Canagliflozin interactions

Canagliflozin (Invokana), an SGLT2 inhibitor has 114 documented interactions across the FDA labels and fact sheets we index: 4 major, 104 moderate, 6 minor, and 0 where a label reports no significant interaction. Each entry below quotes the sentence behind it. This drug page is a starting point, not a verdict for your situation.

Major interactions (4)

  • ChloroquineantimalarialMajor

    Hypoglycemia Chloroquine has been shown to cause severe hypoglycemia including loss of consciousness that could be life-threatening in patients treated with or without antidiabetic medications (see PRECAUTIONS , Drug Interactions ). (Chloroquine label, Warnings)

  • CiprofloxacinfluoroquinoloneMajor

    Antidiabetic agents Hypoglycemia including fatal outcomes have been reported. (Ciprofloxacin label, Drug interactions)

  • Fluconazoleazole antifungalMajor

    Oral hypoglycemics Clinically significant hypoglycemia may be precipitated by the use of fluconazole with oral hypoglycemic agents; one fatality has been reported from hypoglycemia in association with combined fluconazole and glyburide use. (Fluconazole label, Drug interactions)

  • HydroxychloroquineQT-prolonging drugMajor

    Hypoglycemia PLAQUENIL can cause severe and potentially life-threatening hypoglycemia, in the presence or absence of antidiabetic agents [see Drug Interactions (7) ]. (Hydroxychloroquine label, Warnings and precautions)

Moderate interactions (104)

  • AcarboseantidiabeticModerate

    Consider adding another antihyperglycemic agent in patients who require additional glycemic control [see Dosage and Administration (2.3) and Clinical Pharmacology (12.3) ] . (Canagliflozin label, Drug interactions)

  • Acetazolamidecarbonic anhydrase inhibitorModerate

    Patients with impaired renal function (eGFR less than 60 mL/min/1.73 m 2 ), elderly patients, or patients on loop diuretics may be at increased risk for volume depletion or hypotension. (Canagliflozin label, Warnings and precautions)

  • AlcoholAlcoholModerate

    Precipitating conditions for diabetic ketoacidosis or other ketoacidosis include under-insulinization due to insulin dose reduction or missed insulin doses, acute febrile illness, reduced caloric intake, ketogenic diet, surgery, volume depletion, and alcohol abuse. (Canagliflozin label, Warnings and precautions)

  • Amiloridepotassium-sparing diureticModerate

    Patients with impaired renal function (eGFR less than 60 mL/min/1.73 m 2 ), elderly patients, or patients on loop diuretics may be at increased risk for volume depletion or hypotension. (Canagliflozin label, Warnings and precautions)

  • Amlodipine and benazeprildihydropyridine calcium channel blockerModerate

    Antidiabetic Agents: In rare cases, diabetic patients receiving an ACE inhibitor (including benazepril) concomitantly with insulin or oral antidiabetics may develop hypoglycemia. (Amlodipine and benazepril label, Drug interactions)

  • AprepitantCYP3A4 inhibitorModerate

    Table 7: Clinically Significant Drug Interactions with INVOKANA UGT Enzyme Inducers Clinical Impact: UGT enzyme inducers decrease canagliflozin exposure which may reduce the effectiveness of INVOKANA. (Canagliflozin label, Drug interactions)

  • ArmodafinilCNS stimulantModerate

    Table 7: Clinically Significant Drug Interactions with INVOKANA UGT Enzyme Inducers Clinical Impact: UGT enzyme inducers decrease canagliflozin exposure which may reduce the effectiveness of INVOKANA. (Canagliflozin label, Drug interactions)

  • Aspirin and dipyridamoleantiplatelet agentModerate

    Oral Hypoglycemics Moderate doses of aspirin may increase the effectiveness of oral hypoglycemic drugs, leading to hypoglycemia. (Aspirin and dipyridamole label, Drug interactions)

  • BenazeprilACE inhibitorModerate

    Antidiabetics: Increased risk of hypoglycemia ( 7.2 ) (Benazepril label, Drug interactions)

  • Bisoprololbeta blockerModerate

    However, patients subject to spontaneous hypoglycemia, or diabetic patients receiving insulin or oral hypoglycemic agents, should be cautioned about these possibilities and bisoprolol fumarate should be used with caution. (Bisoprolol label, Warnings)

  • Bisoprolol and hydrochlorothiazidebeta blockerModerate

    Patients with impaired renal function (eGFR less than 60 mL/min/1.73 m 2 ), elderly patients, or patients on loop diuretics may be at increased risk for volume depletion or hypotension. (Canagliflozin label, Warnings and precautions)

  • BosentanCYP3A4 inducerModerate

    Table 7: Clinically Significant Drug Interactions with INVOKANA UGT Enzyme Inducers Clinical Impact: UGT enzyme inducers decrease canagliflozin exposure which may reduce the effectiveness of INVOKANA. (Canagliflozin label, Drug interactions)

  • Bumetanideloop diureticModerate

    Patients with impaired renal function (eGFR less than 60 mL/min/1.73 m 2 ), elderly patients, or patients on loop diuretics may be at increased risk for volume depletion or hypotension. (Canagliflozin label, Warnings and precautions)

  • CapecitabineantimetaboliteModerate

    Closely monitor for adverse reactions of CYP2C9 substrates where minimal concentration changes may lead to serious adverse reactions when used concomitantly with XELODA (e.g., anticoagulants, antidiabetic drugs). (Capecitabine label, Drug interactions)

  • CarbamazepineanticonvulsantModerate

    Table 7: Clinically Significant Drug Interactions with INVOKANA UGT Enzyme Inducers Clinical Impact: UGT enzyme inducers decrease canagliflozin exposure which may reduce the effectiveness of INVOKANA. (Canagliflozin label, Drug interactions)

  • Carvedilolbeta blockerModerate

    Insulin and oral hypoglycemics action may be enhanced. (Carvedilol label, Drug interactions)

  • CenobamateanticonvulsantModerate

    Table 7: Clinically Significant Drug Interactions with INVOKANA UGT Enzyme Inducers Clinical Impact: UGT enzyme inducers decrease canagliflozin exposure which may reduce the effectiveness of INVOKANA. (Canagliflozin label, Drug interactions)

  • Chlorthalidonethiazide diureticModerate

    Patients with impaired renal function (eGFR less than 60 mL/min/1.73 m 2 ), elderly patients, or patients on loop diuretics may be at increased risk for volume depletion or hypotension. (Canagliflozin label, Warnings and precautions)

  • Clarithromycinmacrolide antibioticModerate

    Oral Hypoglycemic Agents/Insulin: The concomitant use of clarithromycin tablets and oral hypoglycemic agents and/or insulin can result in significant hypoglycemia. (Clarithromycin label, Warnings and precautions)

  • ClobazambenzodiazepineModerate

    Table 7: Clinically Significant Drug Interactions with INVOKANA UGT Enzyme Inducers Clinical Impact: UGT enzyme inducers decrease canagliflozin exposure which may reduce the effectiveness of INVOKANA. (Canagliflozin label, Drug interactions)

  • DapagliflozinSGLT2 inhibitorModerate

    Consider adding another antihyperglycemic agent in patients who require additional glycemic control [see Dosage and Administration (2.3) and Clinical Pharmacology (12.3) ] . (Canagliflozin label, Drug interactions)

  • Deferasiroxiron supplementModerate

    Table 7: Clinically Significant Drug Interactions with INVOKANA UGT Enzyme Inducers Clinical Impact: UGT enzyme inducers decrease canagliflozin exposure which may reduce the effectiveness of INVOKANA. (Canagliflozin label, Drug interactions)

  • DexamethasonecorticosteroidModerate

    Table 7: Clinically Significant Drug Interactions with INVOKANA UGT Enzyme Inducers Clinical Impact: UGT enzyme inducers decrease canagliflozin exposure which may reduce the effectiveness of INVOKANA. (Canagliflozin label, Drug interactions)

  • Digoxindigitalis glycosideModerate

    Digoxin Clinical Impact: Canagliflozin increases digoxin exposure [see Clinical Pharmacology (12.3) ] . (Canagliflozin label, Drug interactions)

  • Dorzolamide and timololcarbonic anhydrase inhibitorModerate

    Masking of Hypoglycemic Symptoms in Patients with Diabetes Mellitus Beta-adrenergic blocking agents should be administered with caution in patients subject to spontaneous hypoglycemia or to diabetic patients (especially those with labile diabetes) who are receiving insulin or oral hypoglycemic agents. (Dorzolamide and timolol label, Warnings and precautions)

  • DulaglutideGLP-1 receptor agonistModerate

    Consider adding another antihyperglycemic agent in patients who require additional glycemic control [see Dosage and Administration (2.3) and Clinical Pharmacology (12.3) ] . (Canagliflozin label, Drug interactions)

  • EmpagliflozinSGLT2 inhibitorModerate

    Consider adding another antihyperglycemic agent in patients who require additional glycemic control [see Dosage and Administration (2.3) and Clinical Pharmacology (12.3) ] . (Canagliflozin label, Drug interactions)

  • Empagliflozin and metforminSGLT2 inhibitorModerate

    Consider adding another antihyperglycemic agent in patients who require additional glycemic control [see Dosage and Administration (2.3) and Clinical Pharmacology (12.3) ] . (Canagliflozin label, Drug interactions)

  • Eplerenonealdosterone antagonistModerate

    Patients with impaired renal function (eGFR less than 60 mL/min/1.73 m 2 ), elderly patients, or patients on loop diuretics may be at increased risk for volume depletion or hypotension. (Canagliflozin label, Warnings and precautions)

  • EslicarbazepineanticonvulsantModerate

    Table 7: Clinically Significant Drug Interactions with INVOKANA UGT Enzyme Inducers Clinical Impact: UGT enzyme inducers decrease canagliflozin exposure which may reduce the effectiveness of INVOKANA. (Canagliflozin label, Drug interactions)

  • Ethacrynic acidloop diureticModerate

    Patients with impaired renal function (eGFR less than 60 mL/min/1.73 m 2 ), elderly patients, or patients on loop diuretics may be at increased risk for volume depletion or hypotension. (Canagliflozin label, Warnings and precautions)

  • ExenatideGLP-1 receptor agonistModerate

    Consider adding another antihyperglycemic agent in patients who require additional glycemic control [see Dosage and Administration (2.3) and Clinical Pharmacology (12.3) ] . (Canagliflozin label, Drug interactions)

  • FludrocortisonecorticosteroidModerate

    Monitor for symptoms of hyperglycemia; adjust dosage of antidiabetic drug upward if necessary. (Fludrocortisone label, Drug interactions)

  • FluoxetineSSRIModerate

    As is true with many other types of medication when taken concurrently by patients with diabetes, insulin and/or oral hypoglycemic, dosage may need to be adjusted when therapy with PROZAC is instituted or discontinued. (Fluoxetine label, Warnings and precautions)

  • Furosemideloop diureticModerate

    Patients with impaired renal function (eGFR less than 60 mL/min/1.73 m 2 ), elderly patients, or patients on loop diuretics may be at increased risk for volume depletion or hypotension. (Canagliflozin label, Warnings and precautions)

  • GlimepiridesulfonylureaModerate

    • Hypoglycemia with Concomitant Use with Insulin or Insulin Secretagogues : Consider a lower dose of insulin or the insulin secretagogue to reduce the risk of hypoglycemia when used in combination with INVOKANA ( 5.5 ). (Canagliflozin label, Warnings and precautions)

  • GlipizidesulfonylureaModerate

    • Hypoglycemia with Concomitant Use with Insulin or Insulin Secretagogues : Consider a lower dose of insulin or the insulin secretagogue to reduce the risk of hypoglycemia when used in combination with INVOKANA ( 5.5 ). (Canagliflozin label, Warnings and precautions)

  • GlyburidesulfonylureaModerate

    • Hypoglycemia with Concomitant Use with Insulin or Insulin Secretagogues : Consider a lower dose of insulin or the insulin secretagogue to reduce the risk of hypoglycemia when used in combination with INVOKANA ( 5.5 ). (Canagliflozin label, Warnings and precautions)

  • Glyburide and metforminsulfonylureaModerate

    • Hypoglycemia with Concomitant Use with Insulin or Insulin Secretagogues : Consider a lower dose of insulin or the insulin secretagogue to reduce the risk of hypoglycemia when used in combination with INVOKANA ( 5.5 ). (Canagliflozin label, Warnings and precautions)

  • GriseofulvinantifungalModerate

    Table 7: Clinically Significant Drug Interactions with INVOKANA UGT Enzyme Inducers Clinical Impact: UGT enzyme inducers decrease canagliflozin exposure which may reduce the effectiveness of INVOKANA. (Canagliflozin label, Drug interactions)

  • Hydrochlorothiazidethiazide diureticModerate

    Patients with impaired renal function (eGFR less than 60 mL/min/1.73 m 2 ), elderly patients, or patients on loop diuretics may be at increased risk for volume depletion or hypotension. (Canagliflozin label, Warnings and precautions)

  • HydrocortisonecorticosteroidModerate

    Antidiabetic Agents Clinical Impact: Corticosteroids in supraphysiologic doses may increase blood glucose concentrations. (Hydrocortisone label, Drug interactions)

  • Indapamidethiazide diureticModerate

    Patients with impaired renal function (eGFR less than 60 mL/min/1.73 m 2 ), elderly patients, or patients on loop diuretics may be at increased risk for volume depletion or hypotension. (Canagliflozin label, Warnings and precautions)

  • Insulin aspartinsulinModerate

    • Hypoglycemia with Concomitant Use with Insulin or Insulin Secretagogues : Consider a lower dose of insulin or the insulin secretagogue to reduce the risk of hypoglycemia when used in combination with INVOKANA ( 5.5 ). (Canagliflozin label, Warnings and precautions)

  • Insulin degludecinsulinModerate

    • Hypoglycemia with Concomitant Use with Insulin or Insulin Secretagogues : Consider a lower dose of insulin or the insulin secretagogue to reduce the risk of hypoglycemia when used in combination with INVOKANA ( 5.5 ). (Canagliflozin label, Warnings and precautions)

  • Insulin detemirinsulinModerate

    • Hypoglycemia with Concomitant Use with Insulin or Insulin Secretagogues : Consider a lower dose of insulin or the insulin secretagogue to reduce the risk of hypoglycemia when used in combination with INVOKANA ( 5.5 ). (Canagliflozin label, Warnings and precautions)

  • Insulin glargineinsulinModerate

    • Hypoglycemia with Concomitant Use with Insulin or Insulin Secretagogues : Consider a lower dose of insulin or the insulin secretagogue to reduce the risk of hypoglycemia when used in combination with INVOKANA ( 5.5 ). (Canagliflozin label, Warnings and precautions)

  • Insulin lisproinsulinModerate

    • Hypoglycemia with Concomitant Use with Insulin or Insulin Secretagogues : Consider a lower dose of insulin or the insulin secretagogue to reduce the risk of hypoglycemia when used in combination with INVOKANA ( 5.5 ). (Canagliflozin label, Warnings and precautions)

  • Insulin regular (human)insulinModerate

    • Hypoglycemia with Concomitant Use with Insulin or Insulin Secretagogues : Consider a lower dose of insulin or the insulin secretagogue to reduce the risk of hypoglycemia when used in combination with INVOKANA ( 5.5 ). (Canagliflozin label, Warnings and precautions)

  • Itraconazoleazole antifungalModerate

    Antidiabetic Drugs Repaglinide Saxagliptin Monitor for adverse reactions. (Itraconazole label, Drug interactions)

  • Ketoconazoleazole antifungalModerate

    Antidiabetics repaglinide, saxagliptin Antihelmintics and Antiprotozoals praziquantel Antimigraine Drugs ergot alkaloids, such as dihydroergotamine, ergometrine (ergonovine), ergotamine, methylergometrine (methylergonovine) eletriptan Ergot alkaloids: The potential increase in plasma concentrations of ergot alkaloids when coadministered with ketoconazole tablets… (Ketoconazole label, Drug interactions)

  • LevofloxacinfluoroquinoloneModerate

    Blood Glucose Disturbances Fluoroquinolones, including Levofloxacin in 5% Dextrose Injection, have been associated with disturbances of blood glucose, including symptomatic hyperglycemia and hypoglycemia, usually in diabetic patients receiving concomitant treatment with an oral hypoglycemic agent (e.g., glyburide) or with insulin. (Levofloxacin label, Warnings and precautions)

  • Levothyroxinethyroid hormoneModerate

    Worsening of Diabetic Control : May worsen glycemic control and result in increased antidiabetic agent or insulin requirements. (Levothyroxine label, Warnings and precautions)

  • LinagliptinDPP-4 inhibitorModerate

    Consider adding another antihyperglycemic agent in patients who require additional glycemic control [see Dosage and Administration (2.3) and Clinical Pharmacology (12.3) ] . (Canagliflozin label, Drug interactions)

  • LinezolidantibioticModerate

    • Hypoglycemia: Postmarketing cases of symptomatic hypoglycemia have been reported in patients with diabetes mellitus receiving insulin or oral hypoglycemic agents. (Linezolid label, Warnings and precautions)

  • Liothyroninethyroid hormoneModerate

    • Worsening of diabetic control: Therapy in patients with diabetes mellitus may worsen glycemic control and result in increased antidiabetic agent or insulin requirements. (Liothyronine label, Warnings and precautions)

  • LiraglutideGLP-1 receptor agonistModerate

    Consider adding another antihyperglycemic agent in patients who require additional glycemic control [see Dosage and Administration (2.3) and Clinical Pharmacology (12.3) ] . (Canagliflozin label, Drug interactions)

  • LisinoprilACE inhibitorModerate

    Antidiabetics Concomitant administration of Zestril and antidiabetic medicines (insulins, oral hypoglycemic agents) may cause an increased blood-glucose-lowering effect with risk of hypoglycemia. (Lisinopril label, Drug interactions)

  • Lisinopril and hydrochlorothiazideACE inhibitorModerate

    Patients with impaired renal function (eGFR less than 60 mL/min/1.73 m 2 ), elderly patients, or patients on loop diuretics may be at increased risk for volume depletion or hypotension. (Canagliflozin label, Warnings and precautions)

  • Lithiumserotonergic drugModerate

    Lithium Clinical Impact: Concomitant use of an SGLT2 inhibitor with lithium may decrease serum lithium concentrations. (Canagliflozin label, Drug interactions)

  • Losartan and hydrochlorothiazideangiotensin II receptor blocker (ARB)Moderate

    Patients with impaired renal function (eGFR less than 60 mL/min/1.73 m 2 ), elderly patients, or patients on loop diuretics may be at increased risk for volume depletion or hypotension. (Canagliflozin label, Warnings and precautions)

  • MetforminbiguanideModerate

    Consider adding another antihyperglycemic agent in patients who require additional glycemic control [see Dosage and Administration (2.3) and Clinical Pharmacology (12.3) ] . (Canagliflozin label, Drug interactions)

  • MethylprednisolonecorticosteroidModerate

    Antidiabetics : Because corticosteroids may increase blood glucose concentrations, dosage adjustments of antidiabetic agents may be required. (Methylprednisolone label, Drug interactions)

  • Metolazonethiazide diureticModerate

    Patients with impaired renal function (eGFR less than 60 mL/min/1.73 m 2 ), elderly patients, or patients on loop diuretics may be at increased risk for volume depletion or hypotension. (Canagliflozin label, Warnings and precautions)

  • ModafinilCNS stimulantModerate

    Table 7: Clinically Significant Drug Interactions with INVOKANA UGT Enzyme Inducers Clinical Impact: UGT enzyme inducers decrease canagliflozin exposure which may reduce the effectiveness of INVOKANA. (Canagliflozin label, Drug interactions)

  • MoxifloxacinfluoroquinoloneModerate

    Antidiabetic agents Carefully monitor blood glucose. (Moxifloxacin label, Drug interactions)

  • Nadololbeta blockerModerate

    Beta-blockade also reduces the release of insulin in response to hyperglycemia; therefore, it may be necessary to adjust the dose of antidiabetic drugs. (Nadolol label, Warnings)

  • Naltrexone and bupropionopioid antagonistModerate

    Use of Antidiabetic Medications: Weight loss may cause hypoglycemia. (Naltrexone and bupropion label, Warnings and precautions)

  • Nirmatrelvir and ritonavirantiviralModerate

    Examples: Rifampin, phenytoin, phenobarbital, ritonavir Insulin or Insulin Secretagogues Clinical Impact: The risk of hypoglycemia is increased when INVOKANA is used concomitantly with insulin secretagogues (e.g., sulfonylurea) or insulin. (Canagliflozin label, Drug interactions)

  • OfloxacinfluoroquinoloneModerate

    Fluoroquinolones have been associated with disturbances of blood glucose, including symptomatic hyperglycemia and hypoglycemia, usually in diabetic patients receiving concomitant treatment with an oral hypoglycemic agent (e.g., glyburide) or with insulin. (Ofloxacin label, Warnings)

  • OrlistatModerate

    A reduction in dose of oral hypoglycemic medication (e.g., sulfonylureas) or insulin may be required in some patients [see Clinical Studies (14) ] . (Orlistat label, Warnings and precautions)

  • OxcarbazepineanticonvulsantModerate

    Table 7: Clinically Significant Drug Interactions with INVOKANA UGT Enzyme Inducers Clinical Impact: UGT enzyme inducers decrease canagliflozin exposure which may reduce the effectiveness of INVOKANA. (Canagliflozin label, Drug interactions)

  • PhenobarbitalbarbiturateModerate

    Examples: Rifampin, phenytoin, phenobarbital, ritonavir Insulin or Insulin Secretagogues Clinical Impact: The risk of hypoglycemia is increased when INVOKANA is used concomitantly with insulin secretagogues (e.g., sulfonylurea) or insulin. (Canagliflozin label, Drug interactions)

  • PhentermineCNS stimulantModerate

    • A reduction in dose of insulin or oral hypoglycemic medication may be required in some patients. (Phentermine label, Warnings and precautions)

  • Phentermine and topiramateCNS stimulantModerate

    Table 7: Clinically Significant Drug Interactions with INVOKANA UGT Enzyme Inducers Clinical Impact: UGT enzyme inducers decrease canagliflozin exposure which may reduce the effectiveness of INVOKANA. (Canagliflozin label, Drug interactions)

  • PhenytoinanticonvulsantModerate

    Examples: Rifampin, phenytoin, phenobarbital, ritonavir Insulin or Insulin Secretagogues Clinical Impact: The risk of hypoglycemia is increased when INVOKANA is used concomitantly with insulin secretagogues (e.g., sulfonylurea) or insulin. (Canagliflozin label, Drug interactions)

  • Pindololbeta blockerModerate

    Beta-blockade also reduces the release of insulin in response to hyperglycemia; therefore, it may be necessary to adjust the dose of antidiabetic drugs. (Pindolol label, Warnings)

  • PioglitazonethiazolidinedioneModerate

    Consider adding another antihyperglycemic agent in patients who require additional glycemic control [see Dosage and Administration (2.3) and Clinical Pharmacology (12.3) ] . (Canagliflozin label, Drug interactions)

  • Pioglitazone and metforminthiazolidinedioneModerate

    Consider adding another antihyperglycemic agent in patients who require additional glycemic control [see Dosage and Administration (2.3) and Clinical Pharmacology (12.3) ] . (Canagliflozin label, Drug interactions)

  • PrednisolonecorticosteroidModerate

    Antidiabetic Agents: Because corticosteroids may increase blood glucose concentrations, dosage adjustments of antidiabetic agents may be required. (Prednisolone label, Drug interactions)

  • PrednisonecorticosteroidModerate

    Antidiabetic agents: May increase blood glucose concentrations. (Prednisone label, Drug interactions)

  • PregabalinanticonvulsantModerate

    Monitor patients for the development of edema when co-administering LYRICA CR and thiazolidinedione antidiabetic agents. (Pregabalin label, Warnings and precautions)

  • PrimidoneanticonvulsantModerate

    Table 7: Clinically Significant Drug Interactions with INVOKANA UGT Enzyme Inducers Clinical Impact: UGT enzyme inducers decrease canagliflozin exposure which may reduce the effectiveness of INVOKANA. (Canagliflozin label, Drug interactions)

  • RepaglinidemeglitinideModerate

    • Hypoglycemia with Concomitant Use with Insulin or Insulin Secretagogues : Consider a lower dose of insulin or the insulin secretagogue to reduce the risk of hypoglycemia when used in combination with INVOKANA ( 5.5 ). (Canagliflozin label, Warnings and precautions)

  • RifampinantibioticModerate

    Examples: Rifampin, phenytoin, phenobarbital, ritonavir Insulin or Insulin Secretagogues Clinical Impact: The risk of hypoglycemia is increased when INVOKANA is used concomitantly with insulin secretagogues (e.g., sulfonylurea) or insulin. (Canagliflozin label, Drug interactions)

  • RitonavirantiretroviralModerate

    Examples: Rifampin, phenytoin, phenobarbital, ritonavir Insulin or Insulin Secretagogues Clinical Impact: The risk of hypoglycemia is increased when INVOKANA is used concomitantly with insulin secretagogues (e.g., sulfonylurea) or insulin. (Canagliflozin label, Drug interactions)

  • SemaglutideGLP-1 receptor agonistModerate

    Consider adding another antihyperglycemic agent in patients who require additional glycemic control [see Dosage and Administration (2.3) and Clinical Pharmacology (12.3) ] . (Canagliflozin label, Drug interactions)

  • SitagliptinDPP-4 inhibitorModerate

    Consider adding another antihyperglycemic agent in patients who require additional glycemic control [see Dosage and Administration (2.3) and Clinical Pharmacology (12.3) ] . (Canagliflozin label, Drug interactions)

  • Sitagliptin and metforminDPP-4 inhibitorModerate

    Consider adding another antihyperglycemic agent in patients who require additional glycemic control [see Dosage and Administration (2.3) and Clinical Pharmacology (12.3) ] . (Canagliflozin label, Drug interactions)

  • Sotalolbeta blockerModerate

    Insulin and Oral Antidiabetics Hyperglycemia may occur, and the dosage of insulin or antidiabetic drugs may require adjustment. (Sotalol label, Drug interactions)

  • Spironolactonealdosterone antagonistModerate

    Patients with impaired renal function (eGFR less than 60 mL/min/1.73 m 2 ), elderly patients, or patients on loop diuretics may be at increased risk for volume depletion or hypotension. (Canagliflozin label, Warnings and precautions)

  • Spironolactone and hydrochlorothiazidealdosterone antagonistModerate

    Patients with impaired renal function (eGFR less than 60 mL/min/1.73 m 2 ), elderly patients, or patients on loop diuretics may be at increased risk for volume depletion or hypotension. (Canagliflozin label, Warnings and precautions)

  • Like other sulfonamide-containing drugs, sulfamethoxazole and trimethoprim potentiates the effect of oral hypoglycemics. (Sulfamethoxazole and trimethoprim label, Drug interactions)

  • Timololbeta blockerModerate

    Masking of Hypoglycemic Symptoms in Patients with Diabetes Mellitus Beta-adrenergic blocking agents should be administered with caution in patients subject to spontaneous hypoglycemia or to diabetic patients (especially those with labile diabetes) who are receiving insulin or oral hypoglycemic agents. (Timolol label, Warnings and precautions)

  • TirzepatideGLP-1 receptor agonistModerate

    • Hypoglycemia with Concomitant Use with Insulin or Insulin Secretagogues : Consider a lower dose of insulin or the insulin secretagogue to reduce the risk of hypoglycemia when used in combination with INVOKANA ( 5.5 ). (Canagliflozin label, Warnings and precautions)

  • TopiramateanticonvulsantModerate

    Table 7: Clinically Significant Drug Interactions with INVOKANA UGT Enzyme Inducers Clinical Impact: UGT enzyme inducers decrease canagliflozin exposure which may reduce the effectiveness of INVOKANA. (Canagliflozin label, Drug interactions)

  • Torsemideloop diureticModerate

    Patients with impaired renal function (eGFR less than 60 mL/min/1.73 m 2 ), elderly patients, or patients on loop diuretics may be at increased risk for volume depletion or hypotension. (Canagliflozin label, Warnings and precautions)

  • TrandolaprilACE inhibitorModerate

    (See PRECAUTIONS . ) Antidiabetic Agents Concomitant use of ACE inhibitors and antidiabetic medicines (insulin or oral hypoglycemic agents) may cause an increased blood glucose lowering effect with greater risk of hypoglycemia. (Trandolapril label, Drug interactions)

  • TranylcypromineMAO inhibitorModerate

    Hypoglycemia in Diabetic Patients Some MAOIs have contributed to hypoglycemic episodes in diabetic patients receiving insulin or other blood-glucose-lowering agents. (Tranylcypromine label, Warnings and precautions)

  • TriamcinolonecorticosteroidModerate

    Antidiabetics: Because corticosteroids may increase blood glucose concentrations, dosage adjustments of antidiabetic agents may be required. (Triamcinolone label, Drug interactions)

  • Triamterenepotassium-sparing diureticModerate

    Patients with impaired renal function (eGFR less than 60 mL/min/1.73 m 2 ), elderly patients, or patients on loop diuretics may be at increased risk for volume depletion or hypotension. (Canagliflozin label, Warnings and precautions)

  • Triamterene and hydrochlorothiazidepotassium-sparing diureticModerate

    Patients with impaired renal function (eGFR less than 60 mL/min/1.73 m 2 ), elderly patients, or patients on loop diuretics may be at increased risk for volume depletion or hypotension. (Canagliflozin label, Warnings and precautions)

  • Valsartan and hydrochlorothiazideangiotensin II receptor blocker (ARB)Moderate

    Patients with impaired renal function (eGFR less than 60 mL/min/1.73 m 2 ), elderly patients, or patients on loop diuretics may be at increased risk for volume depletion or hypotension. (Canagliflozin label, Warnings and precautions)

  • Voriconazoleazole antifungalModerate

    Sulfonylurea Oral Hypoglycemics (CYP2C9 Inhibition) Not Studied In Vivo or In Vitro , but Drug Plasma Exposure Likely to be Increased Frequent monitoring of blood glucose and for signs and symptoms of hypoglycemia. (Voriconazole label, Drug interactions)

Minor mentions (6)

  • BupropionantidepressantMinor

    Additional predisposing conditions include diabetes mellitus treated with oral hypoglycemic drugs or insulin, use of anorectic drugs, excessive use of alcohol, use of benzodiazepines, sedatives/hypnotics, or opiates. (Bupropion label, Warnings and precautions)

  • ClozapineantipsychoticMinor

    In some cases, hyperglycemia has resolved when the atypical antipsychotic was discontinued; however, some patients required continuation of antidiabetic treatment despite discontinuation of the suspect drug. (Clozapine label, Warnings and precautions)

  • LovastatinstatinMinor

    Oral Hypoglycemic Agents In pharmacokinetic studies of lovastatin in hypercholesterolemic non-insulin dependent diabetic patients, there was no drug interaction with glipizide or with chlorpropamide (see CLINICAL PHARMACOLOGY , Clinical Studies in Adults ). (Lovastatin label, Drug interactions)

  • Miconazoleazole antifungalMinor

    Although the systemic absorption of miconazole following ORAVIG administration is minimal and plasma concentrations of miconazole are substantially lower than when given intravenously, the potential for interaction with drugs metabolized through CYP2C9 and CYP3A4 such as oral hypoglycemics, phenytoin, or ergot alkaloids cannot be ruled out. (Miconazole label, Drug interactions)

  • MoexiprilACE inhibitorMinor

    Moexipril hydrochloride has been used in clinical trials concomitantly with calcium-channel-blocking agents, diuretics, H 2 blockers, digoxin, oral hypoglycemic agents, and cholesterol-lowering agents. (Moexipril label, Drug interactions)

  • ZiprasidoneantipsychoticMinor

    In some cases, hyperglycemia has resolved when the atypical antipsychotic was discontinued; however, some patients required continuation of antidiabetic treatment despite discontinuation of the suspect drug. (Ziprasidone label, Warnings and precautions)

Check Canagliflozin against everything you take. Add your full list; every pair is checked at once.

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Not medical advice. Severity reflects the label's wording, not your circumstances. A "major" flag can be routine under supervision and a "minor" one can matter at high doses. Ask a pharmacist.