canagliflozin, Invokana

GENERIC NAME: canagliflozin

BRAND NAME: Invokana

DRUG CLASS AND MECHANISM: Canagliflozin is an oral drug that reduces blood sugar (glucose) levels in patients with type 2 diabetes. It is a new type of diabetes medication in a class of medications called sodium-glucose co-transporter 2 (SGLT2) inhibitors. Under normal conditions, glucose is filtered out of the blood and into the kidney tubules as blood passes through the kidneys. The glucose then as absorbed from the tubules back into the blood so that glucose is not lost in the urine. SGLT2 is an enzyme in the kidney tubule that causes glucose to be reabsorbed from urine. Canagliflozin blocks the action of SGLT2. Therefore, canagliflozin reduces the reabsorption of glucose from renal tubules, leading to more excretion of glucose in urine. Canagliflozin was approved by the FDA in March 2013.



PREPARATIONS: Tablets: 100 and 300 mg

STORAGE: Tablets should be stored at room temperature, 15 C to 30 C (59 F to 86 F)

PRESCRIBED FOR: Canagliflozin is combined with diet and exercise to improve blood glucose levels in patients with type 2 diabetes.

DOSING: Canagliflozin should be taken before the first meal of the day. The recommended starting dose is 100 mg once daily and the maximum dose is 300 mg once daily. Renal function should be assessed prior to starting canagliflozin and periodically during treatment, and the dose of canagliflozin should be modified based on renal function.

DRUG INTERACTIONS: Canagliflozin may slightly increase the concentration of digoxin (Lanoxin) in the body when both drugs are being taken. Digoxin concentrations should be monitored appropriately.

Rifampin, phenytoin (Dilantin, Dilantin-125, phenobarbital, and ritonavir (Norvir) may reduce the effect of canagliflozin by increasing its elimination and reducing its concentration in the body. The dose of canagliflozin should be increased to 300 mg daily when combined with rifampin, phenytoin, phenobarbital, or ritonavir.

PREGNANCY: There are no adequate studies of canagliflozin in pregnant women.

NURSING MOTHERS: It is unknown whether canagliflozin is secreted in human breast milk.

SIDE EFFECTS AND PRECAUTIONS: The most common side effects of canagliflozin are urinary tract infections, female genital fungal infections, and increased urination. Other side effects of canagliflozin include low blood pressure, increased potassium blood levels (hyperkalemia), low blood glucose, and increased cholesterol.

REFERENCE: FDA prescribing information.

Medically Reviewed by a Doctor on 4/10/2013

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