Canagliflozin

Canagliflozin

Did you know that diabetes affects millions of people worldwide? As the prevalence of this disease continues to increase every year, researchers and doctors work tirelessly to develop effective treatments. One such medication for diabetes mellitus that has gained attention is canagliflozin. This drug offers a new approach to managing blood sugar levels & has shown positive results in clinical trials.
This blog will explore the uses of canagliflozin drugs, their proper administration, potential side effects, and necessary precautions. 

What is Canagliflozin?

It is a medication used to treat type2 diabetes. It belongs to a class of drugs called sodium-glucose co-transporter 2 (SGLT2) inhibitors. Doctors prescribe canagliflozin alongside diet and exercise, and sometimes in combination with other medications, to lower blood glucose in type II diabetes patients.

Canagliflozin Uses

Canagliflozin tablets have several essential uses, such as: 

• The primary use of canagliflozin drug is to control blood sugar levels in type 2 diabetics. It works by prompting your kidneys to get rid of more glucose through urine, lowering blood sugar levels. This action helps manage the condition where blood sugar is too high due to the body's inability to produce or use insulin normally.
• Beyond blood sugar control, canagliflozin has additional benefits for people with type 2 diabetes who also have heart and blood vessel disease. It reduces the risk of serious cardiovascular events such as stroke and heart attack. 
• For those with severe kidney disease alongside type 2 diabetes, the canagliflozin drug helps to reduce the risk of end-stage kidney disease, worsening kidney function, and the need for hospitalisation due to heart failure.

How to Use Canagliflozin Tablets

Patients should follow these guidelines:

• Take the medicine exactly as directed by the doctor. Do not alter the dosage or duration without medical advice.
• Consume the tablet before the day's first meal.
• Adhere to the special meal plan provided by the doctor. This is vital for controlling diabetes and ensuring the medicine works effectively.
• Exercise regularly and test blood or urine sugar levels as instructed.
• Older adults are at greater risk for some side effects from canagliflozin.
• If a dose is missed, take it as soon as possible. However, if it's almost time for the next dose, skip the missed one and return to the regular schedule. Never take double doses.

Side Effects of Canagliflozin Tablet

Canagliflozin, like all medications, may cause unwanted effects alongside its intended benefits. These side effects range from common to rare; some may require immediate medical attention.

• More common canagliflozin side effects include bladder pain, changes in urination patterns, an increased urge to urinate, especially at night, or cloudy or bloody urine. 
• Some individuals report indigestion, nausea, and vomiting. 
• Swelling in the face, eyes, fingers, or lower legs
• Less common side effects encompass a variety of symptoms: 
• Anxiety and depression
• Blurred vision
• Confusion  
• Dizziness
• Dry mouth
• Headaches
• Ketoacidosis
• Vaginal yeast infections in women 
• Penile yeast infections in men
• Skin-related issues such as hives, itching, or rashes may also occur. 
• In rare cases, patients might have seizures or slurred speech.

Precautions

Patients taking canagliflozin should be aware of several vital precautions. Regular check-ups and consultations with your endocrinologist are essential to monitor for unwanted effects. 

• Precaution for Pregnancy: Pregnant women should avoid this medication during the second and third trimesters. It can harm the unborn baby.
• Precaution for Skin Trauma: Canagliflozin increases the risk of leg, toe, or midfoot amputation. Patients should promptly report any pain, tenderness, sores, ulcers, or infections on the legs or feet to their doctor. The medicine may need dose adjustment in those with kidney disease. 
• Manage Position: Canagliflozin increases the risk of low blood pressure. To mitigate this, patients should rise slowly from a lying position.
• Other Conditions: The medication elevates the risk of bone fractures and urinary tract infections. Patients should discuss ways to keep their bones strong and report any signs of urinary tract infections to their doctor.

How Canagliflozin Tablet Works

Canagliflozin targets a specific protein in the kidneys called sodium-glucose co-transporter 2 (SGLT2). This protein plays a crucial role in glucose reabsorption. SGLT2 is located in the kidney's proximal tubules, where it usually reabsorbs filtered glucose from the renal tubular lumen.
When a person takes canagliflozin, it inhibits the SGLT2 co-transporter. This inhibition leads to several effects:

• Reduced Glucose Reabsorption: The drug decreases the amount of filtered glucose that gets reabsorbed into the body.
• Lowered Renal Threshold for Glucose (RTG): Canagliflozin decreases the RTG in a dose-dependent manner.
• Increased Urinary Glucose Excretion: As a result of the above effects, more glucose is excreted in the urine.

The result of these actions is a decrease in glucose concentration in the blood, improving glycemic control in people with type 2 diabetes.

Can I Take Canagliflozin with Other Medicines?

Some medications may affect how the body processes canagliflozin. 

• For instance, abacavir might decrease the excretion rate of canagliflozin, potentially leading to higher serum levels. 
• Similarly, abametapir and abrocitinib can increase the serum concentration of canagliflozin.
• Conversely, canagliflozin can impact the effectiveness of other drugs. It may increase the serum concentration of abemaciclib, for example. 
• The severity of adverse effects can also be heightened when canagliflozin is combined with certain medications, such as abaloparatide.

Dosing Information

Canagliflozin comes in tablet form and is available in 100mg and 300mg strengths. For adults with type 2 DM, the initial dose is 100mg taken orally once daily before the first meal. If tolerated well and additional glycemic control is needed, the dose may be increased to 300mg daily for patients with an eGFR ≥60 mL/min/1.73 m².

Conclusion

Canagliflozin impacts diabetes management by offering a unique approach to blood sugar control. It helps patients with type 2 diabetes lower their glucose levels and has additional benefits for those with heart and blood vessel disease. The medication's ability to reduce the risk of serious cardiovascular events and end-stage kidney disease makes it an asset in the treatment arsenal. However, patients and doctors must weigh these benefits against potential side effects and take necessary precautions.

FAQ's

1. What is canagliflozin mainly used for?

Canagliflozin is primarily used to manage and control type 2 diabetes mellitus. It lowers blood sugar levels in adults when used alongside diet and exercise. Additionally, it reduces the risk of major cardiovascular events in people with type 2 diabetes or established cardiovascular disease. Canagliflozin also lowers the risk of end-stage kidney disease & hospitalisation for heart failure in adults with type 2 diabetes and diabetic nephropathy.

2. Who needs to take canagliflozin?

Adults with type 2 diabetes who require better glycemic control may benefit from canagliflozin. 

3. Is it bad to use canagliflozin every day?

Canagliflozin is designed for daily use. Patients typically take it once a day before their first meal. It's essential to take the medication as a doctor prescribes and not alter the dosage without medical advice.

4. Is canagliflozin safe?

Canagliflozin is generally safe when used as directed. However, it can have side effects, including an increased risk of lower limb amputations in people with cardiovascular disease. Other potential side effects include genital mycotic infections, urinary tract infections, and volume depletion-related events.

5. Who Cannot use canagliflozin?

Canagliflozin is contraindicated in patients on dialysis. It's not recommended for initiation in patients with an estimated GFR below 30 mL/min/1.73 m². Pregnant women, especially during the second and third trimesters, should avoid using canagliflozin.

6. Is canagliflozin safe for kidneys?

Canagliflozin has shown benefits for kidney health in certain patients. It can reduce the risk of end-stage kidney disease and worsening kidney function in adults with type 2 diabetes and diabetic nephropathy. 

7. Can I take canagliflozin at night?

Canagliflozin is typically taken before the day's first meal, usually in the morning. Doctors generally do not recommend taking it at night.

8. What is the best time to take canagliflozin?

The best time to take canagliflozin is before the first meal of the day, preferably in the morning. This timing allows the drug to reduce postprandial plasma glucose excursions by delaying intestinal glucose absorption.