RESINCOLESTIRAMINA 4 g Price

Overview

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This medicine contains an important and useful components, as it consists of
Colestyramineis available in the market in concentration

Name

Canagliflozin

Precaution

Before starting **Canagliflozin**, it is critical for patients to consult their healthcare provider to ensure that this medication is appropriate for their condition. **Canagliflozin** is an **SGLT2 inhibitor** (sodium-glucose cotransporter 2 inhibitor) used primarily for the management of **type 2 diabetes mellitus** and **chronic kidney disease**. Some key precautions include: - **Renal Impairment**: **Canagliflozin** is contraindicated in patients with **severe renal impairment** (e.g., **eGFR <30 mL/min/1.73 m²**) or those with **end-stage renal disease (ESRD)**. This is because the medication relies on kidney function to be effective, and impaired kidneys may lead to ineffective drug action or toxicity. - **Hypotension and Dehydration**: Canagliflozin can cause **fluid loss** through increased urination, leading to dehydration and **hypotension** (low blood pressure). Patients should be monitored for signs of dehydration, especially those who are elderly or have conditions like **diarrhea**, **vomiting**, or **poor fluid intake**. - **Diabetic Ketoacidosis (DKA)**: While rare, SGLT2 inhibitors like **Canagliflozin** can increase the risk of **diabetic ketoacidosis (DKA)**, a serious complication where the body produces high levels of **ketones**. Patients should seek medical help if they experience symptoms like **nausea**, **vomiting**, **abdominal pain**, or **rapid breathing**. - **Genital Infections**: **Canagliflozin** increases the risk of **genital fungal infections** due to the increased glucose in the urine, which provides a growth medium for microorganisms. Patients should maintain good hygiene and report any signs of infection, such as itching, redness, or discomfort in the genital area. - **Bone Fractures**: Long-term use of **Canagliflozin** has been associated with an increased risk of **bone fractures**, particularly in patients with a history of **bone disease** or those at higher risk for fractures. Regular monitoring of bone health is advised. - **Pregnancy and Breastfeeding**: The safety of **Canagliflozin** during pregnancy and breastfeeding has not been established. It is recommended to avoid the use of this medication during pregnancy, especially in the second and third trimesters, as it may harm the developing fetus. Consultation with a healthcare provider is essential for alternatives during these times.

Indication

**Canagliflozin** is primarily indicated for: - **Type 2 Diabetes Mellitus**: Used as an adjunct to diet and exercise to improve **glycemic control** in adults with **type 2 diabetes**. It works by inhibiting the **SGLT2** protein in the kidneys, which helps to **reduce glucose reabsorption** and increase glucose excretion in urine, thereby lowering blood sugar levels. - **Chronic Kidney Disease (CKD)**: It is also approved for the treatment of **chronic kidney disease** in patients with **type 2 diabetes**, as it has been shown to slow the progression of kidney damage, reduce albuminuria, and improve overall kidney function. - **Cardiovascular Risk Reduction**: **Canagliflozin** has been shown to lower the risk of **cardiovascular events** in individuals with **type 2 diabetes**, particularly in those with established heart disease. It helps reduce the incidence of **heart attacks**, **stroke**, and **hospitalization due to heart failure**.

Contra indication

**Canagliflozin** should not be used in the following situations: - **Severe Renal Impairment**: Contraindicated in patients with **severe renal impairment** (e.g., **eGFR <30 mL/min/1.73 m²**), **end-stage renal disease (ESRD)**, or those requiring **dialysis** as the drug is ineffective in such cases and may lead to accumulation in the body, increasing the risk of adverse effects. - **Hypersensitivity**: Contraindicated in patients with a known **hypersensitivity** to **canagliflozin** or any of its components. This includes serious allergic reactions such as **rash**, **swelling**, or **difficulty breathing**. - **Diabetic Ketoacidosis (DKA)**: It is contraindicated in patients with a history of **diabetic ketoacidosis** or **type 1 diabetes** as it may worsen or trigger the condition. - **Severe Liver Disease**: In patients with **severe hepatic impairment**, the use of **canagliflozin** should be avoided or used with extreme caution, as its safety and efficacy in these patients have not been established.

Side Effect

The common and severe side effects of **Canagliflozin** include: - **Genital Mycotic Infections**: Increased glucose in the urine can lead to **genital fungal infections**, including **vaginal yeast infections** in women and **balanitis** (inflammation of the foreskin) in men. Patients should be educated on good hygiene practices. - **Urinary Tract Infections (UTIs)**: There is a slightly increased risk of **urinary tract infections** with **Canagliflozin**, which may present as **painful urination**, **increased frequency**, or **urinary urgency**. - **Hypotension**: Due to its diuretic effects, **Canagliflozin** can cause **low blood pressure**, especially when starting treatment or when combined with other antihypertensive medications. Symptoms of hypotension may include **dizziness**, **fainting**, or **lightheadedness**. - **Dehydration**: As a result of increased urination, **Canagliflozin** can lead to **dehydration**, which may present as **dry mouth**, **thirst**, **weakness**, or **fatigue**. - **Electrolyte Imbalance**: The diuretic effects can cause **electrolyte imbalances**, such as **low sodium** (hyponatremia) or **high potassium** (hyperkalemia), which require monitoring. - **Diabetic Ketoacidosis (DKA)**: Though rare, **Canagliflozin** has been associated with an increased risk of **diabetic ketoacidosis** in people with **type 2 diabetes**. Symptoms of DKA include **nausea**, **vomiting**, **abdominal pain**, **rapid breathing**, and **fruity-smelling breath**. - **Bone Fractures**: Long-term use of **Canagliflozin** may increase the risk of **bone fractures**, particularly in patients with other risk factors for osteoporosis or bone fractures. - **Acute Kidney Injury (AKI)**: Canagliflozin can lead to **acute kidney injury**, particularly in individuals with pre-existing kidney problems or those who experience dehydration.

Pregnancy Category ID

3

Mode of Action

**Canagliflozin** works by inhibiting the **SGLT2** protein in the kidneys, which plays a crucial role in the reabsorption of **glucose** from the urine back into the bloodstream. By blocking this transporter, **Canagliflozin** increases the excretion of **glucose** in the urine, leading to a reduction in **blood glucose levels**. This mechanism helps control **hyperglycemia** in **type 2 diabetes mellitus**. Additionally, **Canagliflozin** reduces the reabsorption of **sodium**, which leads to **osmotic diuresis**, helping to lower blood pressure and improve kidney function, particularly in patients with **chronic kidney disease**.

Interaction

**Canagliflozin** may interact with several drugs or substances, including: - **Diuretics**: The use of **diuretics** (particularly **loop diuretics** and **thiazides**) with **Canagliflozin** can increase the risk of dehydration and hypotension due to the additional fluid loss. Close monitoring of blood pressure and hydration status is recommended. - **RAAS Inhibitors**: **Angiotensin-converting enzyme (ACE) inhibitors**, **angiotensin receptor blockers (ARBs)**, and **aldosterone antagonists** can cause hyperkalemia (high potassium levels) and **hypotension** when used in conjunction with **Canagliflozin**. Monitoring of renal function and potassium levels is advised. - **Insulin and Insulin Secretagogues**: Canagliflozin can increase the risk of **hypoglycemia** (low blood sugar) when used with **insulin** or **insulin secretagogues** (e.g., sulfonylureas). Patients may need to adjust the dosage of their insulin or oral hypoglycemic medications to prevent low blood sugar. - **Lithium**: Coadministration with **lithium** may increase the risk of **lithium toxicity** due to the diuretic effects of **Canagliflozin**, which can alter lithium clearance and increase its concentration in the blood. - **CYP3A4 Inhibitors**: Drugs that inhibit the **CYP3A4 enzyme**, such as **ketoconazole** and **ritonavir**, may increase **canagliflozin** levels, potentially increasing the risk of side effects. Dosing adjustments may be needed when using these agents together.

Pregnancy Category Note

Information not available

Adult Dose

For **adults** with **type 2 diabetes**: - The typical starting dose of **Canagliflozin** is **100 mg once daily**, taken in the morning before or after a meal. - If the 100 mg dose is well tolerated and more control is needed, the dose can be increased to **300 mg once daily**. - For patients with **chronic kidney disease** or those at higher risk for cardiovascular events, **Canagliflozin** is prescribed with consideration of kidney function and overall health status.

Child Dose

**Canagliflozin** is not recommended for use in pediatric patients, as its safety and efficacy in individuals under 18 years of age have not been established. Treatment with this medication should be limited to adults with **type 2 diabetes mellitus** or **chronic kidney disease** unless specifically prescribed by a healthcare provider for exceptional cases.

Renal Dose

**Canagliflozin** is contraindicated in patients with **severe renal impairment** (e.g., **eGFR <30 mL/min/1.73 m²**), **end-stage renal disease (ESRD)**, or those requiring **dialysis**. In patients with **moderate renal impairment** (e.g., **eGFR between 30 and 60 mL/min/1.73 m²**), the use of **Canagliflozin** should be approached with caution, and dose adjustments may be necessary. Regular monitoring of renal function is essential during treatment.

Administration

Information not available