Kagliflozin hydrochloride is an oral hypoglycemic agent of the sodium glucose cotransporter 2 (SGLT2) inhibitor class, which reduces blood sugar by inhibiting renal reabsorption of glucose and promoting urinary glucose excretion.

1、 Drug name

1. Common name: Kagliflozin hydrochloride (Kagliflozin water and substance)

2. Product Name: Canaglu

3. English name: Canagliflozin Hydrate

2、 Indications

1. Type 2 diabetes (combined with diet and exercise therapy)

2. Type 2 diabetes with chronic kidney disease (eGFR ≥ 30mL/min/1.73m ², excluding dialysis patients)

3、 Specifications and characteristics

1. Specifications:

100mg/tablet

2. Characteristic:

1. Ordinary film: light yellow film coated film, diameter 7.6mm, thickness 3.4mm

2. Oral disintegrating tablets (OD): light yellow brown pigment tablets, diameter 9.5mm, thickness 4.4mm

4、 Main components

1. Active ingredients: Kagliflozin water and substance (102mg/tablet, equivalent to 100mg Kagliflozin)

2. Accessories: D-mannitol, hydroxypropyl cellulose, cross-linked carboxymethyl cellulose sodium, etc. (there are slight differences in accessories between regular tablets and OD tablets)

5、 Usage and dosage

1. Regular dose: 100mg once daily, taken orally before or after breakfast.

2. Dose adjustment:

(1) Renal insufficiency:

EGFR30-45mL/min/1.73m ²: Use with caution, monitor renal function;

EGFR<30mL/min/1.73m ²: Disabled (ineffective blood glucose control or insufficient renal protection).

(2) Liver dysfunction: Mild to moderate without adjustment, severe (Child Pugh C grade) without data available.

6、 Medication precautions

1. Before/after meals: Both before and after meals are acceptable, as food absorption may be delayed but does not affect total exposure.

2. Missed dose: Take it as soon as possible, skip if it is close to the next dose, do not double the dose.

3. Vomiting: If vomiting occurs immediately after taking medication, it is recommended to take additional medication; If absorbed (>1 hour), there is no need to supplement.

4. OD tablets: can be taken orally on the tongue (without water) or delivered with water, but bedridden patients need to take them with water to prevent aspiration.

7、 Medication for special populations

1. Pregnant women: prohibited (animal experiments show risk of fetal kidney damage).

2. Breastfeeding period: It is recommended to discontinue medication (drugs detected in breast milk).

3. Children: No safety data, disabled.

4. Elderly people: need to be cautious as they are prone to dehydration or hypoglycemia.

8、 Adverse reactions

1. Common (≥ 1%):

Urinary tract infections, genital fungal infections, hypoglycemia (when combined with insulin/sulfonylurea), polyuria.

2. Serious:

Ketoacidosis (may not have typical symptoms of hyperglycemia);

Dehydration related thrombosis/acute kidney injury;

Necrotizing fasciitis (perineum), pyelonephritis.

9、 Contraindications

Individuals who are allergic to ingredients;

Type 1 diabetes or diabetes ketoacidosis;

Patients with severe infections/injuries/requiring insulin therapy during surgery;

Dialysis or eGFR<30mL/min/1.73m ² (excluding indications for renal protection).

10、 Drug interactions

1. Be cautious when using in combination:

Diuretics (aggravating dehydration);

Digoxin (blood concentration ↑ 20%);

Rifampicin (canagliflozin exposure ↓ 51%).

2. Increased risk of hypoglycemia:

Insulin, sulfonylureas, and fast acting secretagogues.

11、 Storage method

1. Condition: Store at room temperature (avoid high temperature and humidity);

2. Validity period: 3 years;

3. PTP packaging: The tablets need to be taken out to prevent accidental ingestion of aluminum foil.

12、 Manufacturer

Manufacturer: Mitsubishi Tanabe Pharma from Japan;

Canagluinformation