InvoKana 100 mg (CANAGLIFLOZIN)

Invokana 100 mg Tablet, containing Canagliflozin 100 mg, is a prescription SGLT2 inhibitor by Johnson & Johnson Pvt Ltd. Available in strips of 10 film-coated tablets (yellow, capsule-shaped, marked “CFZ” and “100”), it treats type 2 diabetes mellitus, reduces cardiovascular risks, and manages diabetic kidney disease in adults and children ≥10 years. Requires a prescription due to risks of diabetic ketoacidosis, dehydration, and amputation.

Uses

• Manages type 2 diabetes mellitus (with diet/exercise, alone or with other antidiabetics like metformin or sitagliptin)

• Reduces risk of heart attack, stroke, or heart failure hospitalization in type 2 diabetes patients with heart disease

• Slows progression of diabetic kidney disease (reduces end-stage kidney disease risk) in type 2 diabetes patients with albuminuria >300 mg/day

• Lowers hospitalization risk for heart failure in type 2 diabetes patients with kidney disease

Side Effects

• Common: Genital yeast infections, urinary tract infections, frequent urination, dehydration (thirst, dizziness), low blood pressure, constipation

• Rare: Diabetic ketoacidosis (DKA; nausea, fruity breath, rapid breathing), Fournier’s gangrene (genital pain), lower limb amputation (toe/midfoot), bone fractures

• Serious: Acute kidney injury, severe infections (e.g., urosepsis), hypoglycemia (with insulin/sulfonylureas), severe allergic reactions

Seek emergency help for DKA, severe genital pain, or breathing issues. Consult a doctor for persistent side effects.

How to Use

• Dosage: Adults/children ≥10 years: 100 mg once daily, taken before the first meal. May increase to 300 mg if eGFR ≥60 mL/min/1.73m² and additional glycemic control needed. Not for eGFR <45 mL/min/1.73m² initiation.

• Administration: Swallow whole with water, with or without food (preferably before breakfast).

• Missed Dose: Take as soon as remembered unless near next dose; skip and resume schedule. Do not double dose.

• Overdose: Seek urgent help for severe dizziness, dehydration, or hypoglycemia.

How Tablet Works

Canagliflozin inhibits sodium-glucose co-transporter 2 (SGLT2) in the kidneys, blocking ~90% of glucose reabsorption, excreting excess glucose (~70–90 g/day) and sodium via urine. This lowers blood sugar in type 2 diabetes, reduces blood volume to ease heart workload, and slows kidney disease progression. Peak plasma concentration occurs in 1–2 hours; bioavailability ~65%; half-life ~10.6 hours.

Safety Advice

• Allergies: Avoid if allergic to Canagliflozin or excipients (e.g., lactose, microcrystalline cellulose).

• Health Conditions: Contraindicated in type 1 diabetes, severe kidney disease (eGFR <30 mL/min/1.73m²), dialysis, or history of DKA. Caution in low blood pressure, severe liver disease, or amputation risk factors (e.g., peripheral artery disease).

• Drug Interactions:

  • Increased hypoglycemia risk with insulin/sulfonylureas (e.g., glimepiride) or HQ-Star (Hydroxychloroquine).

  • Increased dehydration risk with diuretics (e.g., furosemide).

  • Rifampicin reduces efficacy; monitor glucose or adjust dose.

  • Digoxin levels may increase; monitor closely.

  • List all medications to doctor.

• Pregnancy/Breastfeeding: Unsafe in second/third trimesters (fetal kidney risk); avoid breastfeeding due to potential kidney harm. Consult doctor.

• Driving: Avoid if dizzy, lightheaded, or hypoglycemic symptoms occur.

• Alcohol: Unsafe; increases DKA risk and may alter blood sugar.

• Storage: Store at 20–25°C, away from moisture, heat, and children.