Canagliflozin/metformin

Canagliflozin/metformin, sold under the brand name Vokanamet among others, is a fixed-dose combination anti-diabetic medication used for the treatment of type 2 diabetes. It is used in combination with diet and exercise. It is taken by mouth.

The most common side effects include hypoglycemia (low blood glucose levels) when used in combination with insulin or a sulphonylurea and vulvovaginal candidiasis (thrush, a fungal infection of the female genital area caused by Candida).

Canagliflozin/metformin was approved for medical use in the European Union in April 2014, and for use in the United States in August 2014.

Medical uses

Canagliflozin/metformin is indicated in adults aged 18 years of age and older with type 2 diabetes as an adjunct to diet and exercise to improve glycemic control.

Adverse effects

To lessen the risk of developing ketoacidosis (a serious condition in which the body produces high levels of blood acids called ketones) after surgery, the FDA approved changes to the prescribing information for SGLT2 inhibitor diabetes medicines to recommend they be stopped temporarily before scheduled surgery. Canagliflozin, dapagliflozin, and empagliflozin should each be stopped at least three days before, and ertugliflozin should be stopped at least four days before scheduled surgery.

Symptoms of ketoacidosis include nausea, vomiting, abdominal pain, tiredness, and trouble breathing.

Further reading

• Davidson JA, Sloan L (January 2017). "Fixed-Dose Combination of Canagliflozin and Metformin for the Treatment of Type 2 Diabetes: An Overview". Adv Ther. 34 (1): 41–59. doi:10.1007/s12325-016-0434-2. PMC 5216068. PMID 27854055.

External links

• "Canagliflozin mixture with Metformin". Drug Information Portal. U.S. National Library of Medicine.
• "FDA revises label of diabetes drug canagliflozin". U.S. Food and Drug Administration (FDA). 15 January 2016.
• "FDA Drug Safety Communication: FDA confirms increased risk of leg and foot amputations with the diabetes medicine canagliflozin (Invokana, Invokamet, Invokamet XR)". U.S. Food and Drug Administration (FDA). 18 May 2016.
• "FDA Drug Safety Communication: FDA strengthens kidney warnings for diabetes medicines canagliflozin (Invokana, Invokamet) and dapagliflozin (Farxiga, Xigduo XR)". U.S. Food and Drug Administration (FDA). 17 June 2016.
• "FDA Drug Safety Communication: Interim clinical trial results find increased risk of leg and foot amputations, mostly affecting the toes, with the diabetes medicine canagliflozin (Invokana, Invokamet); FDA to investigate". U.S. Food and Drug Administration (FDA). 9 May 2017.
• "Warning use metformin in certain patients with reduced kidney function". U.S. Food and Drug Administration (FDA). 14 November 2017.
• "Warning: infection of genital area with SGLT2 inhibitors for diabetes". U.S. Food and Drug Administration (FDA). 7 September 2018.