Invokana Tablet

Introduction

Invokana Tablet 100 mg is a medication used primarily for the management of type 2 diabetes mellitus. It belongs to a class of drugs known as sodium-glucose co-transporter 2 (SGLT2) inhibitors, which help control blood sugar levels.

Uses

Invokana Tablet 100 mg is used to:

Improve glycemic control in adults with type 2 diabetes mellitus.
Reduce the risk of major cardiovascular events in patients with type 2 diabetes and established cardiovascular disease.
Assist in weight management and lower blood pressure as secondary benefits.

Brand Name	Invokana
Type	Tablet
Weight	100 mg
Generic	Canagliflozin Hemihydrate
Manufacturer	Janata Traders (Mfg. by: Fresenius Kabi)
Available in	English বাংলা

Mechanism of Action

Invokana Tablet 100 mg works by inhibiting the sodium-glucose co-transporter 2 (SGLT2) in the kidneys. This action prevents glucose reabsorption in the renal tubules, leading to increased glucose excretion in the urine and reduced blood glucose levels.

How Long Does It Take to Work?

Canagliflozin typically begins to lower blood glucose levels within a few hours of administration. The full therapeutic effects may take several weeks to become apparent as the body adjusts to the medication.

Absorption

Canagliflozin is well absorbed following oral administration. The peak plasma concentration occurs approximately 1 to 2 hours after dosing. Food does not significantly affect the absorption of Canagliflozin.

Route of Elimination

Canagliflozin is primarily eliminated via the kidneys, with a significant portion of the drug being excreted in the urine. It is also metabolized by the liver, where it undergoes glucuronidation and other metabolic processes.

Dosage

The recommended starting dose is 100 mg once daily, taken before the first meal of the day. Dose can be increased to 300 mg once daily who have CrCl>60 ml/min or who requires additional glycemic control. No dose adjustment is required for mild renal impairment. For moderate renal impairment (CrCl 45-60 ml/min) Canagliflozin 100 mg is recommended.

The standard dosage of Invokana Tablet 100 mg is:

100 mg to 300 mg once daily, taken orally.

The dosage may be adjusted based on individual patient needs, efficacy, and tolerance. It is generally recommended to start with 100 mg daily and increase to 300 mg if needed and well tolerated.

Administration

Canagliflozin is administered orally, typically in the form of tablets. It should be taken with or without food, usually once daily in the morning. Consistent daily dosing at the same time each day is recommended to maintain stable blood glucose levels.

Side Effects

Common side effects of Invokana Tablet 100 mg include:

Urinary tract infections.
Genital fungal infections.
Increased urination.
Thirst.

Less common but serious side effects can include ketoacidosis, severe dehydration, and renal impairment.

Toxicity

Acute toxicity is rare but may occur with overdosing. Symptoms of overdose may include severe dehydration, hypotension, and electrolyte imbalances. Seek immediate medical attention if an overdose is suspected.

Precautions

Precautions for using Canagliflozin include:

Monitoring for signs of dehydration and hypotension.
Regular kidney function tests, as it may affect renal function.
Careful use in patients with a history of urinary tract infections or genital infections.

Interaction

Canagliflozin may interact with other medications, including:

Diuretics, which can increase the risk of dehydration.
Rifampin, which may reduce the efficacy of Canagliflozin.
Medications affecting renal function.

Disease Interaction

Use Canagliflozin with caution in patients with:

Severe renal impairment.
Type 1 diabetes mellitus or diabetic ketoacidosis.

Drug Interaction

Canagliflozin may interact with drugs that affect renal function or glucose metabolism. For example:

ACE inhibitors and ARBs can increase the risk of hypotension.
Drugs that induce or inhibit CYP3A4 may affect Canagliflozin levels.

Food Interactions

There are no significant food interactions with Canagliflozin. It can be taken with or without food.

Pregnancy Use

Canagliflozin is not recommended for use during pregnancy due to potential risks to the fetus. Alternative diabetes management options should be considered during pregnancy.

Lactation Use

It is not known if Canagliflozin is excreted in breast milk. The use of Canagliflozin during lactation is not recommended unless clearly needed. Consult with a healthcare provider for alternatives.

Acute Overdose

In case of an overdose, symptoms may include severe dehydration, hypotension, and electrolyte imbalances. Immediate medical evaluation and treatment are necessary.

Contraindication

Canagliflozin is contraindicated in patients with:

Severe renal impairment (eGFR < 30 mL/min/1.73 m²).
Diabetic ketoacidosis.

Use Direction

Follow the prescribed dosage and administration instructions. Do not exceed the recommended dose. Regular monitoring of blood glucose levels and renal function is advised.

Storage Conditions

Store Canagliflozin at room temperature, away from moisture and direct light. Keep out of reach of children.

Volume of Distribution

The volume of distribution for Canagliflozin is approximately 70 L, indicating widespread distribution throughout the body.

Half Life

The elimination half-life of Canagliflozin is approximately 10 to 13 hours, allowing for once-daily dosing.

Clearance

Canagliflozin is primarily cleared by the kidneys, with a smaller proportion undergoing hepatic metabolism. Renal clearance is an important factor in its overall elimination from the body.

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