Meta Information
ID:canagliflozin
Name:
Schema Version:AIM-2.0
Interactions
Target id:
/class/antidiabetic-medications
Target name:
Insulin and Insulin Secretagogues (e.g., Sulfonylureas)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Combining canagliflozin with medications that strongly lower blood sugar, like insulin or sulfonylureas, significantly increases the risk of severe hypoglycemia (dangerously low blood sugar).
Actionable advice:
Your doctor will likely need to reduce the dose of your insulin or other diabetes medication when starting canagliflozin.
Target id:
/class/loop-diuretics
Target name:
Loop Diuretics (e.g., Furosemide)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Both canagliflozin and loop diuretics cause fluid and salt loss, and using them together can lead to severe dehydration, low blood pressure, and acute kidney injury.
Actionable advice:
Avoid concurrent use unless closely monitored by a physician, who may need to adjust diuretic dosage.
Target id:
/class/broad-spectrum-inducers
Target name:
UGT Enzyme Inducers (e.g., Rifampin, Phenytoin)
Severity:
major
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
null
Description:
Certain medications (like rifampin, phenytoin, phenobarbital, ritonavir) speed up the metabolism of canagliflozin, significantly reducing its concentration and effectiveness.
Actionable advice:
If you must take these medications, your doctor may need to increase your canagliflozin dose or choose an alternative.
Target id:
/intervention/ketogenic-diet
Target name:
Ketogenic or Very Low-Carbohydrate Diets
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
These diets promote ketone production, and when combined with canagliflozin, they dramatically increase the risk of developing a serious condition called euglycemic diabetic ketoacidosis (DKA).
Actionable advice:
Avoid ketogenic and very low-carbohydrate diets while taking canagliflozin.
Target id:
/procedure/major-surgery
Target name:
Major Surgical or Medical Procedures
Severity:
major
Interaction type:
adverse
Nature:
temporal
Temporal spacing:
Hours before target:
72
Hours after target:
null
Description:
The physiological stress of surgery, combined with fasting, increases the risk of diabetic ketoacidosis (DKA). Canagliflozin should be stopped beforehand to mitigate this risk.
Actionable advice:
Stop taking canagliflozin at least 3 days before any scheduled major surgery or procedure.
Target id:
/condition/renal-impairment
Target name:
Moderate to Severe Renal Impairment (eGFR < 45)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
The glucose-lowering effect of canagliflozin depends on kidney function; its efficacy is reduced in renal impairment, while the risk of side effects like hyperkalemia and volume depletion increases.
Actionable advice:
Avoid this medication if your eGFR is below 30; use with caution and likely at a lower dose if eGFR is below 45.
Target id:
/dietary/meal
Target name:
First Meal of the Day
Severity:
major
Interaction type:
requirement
Nature:
temporal
Temporal spacing:
Hours before target:
0.5
Hours after target:
0
Description:
Taking canagliflozin before the first meal of the day is crucial for its mechanism of action, as it helps to excrete the glucose absorbed from that meal.
Actionable advice:
Always take your daily dose of canagliflozin just before your first meal.
Target id:
/condition/dehydration
Target name:
Dehydration or Inadequate Fluid Intake
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Canagliflozin works by increasing urination, which can lead to dehydration. Being dehydrated significantly increases the risk of low blood pressure, dizziness, and acute kidney injury.
Actionable advice:
Maintain adequate fluid intake throughout the day and be cautious during illness or intense exercise.
Target id:
/condition/type-1-diabetes
Target name:
Type 1 Diabetes Mellitus
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Canagliflozin is not approved for Type 1 Diabetes due to a significantly increased risk of life-threatening diabetic ketoacidosis (DKA).
Actionable advice:
This medication is contraindicated and should not be used if you have Type 1 Diabetes.
Target id:
/condition/pregnancy
Target name:
Pregnancy
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Canagliflozin is not recommended during the second and third trimesters of pregnancy due to potential risks to fetal kidney development.
Actionable advice:
Avoid this medication completely if you are pregnant or planning to become pregnant.
Target id:
/condition/lactation
Target name:
Breastfeeding (Lactation)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
It is not known if canagliflozin passes into breast milk, but due to the potential for serious adverse reactions in the nursing infant, it is not recommended.
Actionable advice:
Do not take this medication while breastfeeding.
Target id:
/condition/peripheral-vascular-disease
Target name:
Peripheral Vascular Disease or History of Amputation
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Clinical trials showed an increased risk of lower limb amputations, primarily of the toe or foot, in patients with established cardiovascular disease or risk factors.
Actionable advice:
Discuss this risk with your doctor; regular foot exams are critical if you take this medication.
Target id:
/class/potassium-elevators
Target name:
Potassium-Elevating Agents (ACEi, ARBs, K-Sparing Diuretics)
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Canagliflozin can cause a small increase in serum potassium. When combined with other drugs that also raise potassium (like ACE inhibitors or ARBs), the risk of hyperkalemia (high potassium) becomes significant.
Actionable advice:
If taking these medications together, regular monitoring of blood potassium levels is necessary.
Target id:
/class/nsaids
Target name:
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
NSAIDs can reduce kidney blood flow. Combining them with canagliflozin, especially during periods of dehydration, can increase the risk of acute kidney injury.
Actionable advice:
Use NSAIDs cautiously and ensure you are well-hydrated; avoid long-term concurrent use if possible.
Target id:
/dietary/alcohol-acute
Target name:
Alcohol
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Alcohol can increase the risk of hypoglycemia, contribute to dehydration, and may increase the risk of ketoacidosis when consumed in large amounts.
Actionable advice:
Limit alcohol consumption and avoid binge drinking while taking this medication.
Target id:
/intervention/digoxin
Target name:
Digoxin
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Canagliflozin can slightly increase the concentration of digoxin in the blood, potentially increasing the risk of digoxin toxicity.
Actionable advice:
If you take digoxin, your doctor should monitor your digoxin levels after starting canagliflozin.
Target id:
/class/sglt2-inhibitors
Target name:
Other SGLT2 Inhibitors (e.g., Dapagliflozin, Empagliflozin)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Using more than one SGLT2 inhibitor at the same time is redundant therapy, provides no additional benefit, and significantly increases the risk of all associated side effects.
Actionable advice:
Never take more than one medication from the SGLT2 inhibitor class at the same time.
Target id:
/condition/osteoporosis
Target name:
Osteoporosis or High Fracture Risk
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
An increased risk of bone fractures has been observed in some clinical trials with canagliflozin, with fractures occurring as early as 12 weeks after starting.
Actionable advice:
If you have osteoporosis or are at high risk for fractures, discuss this potential risk with your doctor.
Target id:
/condition/history-of-yeast-infections
Target name:
History of Genital Mycotic (Yeast) Infections
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
By increasing glucose in the urine, canagliflozin creates a favorable environment for yeast growth, significantly increasing the incidence of genital yeast infections in both men and women.
Actionable advice:
Be aware of the increased risk and maintain good hygiene; seek treatment if symptoms occur.
Target id:
/biomarker/lipid-panel
Target name:
LDL Cholesterol Levels
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Canagliflozin can cause a dose-dependent increase in LDL cholesterol ('bad' cholesterol) levels.
Actionable advice:
Regularly monitor your lipid panel as your LDL cholesterol may increase while on this medication.
Target id:
/biomarker/complete-blood-count
Target name:
Hematocrit
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Due to its diuretic effect, canagliflozin can cause volume contraction, leading to a small increase in hematocrit (the proportion of red blood cells in your blood).
Actionable advice:
Be aware that a small rise in hematocrit is an expected finding and generally not a cause for concern.