Diacana
Generic Name
Canagliflozin
Manufacturer
Hypothetical Pharma Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| diacana 100 mg tablet | ৳ 60.00 | ৳ 600.00 |
Description
Overview of the medicine
Diacana 100 mg Tablet contains Canagliflozin, an SGLT2 inhibitor, used to improve glycemic control in adults with type 2 diabetes mellitus. It also reduces the risk of major adverse cardiovascular events in adults with type 2 diabetes and established cardiovascular disease, and reduces the risk of end-stage kidney disease, cardiovascular death, and hospitalization for heart failure in specific patient populations.
Uses & Indications
Dosage
Adults
The recommended starting dose is 100 mg orally once daily, taken before the first meal of the day. The dose can be increased to 300 mg once daily if additional glycemic control is needed and the patient tolerates the 100 mg dose.
Elderly
No dosage adjustment is required based on age alone. However, renal function should be assessed before initiating and periodically during treatment.
Renal_impairment
For patients with eGFR ≥60 mL/min/1.73 m², no dosage adjustment is needed. For eGFR 45 to <60 mL/min/1.73 m², initiate with 100 mg once daily. For eGFR <45 mL/min/1.73 m², do not initiate Diacana. If eGFR falls persistently below 45 mL/min/1.73 m² during treatment, discontinue use. Contraindicated in severe renal impairment (eGFR <30 mL/min/1.73 m²), end-stage renal disease, or patients on dialysis.
How to Take
Take Diacana orally once daily, preferably before the first meal of the day. Swallow the tablet whole with water. Do not crush, cut, or chew the tablet.
Mechanism of Action
Canagliflozin inhibits Sodium-Glucose Cotransporter 2 (SGLT2) in the renal proximal tubules, which is responsible for reabsorbing most of the filtered glucose from the tubular lumen. By inhibiting SGLT2, Canagliflozin reduces renal glucose reabsorption, leading to increased urinary glucose excretion (glucosuria), thereby lowering blood glucose levels. This also results in osmotic diuresis, leading to reductions in blood pressure and body weight.
Pharmacokinetics
Onset
Glycemic lowering effects observed within hours of administration.
Excretion
Approximately 40% excreted in urine (as unchanged drug and metabolites) and 60% in feces (mainly as metabolites).
Half life
Approximately 10.6 to 13.1 hours.
Absorption
Rapidly absorbed, peak plasma concentrations (Tmax) reached within 1-2 hours after oral administration. Absolute bioavailability is approximately 65%.
Metabolism
Primarily metabolized via O-glucuronidation by UGT1A9 and UGT2B4. Minor metabolism via oxidative pathways.
Side Effects
Contraindications
- Hypersensitivity to Canagliflozin or any component of the formulation.
- Severe renal impairment (eGFR <30 mL/min/1.73 m²), end-stage renal disease, or patients on dialysis.
Drug Interactions
Digoxin
Canagliflozin may increase digoxin exposure. Monitor digoxin levels if co-administered.
Diuretics
May increase the risk of dehydration and hypotension.
Rifampin (and other UGT enzyme inducers)
May decrease the exposure of Canagliflozin, reducing its efficacy.
Insulin and Insulin Secretagogues (e.g., Sulfonylureas)
Increased risk of hypoglycemia; a lower dose of insulin or insulin secretagogue may be required.
Storage
Store below 30°C in a dry place, away from direct light and moisture. Keep out of reach of children.
Overdose
In the event of an overdose, contact a healthcare professional or poison control center immediately. Treatment should be supportive, as no specific antidote is available. Hemodialysis is unlikely to be effective for removing Canagliflozin due to its high protein binding.
Pregnancy & Lactation
Pregnancy: Not recommended during the second and third trimesters due to potential renal developmental effects. Lactation: Not recommended. It is unknown if Canagliflozin is excreted in human milk, but animal studies show excretion. A decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 to 36 months from the date of manufacture, check packaging for exact date.
Availability
Available in retail pharmacies and hospitals nationwide
Approval Status
Approved by regulatory authorities for Type 2 Diabetes Mellitus
Patent Status
Likely generic in many markets, original patent expired or nearing expiry
Clinical Trials
Key clinical trials such as CANVAS (Canagliflozin Cardiovascular Assessment Study) and CREDENCE (Canagliflozin and Renal Events in Diabetes with Established Nephropathy Clinical Evaluation) have demonstrated its cardiovascular and renal benefits in patients with type 2 diabetes.
Lab Monitoring
- Renal function (eGFR) should be assessed before initiating and periodically during treatment.
- Blood glucose and HbA1c levels should be monitored regularly.
- Electrolytes (especially potassium) should be monitored, particularly in patients at risk for hyperkalemia.
- Lipid profile (LDL-C) monitoring is recommended.
Doctor Notes
- Counsel patients on the importance of hydration to prevent volume depletion and symptomatic hypotension.
- Emphasize foot care and prompt reporting of any foot lesions or infections.
- Educate patients about the signs and symptoms of DKA, even in the absence of hyperglycemia, and advise them to seek immediate medical attention.
- Monitor renal function, electrolytes, and lipid profiles periodically.
Patient Guidelines
- Take the medicine exactly as prescribed by your doctor.
- Maintain adequate hydration to reduce the risk of volume depletion.
- Be aware of the symptoms of diabetic ketoacidosis (e.g., nausea, vomiting, abdominal pain, excessive thirst, rapid breathing) and seek immediate medical attention if they occur.
- Practice good foot hygiene and examine your feet regularly for any sores, ulcers, or infections.
- Report any signs of genital or urinary tract infections to your doctor.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not take two doses at once to make up for a missed dose.
Driving Precautions
Diacana may cause dizziness in some patients, especially at the start of treatment or if used with other medications that lower blood pressure or blood sugar. If you experience dizziness, avoid driving or operating machinery.
Lifestyle Advice
- Adhere to a healthy diet plan recommended by your doctor or nutritionist.
- Engage in regular physical activity as advised by your healthcare provider.
- Monitor your blood glucose levels regularly as instructed.
- Maintain good personal hygiene, especially in the genital area, to prevent infections.
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