Canagliflozin is used on its own or together with other medicines to treat type 2 diabetes (a long-term condition in which the body gradually becomes resistant to the effects of insulin or the pancreas does not produce enough insulin).
This medicine helps treat your diabetes by keeping your blood sugar under control.
This medicine is meant to be taken as part of a complete diabetes care programme that should include exercise, a healthy diet and regular monitoring of blood sugar levels.
Take Canagliflozin exactly as directed by your doctor or according to the instructions on the label. Do not take more or less than instructed by your doctor.
This medicine may be taken with or without food. It is recommended to be taken before the first meal of the day. Try to take it at the same time each day.
Canagliflozin must be taken regularly for it to be effective. Continue taking this medicine even when you feel better. Do not stop taking it unless instructed by the doctor.
Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.
DO NOT double a dose under any circumstances.
If you often forget to take your medicine, let your doctor and pharmacist know.
Alert your doctor if you have severe kidney disease or if you are undergoing dialysis as Canagliflozin may not be suitable for you.
Do not breastfeed while you are being treated with this medicine.
Inform your doctor if you have the following conditions:
- history of low blood pressure
- history of fungal infection of the genital area
- prior amputation or at risk for amputation e.g. heart disease, peripheral vascular disease (narrowing of blood vessels in the feet, legs, or arms), neuropathy (nerve damage that causes tingling, numbness, and pain), or foot ulcers or sores
- history of pancreatitis (swelling of the pancreas) or have undergone pancreatic surgery
- restricted food intake
- severe dehydration
- serious illness
- alcohol abuse
- moderate kidney disease
- severe liver disease
Let your doctor know if you are pregnant.
Be sure to check with your doctor or pharmacist before giving Canagliflozin to the elderly. Elderly people may be more sensitive to the side effects.
If you are going to have an operation, including minor surgery and dental work, inform your doctor or dentist that you are taking this medicine. Your doctor may temporarily discontinue your therapy at least 3 days prior to your scheduled surgery.
It is important to check your feet regularly and adhere to the routine foot care advised by your doctor. Inform your doctor immediately if you notice any wounds or discolouration, or if you experience any tenderness or pain in your feet.
This medicine is not intended to be used for the treatment of type 1 diabetes (a long-term condition in which the pancreas produces little or no insulin) or diabetic ketoacidosis (a serious complication of diabetes characterised by a high level of blood acid in the body).
This medicine may interfere with the results of urine tests for sugar. Discuss with your doctor how you should monitor your urine tests while taking this medicine.
If you are taking this medicine with other types of anti-diabetic medicines, you may have been warned about hypoglycaemia (low blood sugar). This medicine itself does not usually cause hypoglycaemia, but it may increase the hypoglycaemic effect of other anti-diabetic medicines.
How do I know if I am experiencing hypoglycaemia?
Hypoglycaemia is the medical term for low blood sugar. Symptoms of hypoglycaemia include dizziness, tremor, shaky hands, feeling hungry, weak or confused, sweating. These signs are your body’s way of warning you that your blood sugar level is low.
It is important to recognise these symptoms and get relief for hypoglycaemia quickly, as the hypoglycaemia may worsen.
What should I do if I am experiencing hypoglycaemia?
Always carry some glucose tablets (also known as dextrose tablets) with you. Take 15 g of glucose tablet at the first sign of hypoglycaemia, wait for 15 minutes and re-check your blood sugar level. If you are not feeling better or if your blood sugar level is still low (less than 4 mmol/L or 70 mg/dL), take another 15 g of glucose tablet.
If you don’t have glucose tablets, you may take any of the following:
- 1/2 cup (120 mL) of juice or regular soda (not diet)
- 1 tablespoon of sugar, honey, or corn syrup
- hard candies, jellybeans, or gumdrops (not sugar-free)
Get medical help should symptoms did not improve after second serving.
Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.
- Routine tests (e.g. liver/kidney function, sugar/electrolyte levels) may be done while you are being treated with this medicine.
- Regular monitoring of signs and symptoms of ketoacidosis (high level of blood acid in the body), infections, foot ulcers or sores, and skin reactions may also be needed.
Your doctor will advise you about how often you need to have these tests.
Canagliflozin may cause any of the following side effects: constipation, increased thirst, nausea, and frequent and excessive urination.
Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:
- signs and symptoms of ketoacidosis e.g. nausea, vomiting, abdominal pain, tiredness, laboured breathing, fruity-smelling breath
- rashes, breathlessness, swollen mouth or eyes
- pain, tenderness, redness, or swelling in the genital or the area between the genitals and anus
- pain or burning sensation when urinating, back pain, fever or chills
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Inform your doctor and pharmacist if you are taking or using any of these medicines:
- other medicines for diabetes e.g. insulin, glimepiride
- rifampicin (medicine for tuberculosis or TB)
- medicines for epilepsy (fits or seizures) e.g. phenytoin, phenobarbital, carbamazepine
- ritonavir (medicine for HIV infection)
- colestyramine (cholesterol-lowering medicine)
- water pills or medicines for water retention e.g. furosemide
- digoxin (medicine for heart disease)
- St. John’s wort (herbal medicine)
This list does not include all medicines that may interact with Canagliflozin.
Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements and medicines that you buy without a prescription.
It is important for you to maintain a healthy diet and weight in order to help keep your diabetes under control.
It may be helpful to discuss your diet plan with your doctor or dietitian to manage your weight and blood sugar levels.
Store in a cool, dry place away from the reach of children.
Medicines must not be used past the expiry date.