Canagliflozin

Canagliflozin, sold under the brand name Invokana among others, is a medication used to treat type 2 diabetes. It is less preferred than metformin. It is used together with exercise and diet. It is not recommended in type 1 diabetes. It is taken by mouth. Canagliflozin, sold under the brand name Invokana among others, is a medication used to treat type 2 diabetes. It is less preferred than metformin. It is used together with exercise and diet. It is not recommended in type 1 diabetes. It is taken by mouth. Common side effects include vaginal yeast infections, nausea, constipation, and urinary tract infections. Serious side effects may include low blood sugar, Fournier's gangrene, leg amputation, kidney problems, high blood potassium, and low blood pressure. Diabetic ketoacidosis may occur despite nearly normal blood sugar levels. Use in pregnancy and breastfeeding is not recommended. Canagliflozin is a sodium-glucose cotransporter 2 (SGLT2) inhibitor. It works by increasing the amount of glucose lost in the urine. Canagliflozin was approved for medical use in the United States in 2013. A month's supply in the United Kingdom costs the NHS about £39.20 as of 2019. In the United States the wholesale cost of this amount is about US$475.20. In 2016 it was the 194th most prescribed medication in the United States with more than 3 million prescriptions. Canagliflozin is an anti-diabetic medication used to improve blood sugar control in people with type 2 diabetes. It less preferred than metformin. Per the British National Formulary it is also less preferred than a sulfonylurea as of 2019 while the American Diabetes Association and European Association for the Study of Diabetes consider either a SGLT2 inhibitor or GLP-1 receptor agonist a reasonable second line medication in those with heart disease. Canagliflozin decreases HbA1c levels by 0.77% to 1.16% when given by itself, in combination with metformin, in combination with metformin and a sulfonylurea, in combination with metformin and pioglitazone, or in combination with insulin, from initial HbA1c levels of 7.8% to 8.1%. When added to metformin, canagliflozin does not appear worse than sitagliptin or glimepiride in reducing HbA1c levels, while canagliflozin maybe better than sitagliptin and glimiperide in decreasing HbA1c. It is unclear whether or not it has any unique cardiovascular benefits beyond lowering blood sugar. Although canagliflozin produces beneficial effects on HDL cholesterol, it has also been shown to increase LDL cholesterol to produce no change in total cholesterol. Evidence shows that apart from positive effects on glycemic levels, canagliflozin also provides reduces the risk of heart attacks and heart failures. SGLT2 inhibitors, including canagliflozin, reduce the likelihood of hospitalization for congestive heart failure or progression of renal disease in persons with diabetes mellitus type 2 and reduce the likelihood of stroke and heart attack in persons with diabetes mellitus type 2 who have known atherosclerotic vascular disease.