Available in:Tablet
Dosage:500MG, 850MG
Manufacturer:Pharmascience
Available in:Tablet
Dosage:100MG, 300MG
Manufacturer:Janssen
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The recommended adult dose of metformin ranges from 500 mg 3 or 4 times a day to 850 mg 2 or 3 times a day. The maximum daily dose should not exceed 2,550 mg. Tablets should be taken with food whenever possible to reduce the risk of nausea and vomiting. Metformin may be used alone or with other medications that reduce blood sugar. To ensure that the medication is working well, monitor your blood glucose on a regular basis as directed by your doctor or diabetes educator.
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 Pms Metformin exactly as prescribed by your doctor. If you miss a 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 Pms Metformin at room temperature, protect it 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 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.
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 Pms Metformin. If you are concerned about side effects, discuss the risks and benefits of Pms Metformin with your doctor.
The following side effects have been reported by at least 1% of people taking Pms Metformin. 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 Pms Metformin.
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).
500 mg
Each white, round, biconvex, coated tablet, imprinted "met" over "500" on the scored side and "P" logo on the other side, contains metformin HCl 500 mg. Nonmedicinal ingredients: colloidal silicon dioxide, croscarmellose sodium, hydroxypropyl methylcellulose, magnesium stearate, microcrystalline cellulose, polyethylene glycol, povidone PVK-90, and pregelatinized starch.
850 mg
Each white, capsule-shaped, biconvex, coated tablet, imprinted "P" logo on one side and "850" on the other side, contains metformin 850 mg. Nonmedicinal ingredients: colloidal silicon dioxide, croscarmellose sodium, hydroxypropyl methylcellulose, magnesium stearate, microcrystalline cellulose, polyethylene glycol, povidone PVK-90, and pregelatinized starch.
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.
Do not take Pms Metformin if you:
Do not use Invokana (Canagliflozin) if you:
Invokana (Canagliflozin) should not be used to treat Type 1 Diabetes.
There may be an interaction between metformin 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 Pms Metformin. 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 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.
Before you begin taking 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 take Pms Metformin.
Alcohol intake: Anyone taking metformin should avoid excessive alcohol intake.
Blood sugar control: If you have fever, trauma, infection, or surgery, you may have a temporary loss of blood sugar control. At such times, your doctor may think it is necessary to stop metformin and temporarily inject insulin. Metformin may be started again after the problem is resolved.
Blood sugar monitoring: Monitor your blood sugar regularly at intervals as discussed with your doctor or diabetes educator.
Diabetes complications: The use of metformin (or any other medication used for diabetes) will not prevent the development of complications particular to diabetes mellitus (e.g., Kidney Disease, nerve disease, eye disease).
Diet: Metformin is a treatment to be taken in combination with a proper diet. Metformin is not a substitute for proper diet.
Dye or contrast agents: If you are going to have an X-ray procedure that uses dye or a contrast agent, you may need to stop taking Pms Metformin for a short time. Contact your doctor for instructions.
Kidney problems: Kidney disease or reduced kidney function causes Pms Metformin to build up in the body, causing side effects. If you have kidney problems, your doctor should closely monitor your condition while you are taking metformin, as it may affect kidney function.
Lactic acidosis: Lactic acidosis is a rare but serious problem that occurs due to metformin accumulation (i.e., the body doesn't get rid of it fast enough) during treatment. If you have severe kidney disease you are at higher risk of developing lactic acidosis. Since alcohol may increase the risk of lactic acidosis, do not drink a lot of alcohol over the short- or long-term while taking Pms Metformin. When it does occur (very rarely), it is fatal in 50% of cases. There have been no reports of lactic acidosis in Canada when metformin was used as directed. If you experience symptoms of lactic acidosis (e.g., weakness, tiredness, drowsiness, unusual muscle pain, trouble breathing, stomach pain with nausea, vomiting or diarrhea, feeling cold, dizziness, light-headedness, or slow or irregular heartbeat), stop taking Pms Metformin and get immediate medical attention.
Liver function: Decreased liver function has been linked to lactic acidosis. Pms Metformin is not recommended for people with severely reduced liver function. If you have moderately reduced liver function, discuss with your doctor how Pms Metformin may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Pms Metformin, and whether any special monitoring is needed.
Low blood sugar: Under usual circumstances, low blood sugar does not occur for people who take only metformin. Low blood sugar could occur when not enough food is eaten, especially when strenuous exercise is undertaken at the same time or when large amounts of alcohol have been consumed.
Reduced response: Over a period of time, you may become progressively less responsive to a particular treatment for diabetes because your diabetes worsens. If metformin fails to lower blood sugar to target levels, talk to your doctor. Your doctor may want to stop metformin or recommend another medication.
Surgery: Pms Metformin should be stopped temporarily for surgery (except for minor surgery where food and fluid intake is not restricted). You will be restarted on Pms Metformin once you are eating and drinking and your kidney function has been tested and is normal. Talk to your doctor for specific instructions.
Vitamin B12 levels: Pms Metformin may decrease vitamin B12 levels. Your doctor will monitor your B12 levels with blood tests while you are taking Pms Metformin.
Pregnancy: Pms Metformin should not be used during pregnancy. If you become pregnant while taking Pms Metformin, contact your doctor immediately.
Breast-feeding: Metformin is believed to pass into breast milk. Pms Metformin should not be used if you are breast-feeding.
Children: The safety and effectiveness of Pms Metformin have not been established for children.
Seniors: Kidney function often decreases with age. As a result, seniors may be more likely to experience side effects of Pms Metformin.
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.
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