Available in:Tablet
Dosage:100MG, 300MG
Manufacturer:Janssen
Available in:Autoinjector
Dosage:0.75MG, 1.5MG
Manufacturer:Eli Lilly
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The recommended starting dose for Invokana (Canagliflozin) is 100 mg taken by mouth once a day. Your doctor may adjust the dose up or down, depending on how effective it is and how well it is tolerated. The maximum recommended dose is 300 mg daily.
Invokana (Canagliflozin) should be taken at the same time every day, preferably before the first meal of the day. The tablets should be swallowed whole with some fluid and may be taken with food or on an empty stomach.
Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.
It is important to take Invokana (Canagliflozin) exactly as prescribed by your doctor. Do not stop using the medication because you feel better. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.
Store Invokana (Canagliflozin) at room temperature, protect from light and moisture, and keep it out of the reach of children.
Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.
The recommended adult starting dose of Trulicity (Dulaglutide) is 0.75 mg, injected subcutaneously (under the skin), once a week. It may be injected at any time of the day, without regard to meals. If necessary, your doctor may increase the dose to a maximum of 1.5 mg once weekly. Do not change your dose unless your doctor has told you to do so. Your doctor or diabetes educator will show you how to inject Trulicity (Dulaglutide).
If you are also using insulin, each medication should be injected separately. Trulicity (Dulaglutide) should be clear and colourless. Do not use Trulicity (Dulaglutide) if you notice anything unusual in the appearance of the solution, such as cloudiness, discolouration, or clumping.
Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.
It is important to take Trulicity (Dulaglutide) exactly as prescribed by your doctor. If you miss a dose, inject it as soon as possible and continue with your regular schedule. If it is less than 3 days until your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.
Store Trulicity (Dulaglutide) in the refrigerator; do not allow it to freeze. Protect it from direct heat and light. Keep this and all medication out of the reach of children. These single-use prefilled pens and syringes may be stored at room temperature for up to 14 days.
Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.
Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.
The side effects listed below are not experienced by everyone who takes Invokana (Canagliflozin). If you are concerned about side effects, discuss the risks and benefits of Invokana (Canagliflozin) with your doctor.
The following side effects have been reported by at least 1% of people taking Invokana (Canagliflozin). Many of these side effects can be managed, and some may go away on their own over time.
Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.
Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:
Stop taking the medication and seek immediate medical attention if any of the following occur:
Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking Invokana (Canagliflozin).
Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.
The side effects listed below are not experienced by everyone who takes Trulicity (Dulaglutide). If you are concerned about side effects, discuss the risks and benefits of Trulicity (Dulaglutide) with your doctor.
The following side effects have been reported by at least 1% of people taking Trulicity (Dulaglutide). Many of these side effects can be managed, and some may go away on their own over time.
Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.
Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:
Stop taking the medication and seek immediate medical attention if any of the following occur:
Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking Trulicity (Dulaglutide).
100 mg
Each yellow, capsule-shaped, film-coated tablet with "CFZ" on one side and "100" on the other, contains Invokana (Canagliflozin) hemihydrate equivalent to 100 mg of Invokana (Canagliflozin). Nonmedicinal ingredients: croscarmellose sodium, hydroxypropyl cellulose, lactose anhydrous, magnesium stearate, and microcrystalline cellulose; film coating: iron oxide yellow, Macrogol (polyethylene glycol), polyvinyl alcohol, talc, and titanium dioxide.
300 mg
Each white, capsule-shaped, film-coated tablet with "CFZ" on one side and "300" on the other, contains Invokana (Canagliflozin) hemihydrate equivalent to 300 mg of Invokana (Canagliflozin). Nonmedicinal ingredients: croscarmellose sodium, hydroxypropyl cellulose, lactose anhydrous, magnesium stearate, and microcrystalline cellulose; film coat: Macrogol (polyethylene glycol), polyvinyl alcohol, talc, and titanium dioxide.
0.75 mg/0.5 mL
Each single-use prefilled pen or prefilled syringe contains 0.75 mg of Trulicity (Dulaglutide) per 0.5 mL of solution. Nonmedicinal ingredients: trisodium citrate dehydrate, citric acid anhydrous, mannitol, and polysorbate 80 in water for injection.
1.5 mg/0.5 mL
Each single-use prefilled pen or prefilled syringe contains 1.5 mg of Trulicity (Dulaglutide) per 0.5 mL of solution. Nonmedicinal ingredients: trisodium citrate dehydrate, citric acid anhydrous, mannitol, and polysorbate 80 in water for injection.
Do not use Invokana (Canagliflozin) if you:
Invokana (Canagliflozin) should not be used to treat Type 1 Diabetes.
Do not take Trulicity (Dulaglutide) if you:
There may be an interaction between Invokana (Canagliflozin) and any of the following:
If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:
An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.
Medications other than those listed above may interact with Invokana (Canagliflozin). Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.
There may be an interaction between Trulicity (Dulaglutide) and any of the following:
If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:
An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.
Medications other than those listed above may interact with Trulicity (Dulaglutide). Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.
Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Invokana (Canagliflozin).
HEALTH CANADA ADVISORY
September 6, 2017
Health Canada has issued new information concerning the use of Invokana (Canagliflozin) (Invokana). To read the full report, visit Health Canada's website at www.hc-sc.gc.ca.
Previous advisories on Invokana (Canagliflozin) were issued on May 16, 2016, and on June 22, 2015.
Amputation: There may be an increased risk for lower leg or toe amputations in people taking Invokana (Canagliflozin), especially if you are at high risk for heart disease. Good foot care is very important for people with diabetes. Contact your doctor as soon as possible if you notice symptoms of leg pain; poor circulation; bluish, cold skin; and poor hair or toenail growth.
Cholesterol: Invokana (Canagliflozin) can cause increased blood cholesterol levels, particularly low-density lipoprotein. If you are at risk of developing High Cholesterol or you have high cholesterol levels before starting Invokana (Canagliflozin), discuss with your doctor how Invokana (Canagliflozin) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Invokana (Canagliflozin), and whether any special monitoring is needed.
Diabetic ketoacidosis: If blood sugar levels are too high (hyperglycemia), a condition known as diabetic ketoacidosis may occur. In this condition, your body starts to use body fat as fuel, eventually leading to a large concentration of acid in the blood stream. This can result in unconsciousness, coma or death. Your risk of developing diabetic ketoacidosis may be increased if you are on a low carbohydrate diet, drink a lot of alcohol, have a severe illness or infection, or have problems with your pancreas. There have been reports of diabetic ketoacidosis in people taking Invokana (Canagliflozin).
If you develop symptoms of diabetic ketoacidosis such as difficulty breathing, feeling very thirsty, vomiting, abdominal pain, nausea, loss of appetite, confusion, and unusual tiredness, seek urgent medical attention.
Dizziness: Some people taking Invokana (Canagliflozin) may experience decreases in blood pressure. This occurs because the medication causes an increased amount of fluid, along with the glucose, to be removed from the body through the kidneys. These blood pressure drops could lead to dizziness, lightheadedness, and falls. This may occur when you shift your body position, such as rising from a sitting or lying position. If you experience this problem, try getting up more slowly. If it persists or if you faint, contact your doctor. Seniors and other individuals who are at risk of experiencing Low Blood Pressure (e.g., dehydration, taking medications for high blood pressure) should discuss with their doctor how Invokana (Canagliflozin) may affect their medical condition, how their medical condition may affect the dosing and effectiveness of Invokana (Canagliflozin), and whether any special monitoring is needed.
Fractures: There is a small increase in the risk of bone fractures for people taking Invokana (Canagliflozin). If you are at risk of Osteoporosis or are taking medications that may decrease the strength of your bones, discuss with your doctor how Invokana (Canagliflozin) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Invokana (Canagliflozin), and whether any special monitoring is needed.
Glucose control: When Invokana (Canagliflozin) is taken along with other medications for diabetes, glucose levels may drop too far, causing confusion, cold sweats, cool and pale skin, headache, fast heartbeat, or weakness. Your doctor may suggest decreasing the dose of your other medications when you first start taking Invokana (Canagliflozin). If you take other medications for diabetes, discuss with your doctor how Invokana (Canagliflozin) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Invokana (Canagliflozin), and whether any special monitoring is needed.
Kidney function: Invokana (Canagliflozin) may cause a decrease in kidney function. If you have reduced kidney function or Kidney Disease, discuss with your doctor how Invokana (Canagliflozin) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Invokana (Canagliflozin), and whether any special monitoring is needed.
Potassium levels: Increases in blood levels of potassium may occur when taking Invokana (Canagliflozin). This is more likely to happen to people who are taking other medications that prevent potassium from being removed from the body, or those who have moderately reduced kidney function. This doesn't often cause problems, but potassium levels should be monitored by your doctor. If you experience unexplained nausea, fatigue, muscle weakness or tingling sensations, contact your doctor.
Yeast infections: There is an increased risk of developing genital or vaginal yeast infections when taking Invokana (Canagliflozin) as a result of increased glucose in the urine. This is more likely to occur for uncircumcised males and for people who have a history of yeast infections.
Pregnancy: Invokana (Canagliflozin) should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking Invokana (Canagliflozin), contact your doctor immediately.
Breast-feeding: It is not known if Invokana (Canagliflozin) passes into breast milk. If you are a breast-feeding mother and are taking Invokana (Canagliflozin), it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.
Children: The safety and effectiveness of Invokana (Canagliflozin) have not been established for children less than 18 years of age.
Seniors: Seniors are more likely to experience side effects with Invokana (Canagliflozin) and may require lower doses.
Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health.
Diabetes identification: It is important to either wear a bracelet (or necklace) or carry a card indicating you have diabetes and are taking medication to manage your blood glucose levels.
Heart problems: Trulicity (Dulaglutide) may increase heart rate and may affect how electrical impulses travel through the heart muscle. If you have heart disease (e.g., recent Heart Attack, Angina, heart failure) or an abnormal heart rhythm (e.g., heart block or fast heart rate), discuss with your doctor how Trulicity (Dulaglutide) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Trulicity (Dulaglutide), and whether any special monitoring is needed.
Intestinal problems: The safety and effectiveness of using Trulicity (Dulaglutide) have not been established for people who have problems with slowed movement of food through the digestive tract. If you have digestive system problems, discuss with your doctor how Trulicity (Dulaglutide) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Trulicity (Dulaglutide), and whether any special monitoring is needed.
Kidney function: The safety and effectiveness of using Trulicity (Dulaglutide) for people with reduced kidney function has not been studied. Ensure that you are drinking enough water to prevent dehydration if you experience nausea or vomiting with Trulicity (Dulaglutide). If you have reduced kidney function or Kidney Disease, discuss with your doctor how Trulicity (Dulaglutide) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Trulicity (Dulaglutide), and whether any special monitoring is needed.
Liver function: The safety and effectiveness of using Trulicity (Dulaglutide) for people with reduced liver function have not been studied. If you have reduced liver function or liver disease, discuss with your doctor how Trulicity (Dulaglutide) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Trulicity (Dulaglutide), and whether any special monitoring is needed.
Low blood glucose (Hypoglycemia): People who use Trulicity (Dulaglutide) and are also taking a sulfonylurea (e.g., Glyburide, Gliclazide) or insulin to control high blood sugar are more at risk of experiencing hypoglycemia (low blood sugar). If you experience symptoms of hypoglycemia such as a cold sweat, nervousness or shakiness, fast heartbeat, headache, hunger, confusion, lightheadedness, weakness, and numbness or tingling of the tongue or lips, contact your doctor. Your doctor may need to adjust the dose of your medication(s).
Pancreatitis (inflammation of the pancreas): Trulicity (Dulaglutide) can cause pancreatitis. If you experience symptoms of pancreatitis such as severe and persistent abdominal pain that may move to the back with or without vomiting, contact your doctor immediately. If you have previously had pancreatitis, discuss with your doctor how Trulicity (Dulaglutide) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Trulicity (Dulaglutide), and whether any special monitoring is needed.
Risk of thyroid cancer: In rare cases, people have developed thyroid cancer while using Trulicity (Dulaglutide). People with a personal or family history of thyroid cancer or people who have multiple endocrine neoplasia syndrome type 2 (a disease where people have tumours in more than one gland in their body) should not use Trulicity (Dulaglutide). If you develop symptoms of a thyroid tumour, such as difficulty swallowing, a mass in the neck or persistent hoarseness, contact your doctor as soon as possible.
Pregnancy: Trulicity (Dulaglutide) should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking Trulicity (Dulaglutide), contact your doctor immediately.
If you are planning to become pregnant, talk to your doctor about discontinuing Trulicity (Dulaglutide). You should not become pregnant for at least 4 weeks after stopping Trulicity (Dulaglutide), to give the medication enough time to completely leave the body.
Breast-feeding: It is not known if Trulicity (Dulaglutide) passes into breast milk. If you are a breast-feeding mother and are taking Trulicity (Dulaglutide), it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.
Children: The safety and effectiveness of using Trulicity (Dulaglutide) have not been established for children.
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