adjustment required.
eGFR 45-<60 mL/min/1.73 m²: Do not exceed 100 mg/day.
eGFR <45 mL/min/1.73 m²: Do not initiate; discontinue if eGFR falls below 45 mL/min/1.73 m².
Hepatic impairment: Mild-moderate: No dose adjustment; severe: Caution required.
Note: Not for treatment of type 1 diabetes or diabetic ketoacidosis.
Side effects
Common side effects (≥5%): Female genital mycotic infections, urinary tract infection, increased urination, increased thirst, nausea, constipation.
Other: Hypotension (postural hypotension), hyperkalemia, hypoglycemia (with other antidiabetic agents), increased LDL cholesterol, toe amputation (rare).
Serious (rare): Diabetic ketoacidosis, acute kidney injury, Fournier's gangrene (life-threatening genital infection), anaphylaxis, angioedema.
Use in pregnancy
May be unsafe during pregnancy (Category C). Limited human studies available; animal studies have shown harmful effects on the developing baby. Use only if potential benefit justifies potential risk to the fetus.
Pregnancy Category: C — always consult a doctor before taking during pregnancy.
Precautions & warnings
- Dehydration and hypotension: Increased urination may cause fluid loss; ensure adequate hydration. Caution in patients taking diuretics, NSAIDs, or renin-angiotensin system blockers for diabetes or dialysis.
- Genital fungal infections and UTIs: Practice good hygiene; inform your doctor if symptoms of infection occur.
- Hypoglycemia: Increased risk when used with insulin or sulfonylureas; monitor blood glucose regularly.
- Diabetic ketoacidosis (DKA): Risk of DKA before surgery, during acute illness, or significantly reduced food intake; monitor blood ketones.
- Renal impairment: Do not use if eGFR <45 mL/min/1.73 m²; monitor eGFR regularly.
- Toe amputation (rare): Caution in patients with peripheral vascular disease, neuropathy, or foot ulcers; perform regular foot examinations.
Overdose effects
Overdose symptoms: Hypoglycemia, dehydration, electrolyte imbalance, hypotension. No specific antidote; general supportive measures. Consult your doctor immediately if overdose is suspected.
Storage conditions
Store in a dry place away from light and heat. Keep out of reach of children.