Canagliflozin Hydrochloride (Canaglu) is a sodium-glucose cotransporter 2 (SGLT2) inhibitor that lowers blood glucose levels by inhibiting renal glucose reabsorption. Like all medications, canagliflozin exerts therapeutic effects while carrying a certain risk of side effects, among which some severe adverse reactions require special vigilance.

What are the Side Effects of Canagliflozin Hydrochloride (Canaglu)?

Urinary Tract Infections

Incidence: 8.4%–9.3% in female patients.

Incidence: 3.6%–4.1% in male patients.

Main manifestations: Symptoms such as urethritis and cystitis.

Most cases are mild to moderate and can be controlled with standard antibiotic treatment.

Genitourinary Fungal Infections

Incidence of vulvovaginal candidiasis in females: Approximately 10%.

Incidence of balanitis in males: Approximately 4%.

Main manifestations: Symptoms such as vulvar pruritus and abnormal discharge.

Diabetic patients are inherently prone to infections, and the risk is further increased with medication use.

Hypovolemia-Related Symptoms

Incidence: Approximately 3%.

Main manifestations: Dizziness, orthostatic hypotension, and fatigue.

Higher risk in elderly patients and those using diuretics.

Lipid Changes

Mild elevation of low-density lipoprotein cholesterol (LDL-C).

Mild elevation of high-density lipoprotein cholesterol (HDL-C).

Lipid levels should be monitored at the initial stage of treatment.

Severe Side Effects of Canagliflozin Hydrochloride (Canaglu)

Ketoacidosis

Clinical manifestations: Blood glucose may not be significantly elevated (<250 mg/dL).

Nausea, vomiting, abdominal pain, fatigue, and dyspnea.

Elevated blood ketones and metabolic acidosis.

Risk factors: Sudden reduction in insulin dosage.

Severe insufficient caloric intake.

Acute infections, surgery, and heavy alcohol consumption.

Acute Kidney Injury

Pathogenesis: Transient decrease in glomerular filtration rate.

May be associated with hypovolemia.

Clinical manifestations: Rapid elevation of serum creatinine levels.

Decreased urine output.

Temporary or permanent discontinuation of medication may be required.

Precautions for Canagliflozin Hydrochloride (Canaglu) Administration

Renal Function Assessment

Estimated glomerular filtration rate (eGFR) should be evaluated.

Contraindicated in patients with eGFR < 30 mL/min/1.73m².

Use with caution in patients with eGFR 30–45 mL/min/1.73m².

Foot Examinations

Assess peripheral vascular status.

Check for ulcers and infections.

Patients are advised to self-examine their feet daily.

Renal Function Monitoring

Baseline assessment before initiating treatment.

Monitor at least once a year during treatment.

Increase monitoring frequency when eGFR < 60 mL/min/1.73m².

Metabolic Monitoring

Regularly monitor blood glucose and blood ketones.

Immediately test if symptoms such as nausea and vomiting occur.

Enhance monitoring before surgery and during acute illnesses.

Infection Monitoring

Pay attention to symptoms of urinary tract infections.

Promptly treat fungal infections.

Educate patients on personal hygiene practices.