Metformin+canagliflozin
About
Metformin+canagliflozin belongs to the class of antidiabetic drugs, primarily used to treat type 2 diabetes mellitus with a proper diet and exercise. Metformin+canagliflozin also lowers the risk of heart attack, stroke or heart failure in type 2 diabetic patients with heart diseases. Diabetes mellitus is a metabolic disease that causes high blood sugar levels. It occurs when the insulin (a hormone produced by the beta cells of the pancreas) is resistant in breaking the glucose to produce energy (insulin resistance) or the pancreas (an organ behind the stomach) produce little or no insulin at all. Metformin+canagliflozin is not indicated for use in type 1 diabetes.
Metformin+canagliflozin is composed of two antidiabetic medicines, namely: Metformin and Canagliflozin. Metformin belongs to the class of biguanides, which reduce increased blood glucose levels without increasing insulin secretion. Canagliflozin belongs to the class of gliflozins. It works by reducing blood sugar levels by eliminating excess sugars from the body through urine.
Use Metformin+canagliflozin as advised by your doctor. Some common side effects of Metformin+canagliflozin include nausea, vomiting, diarrhoea, stomach pain, gas, headache, weakness, frequent urination and indigestion. Sometimes, Metformin+canagliflozin can cause side effects like lactic acidosis (a rare, but serious metabolic complication of excess lactic acid in the blood that is caused by metformin accumulation) and diabetic ketoacidosis (excess production of blood acids (ketones)). These side effects are not familiar to everyone and vary individually. If you notice any side effects that are not manageable, please consult your doctor.
Metformin+canagliflozin may cause hypoglycaemia (low blood sugar), hence it advised to take healthy food with enough calories and avoid heavy exercises. Do not take or stop this medicine, if the doctor did not advise you to do so. Before starting Metformin+canagliflozin, let your doctor know if you have any medical history of heart, kidney or liver diseases, breathing problems, blood disorders, dehydration, alcohol use, low blood pressure and yeast infection of genitals. It is advised to avoid your alcohol intake while using Metformin+canagliflozin to decrease lactic acidosis risk. Metformin+canagliflozin is not recommended during pregnancy and breastfeeding.
Uses of Metformin+canagliflozin
Medicinal Benefits
Metformin+canagliflozin treats type 2 diabetes mellitus and contains Metformin and Canagliflozin. Metformin is a biguanide and manages blood sugar levels. It exhibits a nonpancreatic effect to reduce blood glucose levels without increasing the insulin secretion. It is also known as insulin sensitizer as it increases the effects of insulin. Metformin is considered a unique antidiabetic drug since it does not cause hypoglycemia (lowered blood sugar levels). Canagliflozin belongs to the class of gliflozins. It works by reducing blood sugar levels by eliminating excess sugars from the body through urine. Canagliflozin reduces the risk of end-stage kidney disease in type 2 diabetic patients with renal impairment. Metformin+canagliflozin also reduces the risk of serious heart diseases, such as heart attack or stroke in patients with type 2 diabetes and heart disease. Metformin+canagliflozin may be advised with or without other medications along with diet and exercise to control blood sugar levels.
Directions for Use
Storage
Side Effects of Metformin+canagliflozin
- Nausea
- Vomiting
- Diarrhoea
- Stomach pain
- Gas
- Headache
- Weakness
- Frequent urination
- Indigestion
- Lactic acidosis (rare)
- Diabetic ketoacidosis (rare)
In-Depth Precautions and Warning
Drug Warnings
Inform your doctor if you take other antidiabetic drugs to adjust the dosage of Metformin+canagliflozin accordingly. Do not abruptly stop taking Metformin+canagliflozin midway if the doctor did not advise you. Metformin+canagliflozin may cause hypoglycaemia (low blood sugar), hence it is advised to make healthy food with enough calories and avoid heavy exercises. Brief your medical history if you have any heart, kidney or liver diseases, breathing problems (asthma, obstructive lung diseases), blood problems like anaemia (lack of blood cells), vitamin B12 deficiency, dehydration, alcohol use, low blood pressure, mineral imbalance (high levels of potassium) and yeast infection of genitals. Avoid alcohol intake while using Metformin+canagliflozin since it may increase the risk of lactic acidosis. Canagliflozin in Metformin+canagliflozin may increase the risk of leg amputation (removal of the leg) in conditions like foot ulcers, heart diseases, circulation problems and nerve damage. Hence, it is advised to inform your doctor if you have any of these conditions before you start Metformin+canagliflozin. Metformin+canagliflozin is not recommended for use during pregnancy and breastfeeding. Your doctor may advise alternate medications to control your diabetic condition in such cases. Metformin+canagliflozin is not recommended for people younger than 18 years of age.
Drug Interactions
Drug-Drug Interaction: Metformin+canagliflozin may interact with water pills (hydrochlorothiazide), fits medicines (phenobarbital, phenytoin, carbamazepine), HIV/AIDS drugs (ritonavir, efavirenz), antibiotics (rifampin), cholesterol-lowering drugs (cholestyramine), heart-related drugs (digoxin, digitoxin), asthma treating drugs (salbutamol, terbutaline), pain killers (ibuprofen, celecoxib), drugs that treat acidity (cimetidine) and blood thinners (dabigatran).
Drug-Food Interaction: Avoid alcohol intake since it increases the risk of lactic acidosis.
Drug-Disease Interaction: Tell your doctor before taking Metformin+canagliflozin if you have any heart, kidney or liver diseases, breathing problems, blood disorders, dehydration, foot ulcers, nerve damage, alcohol use, low blood pressure and yeast infection of the genitals.
Drug-Drug Interactions Checker List:
Safety Advice
Alcohol
unsafeIt is advised to avoid alcohol intake since it may worsen the side effects like lactic acidosis and increase the risk of developing low blood sugar levels.
Pregnancy
cautionCanagliflozin in Metformin+canagliflozin is not recommended during pregnancy. Your doctor may suggest other medications to control your blood sugar levels. Please consult your doctor before starting Metformin+canagliflozin if you are pregnant or planning to conceive.
Breast Feeding
cautionMetformin+canagliflozin may be unsafe to use during breastfeeding since it is excreted into the breast milk. Please seek medical advice for further information.
Driving
cautionYour driving may be affected if your blood sugar levels are too high or too low. Do not drive or operate machinery if you also experience blurred vision, dizziness or drowsiness due to extremely low or high blood sugar.
Liver
cautionLet your doctor know if you have any history of liver diseases or hepatic impairment when prescribed Metformin+canagliflozin.
Kidney
unsafeMetformin+canagliflozin is contraindicated in patients with renal impairment/kidney diseases. Let your doctor know if you have any history of kidney diseases when you are prescribed Metformin+canagliflozin.
Children
unsafeMetformin+canagliflozin is not recommended for people younger than 18 years of age.
Habit Forming
Diet & Lifestyle Advise
- Maintain a fibre-rich diet and include healthy carbohydrates from fruits, vegetables and whole grains to maintain your blood glucose levels.
- Eat at regular intervals.
- Keep a check on your weight and exercise regularly to keep your heart healthy.
- Your doctor also guides you on noticing and managing the early symptoms of high/low blood sugar levels.
- Gastrointestinal side effects can be managed with simple modifications in your lifestyle. These include cutting down on sugars and fatty foods, and avoiding carbonated drinks and foods that cause gas.
Special Advise
- It is advised to monitor your blood sugar levels regularly.
- If you need to undergo any x-ray or CT scan using a dye that should be injected into your veins, your doctor may suggest you to stop taking Metformin+canagliflozin temporarily.
- Regular monitoring of kidney functioning is advised while using Metformin+canagliflozin.
- Canagliflozin in Metformin+canagliflozin may make you test positive for a urine glucose test, hence inform your doctor in advance that you take Metformin+canagliflozin.
Patients Concern
Disease/Condition Glossary
Diabetes mellitus 2, also known as adult-onset diabetes, is a metabolic disease that causes high blood sugar levels. It is a type 2 diabetes and occurs when the insulin (a hormone produced by the beta cells of the pancreas) is resistant in breaking the glucose to produce energy (insulin resistance) or the pancreas (an organ behind the stomach) produce little or no insulin at all. This disease mostly occurs in people aged above 40 years, but can also occur in childhood based on the risk factors. The treatment includes oral glucose-lowering medicines and insulin shots.
FAQs
Metformin+canagliflozin contains two antidiabetic medicines: Metformin and Canagliflozin. These drugs lower the blood sugar levels in type 2 diabetes mellitus by eliminating excess sugars through urine and increasing insulin activity. Metformin+canagliflozin also reduces the risk of death due to heart attack, stroke and end-stage kidney disease in type 2 diabetic patients with heart/kidney diseases.
Metformin+canagliflozin may cause low blood sugar levels (hypoglycaemia) and can make you hungry, dizzy, irritable, confused, anxious, or shaky. Hence, it is advised to take Metformin+canagliflozin with a meal. To immediately treat hypoglycaemia, it is advised to eat or drink fast-acting sugar sources like fruit juices, hard candy, raisins or non-diet soda. Consult your doctor immediately.
Your doctor may advise Metformin+canagliflozin with or without other medications to control your blood sugar levels. However, it is advised to maintain a proper diet and exercise to achieve the controlled blood sugar levels while using Metformin+canagliflozin with or without other antidiabetic drugs.
Metformin+canagliflozin should be used with caution in heart, kidney or liver diseases, breathing problems, blood disorders, dehydration, alcohol use, foot ulcers, nerve damage, low blood pressure and yeast infection of genitals. Metformin+canagliflozin is contraindicated in patients with renal impairment and diabetic ketoacidosis.
While using Metformin+canagliflozin, if you experience vomiting, stomach/abdominal pain, muscle cramps, sick feeling, severe tiredness, difficulty in breathing or reduced body temperature and heartbeat, it is important to seek immediate medical help since these are the symptoms of lactic acidosis. Lactic acidosis is a rare but a serious complication caused due to accumulation of metformin. It is a medical emergency and needs immediate treatment. Please consult your doctor for further information.
It is not recommended to use Metformin+canagliflozin along with water pills/diuretics. Simultaneous use of Metformin+canagliflozin and water pills causes dehydration and may increase the risk of lactic acidosis.
Take the missed dose as soon as possible. However, if it is time for the next dose, skip the missed dose and go back to your regular dosing schedule. Do not double the dose.
Yes, long term use of metformin in Metformin+canagliflozin may cause a decrease in the amount of vitamin B12 in your blood, especially if you have had low vitamin B12 blood levels before. Consult your doctor for further advice.
