From the Guidelines
Invokana (canagliflozin) is recommended at an initial dose of 100 mg once daily for patients with type 2 diabetes, with the option to increase to 300 mg once daily if needed for better glycemic control and if the patient tolerates the medication well. This recommendation is based on the most recent and highest quality study, which demonstrated the efficacy and safety of canagliflozin in reducing cardiovascular events and kidney disease progression in patients with type 2 diabetes 1. The medication works by inhibiting sodium-glucose cotransporter 2 (SGLT2) in the kidneys, which reduces glucose reabsorption and increases urinary glucose excretion, thereby lowering blood glucose levels.
Some key points to consider when prescribing Invokana include:
- Patients should maintain adequate hydration while taking this medication and be aware of potential side effects including genital mycotic infections, urinary tract infections, and increased urination.
- Invokana should be used cautiously in patients with renal impairment and is not recommended when eGFR is below 30 mL/min/1.73m².
- The medication offers additional benefits beyond glucose control, including weight loss and reduction in cardiovascular events and heart failure hospitalizations in patients with established cardiovascular disease.
- Regular monitoring of kidney function, blood pressure, and cholesterol levels is important during treatment.
- Invokana can be used as monotherapy or in combination with other antidiabetic medications like metformin, sulfonylureas, or insulin.
It's also important to note that canagliflozin has been associated with an increased risk of lower-limb amputation and fracture, and should be used with caution in patients with a history of these conditions 1. Additionally, the medication may increase the risk of diabetic ketoacidosis, and patients should be educated on the signs and symptoms of this condition 1. Overall, the benefits of Invokana in reducing cardiovascular and kidney disease risk make it a valuable treatment option for patients with type 2 diabetes, and its use should be considered in accordance with the patient's individual needs and medical history.
From the FDA Drug Label
INVOKANA (canagliflozin) is indicated: as an adjunct to diet and exercise to improve glycemic control in adults and pediatric patients aged 10 years and older with type 2 diabetes mellitus The recommended starting dosage of INVOKANA is 100 mg orally once daily to improve glycemic control, taken before the first meal of the day For additional glycemic control, the dosage of INVOKANA may be increased to the maximum recommended dosage of 300 mg once daily
The recommended usage of Invokana (canagliflozin) for patients with type 2 diabetes is:
- As an adjunct to diet and exercise to improve glycemic control
- Starting dosage: 100 mg orally once daily
- Maximum recommended dosage: 300 mg once daily
- To be taken before the first meal of the day 2
From the Research
Recommended Usage of Invokana (Canagliflozin)
The recommended usage of Invokana (canagliflozin) for patients with type 2 diabetes is as follows:
- Canagliflozin is indicated for the once-daily oral treatment of type 2 diabetes (T2D) [ 3 ].
- It can be used as first-line monotherapy or add-on therapy to other antihyperglycaemic agents [ 3 , 4 ].
- Canagliflozin improves glycaemic control in adults with T2D, including those of older age and/or at high cardiovascular (CV) risk [ 3 ].
- It also has beneficial effects on bodyweight and blood pressure (BP) [ 3 , 4 ].
Dosage and Administration
- The dosage of canagliflozin should be adjusted according to the patient's renal function [ 4 ].
- Canagliflozin can be used in combination with metformin alone or with other antihyperglycemic agents [ 5 ].
Safety Profile
- Canagliflozin is generally well tolerated, with a low risk of hypoglycaemia [ 3 , 4 ].
- The most frequently reported adverse events with canagliflozin are female genital mycotic infections, urinary tract infections, and increased urination [ 3 , 4 ].
- An increased risk of amputations was observed in the CANVAS program, which requires further study [ 6 ].