Canagliflozin, Metformin Hydrochloride
Canagliflozin, Metformin Hydrochloride



Canagliflozin, also known as Invokana, is a sodium-glucose cotransporter 2 (SGLT2) inhibitor used in the management of type 2 diabetes mellitus along with lifestyle changes including diet and exercise Label.

It was initially approved by the FDA in 2013 for the management of diabetes and later approved in 2018 for a second indication of reducing the risk of cardiovascular events in patients diagnosed with type 2 diabetes mellitus 8, Label. Canagliflozin is the first oral antidiabetic drug approved for the prevention of cardiovascular events in patients with type 2 diabetes 8. Cardiovascular disease is the most common cause of death in these patients


Canagliflozin, a sodium–glucose cotransporter 2 inhibitor (SGLT2-I), is known as an antidiabetic agent. Canagliflozin was selected for the phenotypic screening based on the given fact of high expression levels of SGLT2 in HCC cell lines. Initially, the antiproliferative ability of canagliflozin against HCC cell lines was assessed to show inhibitory profile in a dose-dependent manner along with induction of apoptosis at G2/M phase with elevated levels of caspase-3 and inhibition of ERK. This suggested that canagliflozin can inhibit glycolytic metabolism including glucose uptake, lactate, and intracellular ATP production.




  • Canagliflozin is used along with diet and exercise, and sometimes with other medications, to lower blood sugar levels in people with type 2 diabetes (condition in which blood sugar is too high because the body does not produce or use insulin normally).
  • Canagliflozin is also used to reduce the risk of stroke, heart attack, or death in people who have type 2 diabetes along with heart and blood vessel disease.
  • Canagliflozin is also used to reduce the risk of end-stage kidney disease, worsening of kidney function, needing to be hospitalized for heart failure, and cardiovascular death in people who have type 2 diabetes along with severe kidney disease. Canagliflozin is in a class of medications called sodium-glucose co-transporter 2 (SGLT2) inhibitors. It lowers blood sugar by causing the kidneys to get rid of more glucose in the urine. Canagliflozin is not used to treat type 1 diabetes (condition in which the body does not produce insulin and, therefore, cannot control the amount of sugar in the blood).

Over time, people who have diabetes and high blood sugar can develop serious or life-threatening complications, including heart disease, stroke, kidney problems, nerve damage, and eye problems. Taking medication(s), making lifestyle changes (e.g., diet, exercise, quitting smoking), and regularly checking your blood sugar may help to manage your diabetes and improve your health. This therapy may also decrease your chances of having a heart attack, stroke, or other diabetes-related complications such as kidney failure, nerve damage (numb, cold legs or feet; decreased sexual ability in men and women), eye problems, including changes or loss of vision, or gum disease. Your doctor and other healthcare providers will talk to you about the best way to manage your diabetes.


Canagliflozin comes as a tablet to take by mouth. It is usually taken once a day before breakfast or the first main meal of the day. Take canagliflozin at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take canagliflozin exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
Your doctor may start you on a low dose of canagliflozin and gradually increase your dose.




  • If you experience hives, difficulty breathing, or swelling of your face, lips, tongue, or neck, a light-headed feeling as if you could pass out;
    urination is minimal or non-existent; you may experience pain or a burning sensation.
  • New leg or foot pain, tenderness, sores, ulcers, or infections;
    Nausea, irregular heartbeats, weakness, and loss of mobility are all symptoms of elevated potassium levels.
  • Nausea, vomiting, stomach pain, confusion, unusual drowsiness, or trouble breathing; or ketoacidosis (too much acid in the blood)—nausea, vomiting, stomach pain, confusion, unusual drowsiness, or trouble breathing; or
  • Symptoms of dehydration include dizziness, weakness, and a sense of being light-headed (like you might pass out).
    Genital infections and excessive urination are two common side effects.



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