Canagliflozin Hydrochloride (Canaglu) is a new-generation sodium-glucose cotransporter 2 (SGLT2) inhibitor that provides an innovative solution for type 2 diabetes mellitus management through a unique mechanism of action.

How to Use Canagliflozin Hydrochloride (Canaglu)

Administration Route and Timing

This medication is administered orally, recommended to be taken once daily at a fixed time.

Administration is not affected by food intake; however, patients are advised to establish a regular dosing routine (e.g., before or after breakfast or another fixed time) to maintain stable plasma concentrations.

Standard Dosage Regimen

The recommended initial dosage is 100 mg once daily. For patients with inadequate glycemic control who tolerate the medication well, the dosage may be increased to 300 mg once daily.

Dosage adjustments should be performed under the guidance of a healthcare professional, based on individual glycemic responses and safety assessments.

Administration Precautions

A comprehensive evaluation of the patient’s baseline conditions (including renal function, intravascular volume status, and electrolyte levels) should be conducted prior to treatment.

Adequate fluid intake is recommended during treatment, especially in the initial treatment phase or when combined with diuretics, to prevent hypovolemia.

Dosage Adjustments for Canagliflozin Hydrochloride (Canaglu)

Patients with Renal Impairment

Mild renal impairment (eGFR ≥ 60 mL/min/1.73m²): No dosage adjustment is required.

Moderate renal impairment (eGFR 45–59 mL/min/1.73m²): The maximum dosage should not exceed 100 mg once daily.

Severe renal impairment (eGFR < 45 mL/min/1.73m²): Not recommended for use.

End-stage renal disease (ESRD): Contraindicated.

Special Clinical Situations

Elderly patients generally do not require dosage adjustment based solely on age; however, physiological function decline and concurrent medications should be considered.

For patients with hepatic impairment: No dosage adjustment is needed for mild to moderate impairment. Experience with severe hepatic impairment is limited, and cautious assessment is required.

Management of Adverse Reactions

For symptomatic hypotension, assess intravascular volume status and discontinue the medication if necessary.

Immediately discontinue the medication and initiate aggressive intervention if diabetic ketoacidosis occurs.

Consider adjusting the treatment regimen in cases of recurrent urinary tract infections.

Use in Special Populations

Elderly Patients

When using this medication in elderly patients with diabetes mellitus, special attention should be paid to monitoring changes in renal function and intravascular volume status.

The recommended starting dosage is 100 mg once daily, with gradual adjustment to the optimal effective dosage.

Patients with Hepatic Impairment

Patients with Child-Pugh Class A or B hepatic impairment: No dosage adjustment is required.

Patients with Child-Pugh Class C hepatic impairment: Insufficient safety data are available; close monitoring of hepatic function indices is necessary if used.

Pregnancy and Lactation

Insufficient human study data are available; use during pregnancy is not recommended.

The safety of use during lactation has not been established; the potential benefits and risks should be weighed before decision-making.