Brand: Invokana®
NICE TA: 315
Indication: In combination therapy for treating type 2 diabetes (NICE TA315)
Disease category: Endocrine system
Commissioning responsibility: CCG
PbR excluded: No

Background

If a person needs to take 2 antidiabetic drugs, canagliflozin is recommended as a possible treatment for people with type 2 diabetes when taken with a drug called metformin, only if the person:
• cannot take a type of drug called a sulfonylurea or
• is at significant risk of hypoglycaemia or its consequences.

If a person needs to take 3 antidiabetic drugs, canagliflozin is recommended as a possible treatment when taken with either metformin and a sulfonylurea, or metformin and a type of drug called a thiazolidinedione.
Canagliflozin is recommended as a possible treatment taken with insulin, with or without other antidiabetic drugs.
The LMMG recommends canagliflozin as the 2^nd line ““gliflozin”” (1^st line — dapagliflozin or empagliflozin).

Recommendation

LMMG recommendation: Green
Click here to find the definitions for the colour classifications

Reason for decision:  Suitable for initiation in primary care in line with NICE restrictions (see background paragraph)

Supporting documents:

NICE TA315 - Canagliflozin in combination therapy for treating type 2 diabetes

MHRA Drug Safety Update - SGLT2 inhibitors (canagliflozin, dapagliflozin, empagliflozin): risk of diabetic ketoacidosis

Algorithm For Antihyperglycaemic Therapy In Adults With Type II (Version 1.5) (454.0 KiB)

Decisions of Lancashire local decision making groups: