سعر فوكاناميت Vokanamet‏ 150مجم/850مجم 60 اقراص 2026

Vokanamet: canagliflozin 150 mg + metformin hydrochloride 850 mg film-coated tablets (60), fixed-dose combination for type 2 diabetes.

• Most common: hypoglycaemia with insulin or a sulphonylurea, vulvovaginal candidiasis, urinary tract infection, polyuria; metformin gastrointestinal symptoms (nausea, vomiting, diarrhoea, abdominal pain, loss of appetite).International label, same product · European Medicines Agency (EMA)

• Hypersensitivity; acute metabolic acidosis (lactic acidosis, diabetic ketoacidosis); diabetic pre-coma; severe renal failure (eGFR <30); acute conditions that may alter renal function; diseases causing tissue hypoxia; hepatic impairment, acute alcohol intoxication, alcoholism.International label, same product · European Medicines Agency (EMA)

• Lactic acidosis (metformin): stop temporarily in dehydration; stop at iodinated contrast and at surgery under general/spinal/epidural anaesthesia, restart no earlier than 48 h after with stable renal function.International label, same product · European Medicines Agency (EMA)
• Diabetic ketoacidosis, including life-threatening and fatal cases, possibly with only moderately raised glucose.International label, same product · European Medicines Agency (EMA)
• Volume depletion, especially with eGFR <60, diuretics or age 65+; lower-limb amputation (observed with canagliflozin); Fournier gangrene; genital mycotic infections; vitamin B12 reduction with metformin.International label, same product · European Medicines Agency (EMA)

• Iodinated contrast agentsRisk of metformin accumulation and lactic acidosis; stop before/at imaging, restart no earlier than 48 h after if renal function stable.European Medicines Agency (EMA)
• Loop diuretics and other diureticsAdditive volume depletion with canagliflozin and possible renal impairment.European Medicines Agency (EMA)
• UGT enzyme inducers (rifampicin, St John's wort, phenytoin, barbiturates, ritonavir)Reduce canagliflozin exposure; consider increase to 150 mg twice daily if tolerated.European Medicines Agency (EMA)

• No data in pregnant women; canagliflozin showed reproductive toxicity in animals. Should not be used during pregnancy; discontinue when pregnancy is detected.International label, same product · European Medicines Agency (EMA)
• Should not be used during breast-feeding (canagliflozin excreted in animal milk; metformin excreted in small amounts in human milk).International label, same product · European Medicines Agency (EMA)

• Canagliflozin: Inhibits SGLT2 in the proximal renal tubule, reducing glucose reabsorption and increasing urinary glucose excretion.
• Metformin hydrochloride: