canagliflozin hemihydrate at a glance
Medicine class
Sodium-glucose co-transporter 2 (SGLT2) inhibitor
Licensed use
Insufficiently controlled type 2 diabetes in adults and children aged 10 years and older
Taking the tablet
Swallow whole; it may be taken with or without food
Low blood sugar
Risk is greatest when combined with insulin or a sulphonylurea
What is canagliflozin hemihydrate used for?
Licensed uses include:
Treating insufficiently controlled type 2 diabetes in adults and children aged 10 years and older, alongside diet and exercise.
Use alone when metformin is contraindicated or not tolerated.
Use with other diabetes treatments.
How does canagliflozin hemihydrate work?
Canagliflozin blocks SGLT2 in the kidney. This reduces glucose reabsorption, so more glucose leaves the body in urine and blood glucose falls independently of insulin. It can also increase urination and reduce circulating fluid volume.
canagliflozin hemihydrate preparations and strengths
Tablet
Route: Oral
Strengths: 100 mg, 300 mg
How to take canagliflozin hemihydrate
Follow the dispensing label and prescriber’s instructions.
Swallow the film-coated tablet whole.
It can be taken with or without food.
Continue the agreed diet and exercise measures.
canagliflozin hemihydrate side effects
Common or expected effects
- Genital thrush or inflammation around the penis or foreskin
- Urinary tract infection
- Passing urine more often or in larger amounts
- Thirst, nausea or constipation
- Low blood sugar when used with insulin or a sulphonylurea
Get urgent medical advice
- Diabetic ketoacidosis, which can occur without markedly raised blood glucose
- Severe allergic reaction or angioedema
- Severe dehydration, fainting or passing very little urine
- Fournier’s gangrene: painful, red or swollen genital or perineal tissue with fever or malaise
- Complicated urinary infection with fever, chills or back or side pain
- New foot ulcer, infection, discolouration, tenderness or pain
canagliflozin hemihydrate in pregnancy
Canagliflozin should not be used during pregnancy. Anyone planning pregnancy or who becomes pregnant while taking it should promptly contact their diabetes or maternity team for review.
canagliflozin hemihydrate while breastfeeding
Canagliflozin should not be used while breastfeeding because transfer into human milk is unknown and a risk to the infant cannot be excluded. Discuss an alternative with the prescriber.
canagliflozin hemihydrate interactions
Important interactions include:
Insulin and sulphonylureas
The combination increases the risk of hypoglycaemia and may require review of the accompanying diabetes treatment.
Diuretics and antihypertensives
Additive fluid loss or blood-pressure lowering can increase dehydration, dizziness and hypotension.
Rifampicin, carbamazepine, phenytoin, phenobarbital, efavirenz, ritonavir and St John’s wort
Enzyme or transporter induction may reduce canagliflozin exposure and glucose-lowering effect.
Common questions about canagliflozin hemihydrate
Answers are fully visible for fast scanning and source review.
Is canagliflozin hemihydrate the same as canagliflozin?
Canagliflozin hemihydrate is the hydrated crystal form used in the tablet; product strength is expressed as the equivalent amount of canagliflozin.
Is canagliflozin hemihydrate insulin?
No. It reduces glucose reabsorption in the kidneys rather than replacing insulin.
Can it cause glucose in urine tests?
Yes. Glucose-positive urine is expected because it increases urinary glucose excretion.
Can it cause ketoacidosis with normal blood glucose?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.