The MHRA has advised the following:
• As a precaution, consider stopping canagliflozin if a patient develops a significant lower limb complication- at least until the condition has resolved, and continue to monitor the patient closely.
• Carefully monitor patients receiving canagliflozin who have risk factors for amputation.
• Monitor all patients for signs and symptoms of water or salt loss; ensure patients stay sufficiently hydrated to prevent volume depletion in line with recommendations in the product information.
• Advise patients to: stay well hydrated, carry out routine preventive foot care, and seek medical advice promptly if they develop skin ulceration, discolouration, or new pain or tenderness.
• Start treatment for foot problems as early as possible.
• Continue to follow standard treatment guidelines for routine preventive foot care for people with diabetes.