How Does Canagliflozin Work?


Canagliflozin is a prescription medication for diabetes that is taken once a day, usually before the first meal of the day. The dose is based on the individual's medical condition, the response to the treatment, and the presence of other medications. To be effective, it is important to take canagliflozin at the same time each day. However, this medication does have some side effects, including amputation.


Inhibition of SGLT2 transporter


The sodium-glucose co-transporter-2 (SGLT2) inhibitors are the newest class of oral glucose-lowering agents. They work by increasing urinary glucose excretion, leading to decreased blood glucose concentrations. Because they inhibit SGLT2, they can be used in conjunction with other glucose-lowering drugs. There are a few caveats, though.

Canagliflozin is effective in lowering fasting glucose and reducing A1C. It can be taken with or without metformin, depending on the patient's glycemic needs. However, there are concerns about the safety signals. Further data will be necessary to exclude the possibility of an elevated risk of cancer. Despite these concerns, the SGLT2 inhibitors are not without benefits for diabetics.

The SGLT2is have a profound impact on heart failure, and restoration of anabolic/catabolic cycles could improve brain health. This new treatment can also improve kidney function. Canagliflozin inhibits SGLT2 transporter


Mechanism of action


The mechanisms of action of canagliflozin are not entirely clear. It is thought that this new diabetes drug may work by regulating the amount of insulin produced by the pancreas. The drug was developed by Janssen Research & Development, LLC, which is part of Janssen Global Services, LLC, and Mitsubishi Tanabe Pharma Corporation. It has also undergone a safety evaluation and compares its efficacy to existing therapies.

It is not known if canagliflozin undergoes hydrolysis in the environment. It also lacks chromophores, especially those with wavelengths below 290 nm. Therefore, it is not expected to be directly photo-degradable by sunlight. As such, some experts consider its mechanism of action to be limited. However, this drug may help some patients to get off insulin therapy.


Side effects


One of the main side effects of canagliflozin is increased risk of infection. It can cause vulvovaginitis, vaginal yeast infection, and increased output of urine. Patients may also experience skin discoloration and sensitivity to light. In women, Canagliflozin can cause vaginal yeast infection. For men, it can cause a higher risk of lower limb amputation. As with all diabetes medications, Canagliflozin should be used as directed by a physician and for the entire course of treatment.

Some other side effects of canagliflozin include hyperkalemia, hypotension, and renal impairment. Dialysis patients may have a higher risk of developing kidney failure if they take canagliflozin. They should inform their healthcare provider if they are currently receiving dialysis, as it can cause severe kidney failure. Patients with kidney disease should avoid using canagliflozin if they are on other medications that may cause an allergic reaction.


Invokana has a black box warning for amputation


Invokana has an increased risk of amputation. While the risk is extremely rare, it can occur if the patient experiences an ulcer, severe infection, or puncture wound. When this occurs, the blood supply to the legs, feet, and toes is decreased. The resulting reduced blood supply can lead to amputation. The FDA required drug makers to include a black box warning with Invokana, the strongest possible type of warning.

Canagliflozin is an oral insulin that inhibits the sodium-glucose co-transporter. In a clinical study, it doubled the risk of lower-limb amputations. Despite the new FDA warning, the drug still comes with a standard warning for amputation. As a result, it's important to read the drug label.