| Summary: | Canagliflozin is the first sodium-glucose cotransporter-2 (SGLT2) inhibitor to be approved for use in Canada. Canagliflozin is indicated for patients with type 2 diabetes to improve glycemic control as monotherapy or in combination with metformin; a sulfonylurea; metformin and a sulfonylurea; metformin and pioglitazone; or insulin (with or without metformin) when these drugs do not provide adequate glycemic control. The recommended starting dose is 100 mg once daily. A dose of 300 mg once daily may be considered for patients who have tolerated a dose of 100 mg once daily and who need tighter glycemic control, provided they have an estimated glomerular filtration rate (eGFR) of e 60 mL/min/1.73 m2 and have a low risk of adverse reactions associated with reduced intravascular volume. Canagliflozin is contraindicated in renally impaired patients who have an eGFR of less than 45 mL/min/1.73 m2, have end-stage renal disease, or are on dialysis. The current CADTH Common Drug Review (CDR) submission for canagliflozin is for use in combination with metformin and a sulfonylurea in adult patients with type 2 diabetes mellitus to improve glycemic control when diet, exercise, and dual therapy do not provide adequate glycemic control
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