*If further glycaemic control is needed, the addition of other anti-hyperglycaemic agents should be considered.
- Care should be taken when increasing the dose in patients ≥75 years of age, patients with known cardiovascular disease, or other patients for whom the initial canagliflozin-induced diuresis poses a risk2
- In patients with evidence of volume depletion, correcting this condition prior to initiation of canagliflozin is recommended. When canagliflozin is used as add-on therapy with insulin or an insulin secretagogue (e.g. sulphonylurea), a lower dose of insulin or the insulin secretagogue may be considered to reduce the risk of hypoglycaemia2
- Hepatic impairment: no dose adjustment required for patients with mild or moderate hepatic impairment (canagliflozin has not been studied in severe hepatic impairment and is not recommended for these patients)2
SGLT2 inhibitor Prescribing Tool
An SGLT2 Inhibitor Prescribing Tool has been developed by the Improving Diabetes Steering Committee (IDSC), a multi-disciplinary group of healthcare professionals assembled to offer evidence-based practical guidelines for the use of oral type 2 diabetes medications. The IDSC seeks to support HCPs in appropriate treatment of people with type 2 diabetes who are at risk of developing, or have established, cardiovascular disease and examines the role of SGLT2 inhibitor therapy for these people from the perspective of the current UK treatment pathway.
This prescribing tool has been developed by the IDSC as a quick reference guide to provide clarity and support clinicians with treatment decisions. The tool uses a traffic light system to help inform clinicians decision making for prescribing SGLT2 inhibitors, and situations where these therapies would not be recommended, with associated evidence levels for each recommendation.
The Improving Diabetes Steering Committee is now supported and funded by Menarini.
