What is the most important information I should know about canagliflozin?
You should not use canagliflozin if you have severe kidney disease or if you are on dialysis. Canagliflozin is not for treating type 1 diabetes.
What is canagliflozin?
Canagliflozin is an oral diabetes medicine that helps control blood sugar levels. Canagliflozin works by helping the kidneys get rid of glucose from your bloodstream.
Canagliflozin is used together with diet and exercise to improve blood sugar control in adults with type 2 diabetes mellitus. Canagliflozin is not for treating type 1 diabetes.
Canagliflozin may also be used for purposes not listed in this medication guide.
What should I discuss with my healthcare provider before taking canagliflozin?
You should not use canagliflozin if you are allergic to it, or if you have:
- severe kidney disease (or if you are on dialysis).
To make sure canagliflozin is safe for you, tell your doctor if you have ever had:
- kidney disease;
- liver disease;
- bladder infections or other urination problems;
- blood circulation problems;
- nerve problems caused by diabetes;
- a diabetic foot ulcer or amputation;
- an electrolyte imbalance (such as high levels of potassium in your blood);
- high cholesterol levels;
- diabetic ketoacidosis (call your doctor for treatment with insulin);
- if you are on a low salt diet; or
- if you use insulin or other oral diabetes medicines.
It is not known whether canagliflozin will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.
It is not known whether canagliflozin passes into breast milk or if it could harm a nursing baby. You should not breast-feed while using this medicine.
Canagliflozin is not approved for use by anyone younger than 18 years old.
How should I take canagliflozin?
Follow all directions on your prescription label. Your doctor may occasionally change your dose. Do not take this medicine in larger or smaller amounts or for longer than recommended.
Canagliflozin is usually taken once per day, before the first meal of the day.
You may have very low blood pressure while taking this medicine. Call your doctor if you are sick with vomiting or diarrhea, or if you are sweating more than usual. Drink plenty of liquids while you are taking canagliflozin.
Low blood sugar (hypoglycemia) can happen to everyone who has diabetes. Symptoms include headache, hunger, sweating, irritability, dizziness, nausea, fast heart rate, and feeling anxious or shaky. To quickly treat low blood sugar, always keep a fast-acting source of sugar with you such as fruit juice, hard candy, crackers, raisins, or non-diet soda.
Your doctor can prescribe a glucagon emergency injection kit to use in case you have severe hypoglycemia and cannot eat or drink. Be sure your family and close friends know how to give you this injection in an emergency.
Also watch for signs of high blood sugar (hyperglycemia) such as increased thirst or urination, blurred vision, headache, and tiredness.
Blood sugar levels can be affected by stress, illness, surgery, exercise, alcohol use, or skipping meals. Ask your doctor before changing your insulin dose or schedule.
Canagliflozin is only part of a complete treatment program that may also include diet, exercise, weight control, regular blood sugar testing, and special medical care. Follow your doctor's instructions very closely.
Canagliflozin can cause positive results with certain lab tests for glucose (sugar) in the urine. Tell any doctor who treats you that you are using canagliflozin.
Store at room temperature away from moisture and heat.
What happens if I miss a dose?
Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
What should I avoid while taking canagliflozin?
Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.
What are the possible side effects of canagliflozin?
Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have:
- a light-headed feeling, like you might pass out;
- pain or burning when you urinate;
- signs of a genital infection (penis or vagina), such as pain, burning, itching, redness, swelling, odor, or discharge;
- new pain, tenderness, sores, ulcers, or infections in your legs or feet;
-
high potassium --nausea, slow or unusual heart rate, weakness, loss of movement;
-
ketoacidosis (too much acid in the blood) --nausea, vomiting, stomach pain, confusion, unusual drowsiness, or trouble breathing;
-
kidney problems --little or no urination, swelling in your feet or ankles, feeling tired or short of breath; or
-
dehydration symptoms --feeling very thirsty or hot, being unable to urinate, heavy sweating, or hot and dry skin.
You may be more likely to have bone fractures (even after only a minor impact trauma) while you are taking canagliflozin. Talk with your doctor about how to avoid the risk of fractures.
Side effects may be more likely to occur in older adults.
Common side effects may include:
- genital infections; or
- urinating more than usual.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
What other drugs will affect canagliflozin?
Tell your doctor about all your current medicines and any you start or stop using, especially:
- a diuretic or "water pill";
- digoxin, digitalis;
- rifampin;
- ritonavir; or
- seizure medication--phenobarbital, phenytoin.
This list is not complete. Other drugs may interact with canagliflozin, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.
Where can I get more information?
Your pharmacist can provide more information about canagliflozin.
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
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