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Why do invokana amputations take place?

Invokana is an antidiabetic medicine that contains the active substance canagliflozin. You can see in the following why does invokana cause amputations?

It is used in adults with type 2 diabetes to control blood sugar (blood sugar). Invokana can be given as a single agent in patients whose blood sugar is not satisfactorily controlled only by diet and exercise and who cannot be given metformin (another antidiabetic medicine). Invokana can also be used as an “adjuvant” to other antidiabetic medicines, including insulin, when these medicines, along with exercise and diet, do not provide adequate control of diabetes.

How is Invokana used?

Invokana is available as tablets (100 and 300 mg) and can only be obtained with a prescription. The tablets are taken once a day, preferably before the first meal of the day. The recommended starting dose is 100 mg once a day. If necessary, the dose may be increased to 300 mg once a day.

Because the effects of Invokana are dependent on renal function, the efficacy and tolerability of the drug are reduced in patients with renal impairment. Therefore, the use of Invokana is not recommended in patients with severe renal impairment. In patients with moderate renal insufficiency, the dose should be limited to 100 mg once daily. For more information, see here.

How does Invokana work?

Type 2 diabetes is a disease in which the pancreas does not produce enough insulin to control the glucose or when the body cannot use insulin effectively. This leads to high blood glucose concentrations. The active substance in Invokana, canagliflozin, works by blocking a kidney protein, called sodium-glucose co-transporter (SGLT2). SGLT2 is a protein that absorbs urine glucose by transporting it into the bloodstream after the blood is filtered through the kidneys. By blocking the action of SGLT2, Invokana causes urine removal of larger amounts of glucose, thereby reducing blood glucose concentrations.

What benefit has Invokana shown during the studies?

Invokana was evaluated in 9 main studies that included a total of approximately 10,000 patients with type 2 diabetes. One of the studies compared Invokana with placebo (a dummy treatment) used alone in patients whose blood sugar be satisfactorily controlled only by diet and exercise. Three studies investigated Invokana used as an adjunct in combination with another antidiabetic medicine (metformin or insulin), and three additional studies looked at Invokana used as an adjunct in combination with two other antidiabetic medicines (including metformin), when these medicines, along with exercises physical and dietary regimens did not provide adequate control of diabetes. Also, a study was conducted in patients with moderate renal impairment and a study in elderly patients aged between 55 and 80 years. In all studies, the main measure of efficacy was the blood concentration of a substance called glycosylated hemoglobin (HbA1c), which indicates to what extent the glucose is controlled. Invokana has been shown to be more effective than placebo and at least as effective as similar medicines, reducing HbA1c concentrations when given alone and in combination with other antidiabetic medicines:

When Invokana was used alone at a dose of 100 mg, it reduced the HbA1c concentration by 0.91% more than placebo after 26 weeks, while the 300 mg dose resulted in a reduction of 1 , 16% higher than placebo.

During the studies investigating Invokana when used as an adjunct in combination with another antidiabetic medicine or two other antidiabetic medicines, reductions in HbA1c concentrations after 26 weeks compared with placebo were between 0.76% and 0 , 92% at the 300 mg dose and between 0.62% and 0.74% at the 100 mg dose.

When Invokana was used as an insulin adjuvant at a dose of 300 mg, it reduced HbA1c concentrations by 0.73% more than placebo after 18 weeks, while the 100 mg dose resulted in a reduction in 0.65% higher than placebo. It has also been shown that Invokana is at least as effective as glimepiride and sitagliptin antidiabetic medicines after 52 weeks of treatment. The study in patients with moderate renal impairment demonstrated that the effects of Invokana were reduced in these patients but clinically relevant: reduction in HbA1c concentrations compared to placebo was It has also been shown that Invokana is at least as effective as glimepiride and sitagliptin antidiabetic medicines after 52 weeks of treatment.

 

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