Drug General Information (ID: DDI0N132SH)
Drug Name			Polythiazide		Drug Info		Canagliflozin		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antihypertensive Agents				Antidiabetic Agents
Structure

Mechanism of Polythiazide-Canagliflozin Interaction (Severity Level: Moderate)
Additive hypotensive effects Click to Show/Hide Mechanism Graph
Drug Name		Polythiazide				Canagliflozin
Mechanism 1		Antihypertensive agent				Antihypertensive agent
Key Mechanism Factor 1
		Factor Name		Hypotensive effects
		Factor Description		Hypotension is a blood pressure reading below the prescribed limit (90/60 mmHg). Symptoms of hypotension may include: blurred or faded vision , dizziness or light-headedness, fainting , fatigue , difficulty concentrating, nausea.
Mechanism Description		Additive hypotensive effects by the combination of Polythiazide and Canagliflozin
Mechanism 2		Antihypertensive agent				Hypotensive effects
Key Mechanism Factor 2
		Factor Name		Hypotensive effects
		Factor Description		Hypotension is a blood pressure reading below the prescribed limit (90/60 mmHg). Symptoms of hypotension may include: blurred or faded vision , dizziness or light-headedness, fainting , fatigue , difficulty concentrating, nausea.
Mechanism Description		Additive hypotensive effects by the combination of Polythiazide and Canagliflozin

Recommended Action
Management		Caution is advised during concomitant use of SGLT-2 inhibitors and thiazides, particularly in the elderly and patients with impaired renal function. Prior to initiating SGLT-2 inhibitors, volume status should be assessed and corrected, if necessary. Clinical and laboratory monitoring are recommended during therapy, including electrolytes, fluid status, renal function, and blood pressure. Blood glucose should also be monitored more closely. If volume depletion occurs, treatment with SGLT-2 inhibitors should be interrupted until the condition is corrected.

References
1	Product Information. Farxiga (dapagliflozin). Bristol-Myers Squibb, Princeton, NJ.
2	Product Information. Invokana (canagliflozin). Janssen Pharmaceuticals, Titusville, NJ.
3	Product Information. Steglatro (ertugliflozin). Merck &amp Company Inc, Whitehouse Station, NJ.