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.
Canagliflozin 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.
This medicine may be used to treat other conditions as decided by your doctor.
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.
You may take this medicine with or without food. It is best to take this medicine 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.
Inform your doctor if you have the following conditions:
- history of low blood pressure
- heart disease
- stomach or bowel illness
- problems in your pancreas
- having changes in diet or eating less
- severe excessive water loss from the body
- low volume of circulating fluids in the body
- history of fungal infections in the genital
- kidney disease
- severe liver disease
Let your doctor know if you are pregnant or breastfeeding.
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.
Notify your doctor if you consume large amounts of alcohol or if you are a frequent drinker.
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.
Canagliflozin 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.
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.
Why is it important to keep my appointments with the doctor?
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. kidney function, sugar levels) may be done while you are being treated with this medicine. Your doctor will advise you about how often you need to have these tests.
- Your blood pressure may fall to unsafe levels without you noticing it. Monitor your blood pressure regularly during treatment.
- Regular monitoring of signs and symptoms of infections in the genitals or urinary tract, allergic reactions and diabetic ketoacidosis (complication of diabetes characterised by high level of blood acid in your body) may also be needed.
To help control your diabetes, it is important to continue following the diet and exercise recommended by your doctor while you are taking Canagliflozin.
If you are taking this medicine with other types of oral 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 oral 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, and 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 grams 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 grams 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 not improve after the second serving.
Canagliflozin may cause any of the following side effects: constipation, nausea, thirst, and frequent urination.
Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:
- signs and symptoms of diabetic ketoacidosis e.g. nausea, vomiting, stomach pain, tiredness, shortness of breath
- pain or tenderness, swelling, skin redness in the area between and around the anus and genital
- genital itching and irritation, unusual discharge or genital odour
- pain or difficulty in passing urine, change in how much urine is passed, blood in the urine
- muscle pain or weakness, fast or abnormal heartbeat, mood changes, confusion
- signs and symptoms of allergic reactions e.g. rashes, breathlessness, swelling of the face, eyes or mouth
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 any of these medicines:
- other medicines for diabetes e.g. insulin, glimepiride, glipizide
- water pills or medicines for water retention
- medicines for HIV infection e.g. efavirenz, ritonavir
- rifampicin (medicine to treat TB [lung infection known as tuberculosis])
- medicines for epilepsy (fits or seizures) e.g. phenytoin, phenobarbital, carbamazepine
- lithium (medicine for mood disorders)
- colestyramine (cholesterol-lowering medicine)
- 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 medicine, supplements, and medicines that you buy without a prescription.
Avoid alcohol.
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.
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