Drug General Information (ID: DDIL3ONY15)
Drug Name			Canagliflozin		Drug Info		Riociguat		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antidiabetic Agents				Vasodilator Agents
Structure

Mechanism of Canagliflozin-Riociguat Interaction (Severity Level: Moderate)
Additive hypotensive effects Click to Show/Hide Mechanism Graph
Drug Name		Canagliflozin				Riociguat
Mechanism 1		Antihypertensive agent				Hypotensive effects Soluble guanylyl cyclase  Agonist
Key Mechanism Factor 1
		Factor Name		Guanylate cyclase soluble				Structure Sequence
		Protein Family		Adenylyl cyclase class-4/guanylyl cyclase family
		Protein Function		Mediates responses to nitric oxide (NO) by catalyzing the biosynthesis of the signaling molecule cGMP.     Click to Show/Hide
Mechanism Description		Additive hypotensive effects by the combination of Canagliflozin and Riociguat
Mechanism 2		Hypotensive effects				Hypotensive effects Soluble guanylyl cyclase  Agonist
Key Mechanism Factor 2
		Factor Name		Guanylate cyclase soluble				Structure Sequence
		Protein Family		Adenylyl cyclase class-4/guanylyl cyclase family
		Protein Function		Mediates responses to nitric oxide (NO) by catalyzing the biosynthesis of the signaling molecule cGMP.     Click to Show/Hide
Mechanism Description		Additive hypotensive effects by the combination of Canagliflozin and Riociguat

Recommended Action
Management		Caution is advised if SGLT-2 inhibitors are coadministered with diuretics and other hypotensive agents, 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. If volume depletion occurs, treatment with SGLT-2 inhibitors should be interrupted until the condition is corrected.

References
1	Cerner Multum, Inc. "Australian Product Information.".
2	Cerner Multum, Inc. "UK Summary of Product Characteristics.".
3	Product Information. Jardiance (empagliflozin). Boehringer Ingelheim, Ridgefield, CT.