Recommended Dose: The recommended starting dose is 100 mg once daily before the first meal of the day. For patients requiring additional glycemic control and with adequate renal function, the dose may be increased to 300 mg once daily.

Time: Take once daily before the first meal.

Instructions for use: Swallow the tablet whole with water. It may be used alone or together with metformin, sulfonylureas, insulin, or other antidiabetic medicines. Maintain adequate hydration during treatment, and monitor renal function regularly. Dose adjustment may be needed when used with insulin or insulin secretagogues to reduce the risk of hypoglycemia.

Interaction: The glucose-lowering effect may be enhanced by insulin or sulfonylureas, increasing the risk of hypoglycemia. Diuretics may increase the risk of dehydration and hypotension. UGT enzyme inducers such as rifampin may reduce canagliflozin exposure, while certain UGT inhibitors may increase drug levels.

Side effects: The most common adverse reactions include genital mycotic infections, urinary tract infections, increased urination, thirst, hypotension, dizziness, constipation, nausea, and hypoglycemia when used with insulin or sulfonylureas. Serious but uncommon adverse reactions include diabetic ketoacidosis, acute kidney injury, Fournier’s gangrene, lower-limb amputation, and bone fractures.