Invokana Dosage/Direction for Use

Posology: The recommended starting dose of canagliflozin is 100 mg once daily. In patients tolerating canagliflozin 100 mg once daily who have an estimated glomerular filtration rate (eGFR) ≥60 mL/min/1.73 m² or CrCl ≥60 mL/min and need tighter glycaemic control, the dose can be increased to 300 mg once daily orally (see as follows and Precautions). For dose adjustment recommendations according to eGFR refer to Table 4.
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 risk (see Precautions). In patients with evidence of volume depletion, correcting this condition prior to initiation of canagliflozin is recommended (see Precautions).
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 hypoglycaemia (see Adverse Reactions and Interactions).
Special populations: Elderly (≥65 years old): Renal function and risk of volume depletion should be taken into account (see Precautions).
Renal impairment: For treatment of diabetic kidney disease as add on to standard of care (eg. ACE-inhibitors or ARBs), a dose of 100 mg canagliflozin once daily should be used (see table 4). Because the glycaemic lowering efficacy of canagliflozin is reduced in patients with moderate renal impairment and likely absent in patients with severe renal impairment, if further glycaemic control is needed, the addition of other anti-hyperglycaemic agents should be considered. For dose adjustments, recommendations according to eGFR refer to Table 4. (See Table 4.)

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Hepatic impairment: For patients with mild or moderate hepatic impairment, no dose adjustment is required.
Canagliflozin has not been studied in patients with severe hepatic impairment and is not recommended for use in these patients (see Pharmacology: Pharmacokinetics under Actions).
Paediatric population: The safety and efficacy of canagliflozin in children under 18 years of age have not yet been established. No data are available.
Method of administration: For oral use.
INVOKANA should be taken orally once a day, preferably before the first meal of the day. Tablets should be swallowed whole.
If a dose is missed, it should be taken as soon as the patient remembers; however, a double dose should not be taken on the same day.