# Canagliflozin - Another Top Longevity Drug **URL:** \ **Category:** General\ **Created:** [October 23, 2021, 6:22pm UTC](https://www.rapamycin.news/t/canagliflozin-another-top-longevity-drug/91 "2021-10-23T18:22:56Z")\ **Posts on this page:** 20\ **Page:** 72
**Author:** ![Neo](https://www.rapamycin.news/letter_avatar_proxy/v4/letter/n/9fc348/32.png) [@Neo](https://www.rapamycin.news/u/Neo)\ **Post date:** [February 22, 2025, 3:42am UTC](https://www.rapamycin.news/t/canagliflozin-another-top-longevity-drug/91/1426 "2025-02-22T03:42:17Z")
Flozins might help those with higher Lp(a) avoid aortic stenosis? @Davin8r et al any thoughts? ![IMG_0098](https://www.rapamycin.news/uploads/default/original/3X/2/f/2f04a6b30eecc2ebff17d247e4c5994d9842ca7b.jpeg) ![IMG_0099](https://www.rapamycin.news/uploads/default/original/3X/5/1/5158f11cf4f243908d81283129b94dae5bd6a61c.jpeg) [https://www.jacc.org/doi/abs/10.1016/j.jcin.2024.11.036](https://www.jacc.org/doi/abs/10.1016/j.jcin.2024.11.036) ---
**Author:** ![Davin8r](https://www.rapamycin.news/user_avatar/www.rapamycin.news/davin8r/32/30524_2.png) [@Davin8r](https://www.rapamycin.news/u/Davin8r)\ **Post date:** [February 22, 2025, 3:50am UTC](https://www.rapamycin.news/t/canagliflozin-another-top-longevity-drug/91/1427 "2025-02-22T03:50:37Z")
That’s exciting!! Thanks so much for posting this, Neo. ---
**Author:** ![Davin8r](https://www.rapamycin.news/user_avatar/www.rapamycin.news/davin8r/32/30524_2.png) [@Davin8r](https://www.rapamycin.news/u/Davin8r)\ **Post date:** [February 22, 2025, 4:00am UTC](https://www.rapamycin.news/t/canagliflozin-another-top-longevity-drug/91/1428 "2025-02-22T04:00:50Z")
**“The discovery that the pathogenetic mechanism of aortic stenosis is similar to the atherosclerosis process…”** Hopefully this means by extension that SGLT2i meds can inhibit Lp(a)-induced atherosclerosis in the coronary arteries in addition to the aortic valve. > **[Lp(a) in the Pathogenesis of Aortic Stenosis and Approach to Therapy with...](https://pubmed.ncbi.nlm.nih.gov/37834387/)** > > To date, no medical therapy can slow the progression of aortic stenosis. Fibrocalcific stenosis is the most frequent form in the general population and affects about 6% of the elderly population. Over the years, diagnosis has evolved thanks to... ---
**Author:** ![RapamycinCurious](https://www.rapamycin.news/letter_avatar_proxy/v4/letter/r/7ba0ec/32.png) [@RapamycinCurious](https://www.rapamycin.news/u/RapamycinCurious)\ **Post date:** [February 22, 2025, 5:59pm UTC](https://www.rapamycin.news/t/canagliflozin-another-top-longevity-drug/91/1429 "2025-02-22T17:59:34Z")
> [@CronosTempi](#): > > This paper here makes an offhand claim that empagliflozin and canagliflozin are insulin analogues, unlike dapagliflozin and other SGLT2i. > > Key Quote: > > “**Regarding antidiabetic medication, […] studies examining the effect of insulin analogues, empagliflozin and canagliflozin on EF are limited.**” You’re misreading this. They’re saying there are limited studies on the effects of (a) insulin analogs, (b) empa, and (c) cana on EF. If they had meant what you misunderstood here, they would ahve said “studies examining the effect of the insulin analogues empagliflozin and canagliflozin on EF are limited” or “studies examining the effect of insulin analogues such as empagliflozin and canagliflozin on EF are limited”. At minimum, they would have omitted the comma. ---
**Author:** ![CronosTempi](https://www.rapamycin.news/user_avatar/www.rapamycin.news/cronostempi/32/2504_2.png) [@CronosTempi](https://www.rapamycin.news/u/CronosTempi)\ **Post date:** [February 22, 2025, 6:04pm UTC](https://www.rapamycin.news/t/canagliflozin-another-top-longevity-drug/91/1430 "2025-02-22T18:04:59Z")
Correct. It was clarified not long after I made that post. My bad. I should’ve re-read it more carefully, since the claim would’ve been so bizarre otherwise. ---
**Author:** ![anon48954213](https://www.rapamycin.news/letter_avatar_proxy/v4/letter/a/7feea3/32.png) [@anon48954213](https://www.rapamycin.news/u/anon48954213)\ **Post date:** [February 22, 2025, 10:36pm UTC](https://www.rapamycin.news/t/canagliflozin-another-top-longevity-drug/91/1431 "2025-02-22T22:36:34Z")
I took 50 mg of cana, half the usual starting dose. In anticipation of some initial dehydration, I upped my water intake to four quarts per day. After a week I had a blood test. It showed that my BUN (blood urea nitrogen), a sign of dehydration, had doubled from baseline. I think that those of us with kidney problems, which in my case includes an episode of hypovolemia, should be careful with these inhibitors. In my opinion, a case of severe dehydration leaves behind at least a trace of damage, which makes the kidneys more susceptible to future dehydration. The body remembers. ---
**Author:** ![mchasemd](https://www.rapamycin.news/letter_avatar_proxy/v4/letter/m/ce73a5/32.png) [@mchasemd](https://www.rapamycin.news/u/mchasemd)\ **Post date:** [February 23, 2025, 8:09pm UTC](https://www.rapamycin.news/t/canagliflozin-another-top-longevity-drug/91/1432 "2025-02-23T20:09:23Z")
Interesting paper in how perhaps canagliflozin could target amyloid formation in patients with type-2 DM to prevent/slow dementia. While it might suggest another reason to take canagliflozin, a study from 2023 might suggest not getting too excited yet: Diabetes Care. 2023 Feb 1;46(2):297-304. “Association of Sodium-Glucose Cotransporter 2 Inhibitors With Time to Dementia: A Population-Based Cohort Study”. The Reader’s Digest version is among 106K diabetic patients followed, the hazard ratio for a subsequent dementia diagnosis was 0.53 for dapagliflozin, 0.78 for empagliflozin, and 0.96 for canagliflozin over a mean follow-up of 2.80 years from cohort entry (and cohort entry was delayed by 1 yr after starting the SGLT2i for better investigative integrity). So dapagliflozin dropped the risk by 47% but canagliflozin by only 4%. ---
**Author:** ![CronosTempi](https://www.rapamycin.news/user_avatar/www.rapamycin.news/cronostempi/32/2504_2.png) [@CronosTempi](https://www.rapamycin.news/u/CronosTempi)\ **Post date:** [February 24, 2025, 2:32am UTC](https://www.rapamycin.news/t/canagliflozin-another-top-longevity-drug/91/1433 "2025-02-24T02:32:14Z")
**Concomitant use of statins and sodium-glucose co-transporter 2 inhibitors and the risk of myotoxicity reporting: A disproportionality analysis** [https://bpspubs.onlinelibrary.wiley.com/doi/10.1111/bcp.15711](https://bpspubs.onlinelibrary.wiley.com/doi/10.1111/bcp.15711) "Conclusion There was no increased risk of myotoxicity reporting associated with concomitant use of SGLT2 inhibitors and statins or for specific drug pairs." “SGLT2 inhibitors included [**canagliflozin**](https://www.guidetopharmacology.org/GRAC/LigandDisplayForward?ligandId=4582), dapagliflozin, [**empagliflozin**](https://www.guidetopharmacology.org/GRAC/LigandDisplayForward?ligandId=4754) and ertugliflozin, while statins included atorvastatin, fluvastatin, lovastatin, pitavastatin, pravastatin, [**rosuvastatin**](https://www.guidetopharmacology.org/GRAC/LigandDisplayForward?ligandId=2954) and simvastatin.” ---
**Author:** ![LukeMV](https://www.rapamycin.news/letter_avatar_proxy/v4/letter/l/7cd45c/32.png) [@LukeMV](https://www.rapamycin.news/u/LukeMV)\ **Post date:** [February 24, 2025, 3:53am UTC](https://www.rapamycin.news/t/canagliflozin-another-top-longevity-drug/91/1434 "2025-02-24T03:53:02Z")
Another win for poly pharmacy ---
**Author:** ![adssx](https://www.rapamycin.news/user_avatar/www.rapamycin.news/adssx/32/14464_2.png) [@adssx](https://www.rapamycin.news/u/adssx)\ **Post date:** [February 26, 2025, 11:17am UTC](https://www.rapamycin.news/t/canagliflozin-another-top-longevity-drug/91/1435 "2025-02-26T11:17:56Z")
Chinese paper (not from the best university) with some weird findings: [Effects of Sodium-Glucose Cotransporter 2 Inhibitors on Nervous System Disorders: A Systematic Review and Meta-Analysis](https://journals.sagepub.com/doi/abs/10.1177/10600280251317495) 2025 > We included 52 publications/trials covering 111 376 participants (SGLT2 inhibitors 62 192; Placebo 49 184). Sodium-glucose cotransporter 2 inhibitors had no significant effect on ischaemic stroke (RR = 0.97; 95% CI = 0.87-1.09; P = 0.64), cerebrovascular accident (RR = 1.05; 95% CI = 0.91-1.22; P = 0.50), dementia (RR = 1.29; 95% CI = 0.78-2.12; P = 0.32), carotid artery occlusion/carotid artery stenosis (RR = 1.18; 95% CI: 0.92-1.53; P = 0.20), haemorrhagic stroke (RR = 0.84; 95% CI = 0.62-1.12; P = 0.23), and transient ischaemic attack (RR = 0.97; 95% CI = 0.82-1.15; P = 0.73) compared to placebo. No significant heterogeneity was observed. **However, SGLT2 inhibitors showed slight effects to reduce the risk of Parkinson’s disease (major heart failure subgroup). Empagliflozin and dapagliflozin significantly increased the risk of syncope (RR = 1.65; 95% CI = 1.15-2.38; P \< 0.01) and carotid artery occlusion/carotid artery stenosis (RR = 1.65; 95% CI = 1.04-2.61; P = 0.03), respectively.** ---
**Author:** ![A\_User](https://www.rapamycin.news/user_avatar/www.rapamycin.news/a_user/32/40991_2.png) [@A\_User](https://www.rapamycin.news/u/A_User)\ **Post date:** [February 26, 2025, 11:31am UTC](https://www.rapamycin.news/t/canagliflozin-another-top-longevity-drug/91/1436 "2025-02-26T11:31:56Z")
> [@adssx](#): > > Empagliflozin and dapagliflozin significantly increased the risk of syncope (RR = 1.65; 95% CI = 1.15-2.38; P \< 0.01) From diuresis/dehydration? ---
**Author:** ![John\_Hemming](https://www.rapamycin.news/user_avatar/www.rapamycin.news/john_hemming/32/6542_2.png) [@John\_Hemming](https://www.rapamycin.news/u/John_Hemming)\ **Post date:** [February 26, 2025, 11:53am UTC](https://www.rapamycin.news/t/canagliflozin-another-top-longevity-drug/91/1437 "2025-02-26T11:53:44Z")
If we start with the hypothesis that Parkinsons is accelerated aging of brain cells (because of too little melatonin in the CSF) then higher glucose levels will cause more ROS from Complexes 1 and 3 in the Electron Transport Train and further accelerate the aging process. Hence if an SLGT2 helps control glucose peaks that should be useful. ---
**Author:** ![CronosTempi](https://www.rapamycin.news/user_avatar/www.rapamycin.news/cronostempi/32/2504_2.png) [@CronosTempi](https://www.rapamycin.news/u/CronosTempi)\ **Post date:** [February 26, 2025, 2:29pm UTC](https://www.rapamycin.news/t/canagliflozin-another-top-longevity-drug/91/1438 "2025-02-26T14:29:17Z")
I don’t have access to the full paper, but following the link, I’m trying to understand the claims. The claim of carotid occlusion or stenosis is specific to empagliflozin and dapagliflozin, but not other SGLT2i? That’s how I’m reading it, unless I’m misunderstanding something. That’s rather odd. Empagliflozin and dapagliflozin, together with canagliflozin are some of the most studied SGLT2i. If these two cause carotid stenosis (at least in t2 diabetics), then it’s possible that all SGLT2i do, but we haven’t studied these other ones sufficiently to turn the non significant effect of 12% higher risk into a significant effect upon more data. However, carotid stenosis is caused by atherosclerotic plaque at those locations. There are several risk factors for plaque deposition. The general effect of SGLT2i, including empa and dapa is some slight lowering of BP, or at least not raising BP, so that particular risk factor falls away. Lipid levels are effected very slightly if at all, so it’s unlikely that elevated lipids are the mechanism here. Inflammation is lowered rather than raised, and endothelial function seems to benefit and not be impaired by either of those SGLT2i. The question is: by what mechanism do these two increase carotid stenosis? **The Role of SGLT2 Inhibitors in Atherosclerosis: A Narrative Mini-Review** > **[The Role of SGLT2 Inhibitors in Atherosclerosis: A Narrative Mini-Review](https://pmc.ncbi.nlm.nih.gov/articles/PMC8602558/)** > > Objective: Sodium glucose cotransporter 2 inhibitors (SGLT2-is) are antidiabetic drugs that improve glycemic control by limiting urinary glucose reuptake in the proximal tubule. SGLT2-is might suppress atherosclerotic processes and ameliorate the ... “We first review the underlying mechanisms of SGLT2-is on the development and progression of atherosclerosis, including favorable effects on lipid metabolism, reduction of systemic inflammation, and improvement of endothelial function. We then discuss the putative impact of SGLT2-is on the formation, composition, and stability of atherosclerotic plaque. **Furthermore, we evaluate the effects of SGLT2-is in subclinical atherosclerosis assessed by carotid intima media thickness and pulse wave velocity.** Subsequently, we summarize the effects of SGLT2-is in ASCVD events, including ischemic stroke, angina pectoris, myocardial infarction, revascularization, and peripheral artery disease, as well as major adverse cardiovascular events, cardiovascular mortality, heart failure, and chronic kidney disease. Moreover, we examine factors that could modify the role of SGLT2-is in atherosclerosis, including sex, age, diabetes, glycemic control, ASCVD, and SGLT2-i compounds.” “PubMed and Google Scholar were searched to identify relevant publications on SGLT2-is and atherosclerosis. Key words included the following: “SGLT2 inhibitor, canagliflozin, **dapagliflozin, empagliflozin** , ertugliflozin, ipragliflozin, luseogliflozin, remogliflozin, sotagliflozin, tofogliflozin, atherosclerosis, **carotid intima media thickness, plaque** , ankle-brachial index, coronary artery calcification score, pulse wave velocity, transient ischemic attack, ischemic stroke, coronary heart disease, angina pectoris, acute coronary syndrome, myocardial infarction, coronary revascularization, renal artery stenosis, and peripheral artery disease.” All types of articles were considered, including clinical trials, animal studies, _in vitro_ observations, reviews, and meta-analyses. Since this is a narrative mini-review, we prioritized the most clinically relevant and up-to-date articles in the current literature.” I don’t want to quote the whole paper here, but the bottom line is that examining all commonly accepted risk factors for atherosclerosis, they find that SGLT2i, and empa and dapa too, either _lower_ the risk factors or are neutral across multiple studies, including studies focused specifically on empa or dapa. When it came to plaque burden and size, canagliflozin was least effective at amelioration of plaque, so if we are to blame empa and dapa, you’d expect cana to be even worse, and yet, that’s not what the Chinese paper claims (and to be clear cana is at least as extensively studied). Carotid stenosis or occlusion results in the clinical outcome of **stroke**. So how do empa/dapa/SGLT2i do with stroke? If they significantly increase carotid occlusion, you would expect to see increased incidence of strokes: “Stroke and TIA. Several meta-analyses and reviews reported that SGLT2-is, including canagliflozin, **dapagliflozin, and empagliflozin, do not affect the risk of stroke** ([Milonas and Tziomalos, 2018](https://pmc.ncbi.nlm.nih.gov/articles/PMC8602558/#B40); [Zheng et al., 2018](https://pmc.ncbi.nlm.nih.gov/articles/PMC8602558/#B64); [Sinha and Ghosal, 2019b](https://pmc.ncbi.nlm.nih.gov/articles/PMC8602558/#B56); [Sinha and Ghosal, 2019a](https://pmc.ncbi.nlm.nih.gov/articles/PMC8602558/#B55); [Zhu et al., 2020](https://pmc.ncbi.nlm.nih.gov/articles/PMC8602558/#B66)). **In line, the empagliflozin and placebo arms in the EMPA-REG OUTCOME trial did not differ in the risk of TIA** ([Zinman et al., 2015](https://pmc.ncbi.nlm.nih.gov/articles/PMC8602558/#B67)). Further investigations evaluating the role of SGLT2-is in ischemic stroke are needed.” Without reading the full Chinese paper, I am not going to attempt to evaluate it, but given my reading of the literature in the past few months, I find their claims rather puzzling and contrary to generally accepted clinical experience. ---
**Author:** ![A\_User](https://www.rapamycin.news/user_avatar/www.rapamycin.news/a_user/32/40991_2.png) [@A\_User](https://www.rapamycin.news/u/A_User)\ **Post date:** [February 28, 2025, 1:20am UTC](https://www.rapamycin.news/t/canagliflozin-another-top-longevity-drug/91/1439 "2025-02-28T01:20:01Z")
I asked R1 + DeepSearch, and it suggested that the increase in carotid artery stenosis was simply the criteria among the trials differing in what that was, whether they measured at baseline, and simply a statistically significant result due to chance. It hallucinated a trial that didn’t exist though and I haven’t seen that in a long time. I would think it is unlikely this result is case because carotid artery stenosis has also to do with atherosclerosis, why would empa and dapagliflozin increase this (the small increase in LDL can’t be it)? I haven’t looked at the full paper. It looks weird. I don’t know if they tested for everything if so the [multiple comparison problem](https://en.wikipedia.org/wiki/Multiple_comparisons_problem). ---
**Author:** ![hamtaro](https://www.rapamycin.news/user_avatar/www.rapamycin.news/hamtaro/32/5345_2.png) [@hamtaro](https://www.rapamycin.news/u/hamtaro)\ **Post date:** [March 6, 2025, 6:48pm UTC](https://www.rapamycin.news/t/canagliflozin-another-top-longevity-drug/91/1440 "2025-03-06T18:48:05Z")
I’m waiting for agelessrx to have it as well. In the meantime, you can still get cana at [https://gethealthspan.com](https://gethealthspan.com) for $100 a month. ---
**Author:** ![Neo](https://www.rapamycin.news/letter_avatar_proxy/v4/letter/n/9fc348/32.png) [@Neo](https://www.rapamycin.news/u/Neo)\ **Post date:** [March 7, 2025, 5:18am UTC](https://www.rapamycin.news/t/canagliflozin-another-top-longevity-drug/91/1441 "2025-03-07T05:18:57Z")
Thx. I don’t think the Healthspan flozin is Cana, but some other less known one? ---
**Author:** ![adssx](https://www.rapamycin.news/user_avatar/www.rapamycin.news/adssx/32/14464_2.png) [@adssx](https://www.rapamycin.news/u/adssx)\ **Post date:** [March 7, 2025, 8:57am UTC](https://www.rapamycin.news/t/canagliflozin-another-top-longevity-drug/91/1442 "2025-03-07T08:57:13Z")
[Comparative risk of dementia in diabetic stroke patients prescribed SGLT2 vs. DPP-4 inhibitors: A propensity-matched retrospective cohort study](https://www.sciencedirect.com/science/article/pii/S1052305725000552) 2025 > After propensity score matching, each group consisted of 15901 patients. Over a mean follow-up of 2.52 years, SGLT2 inhibitor use was associated with lower risks of overall dementia (hazard ratio [HR] 0.66; 95% confidence interval [CI] 0.59–0.74), degenerative dementia (HR 0.68; 95% CI 0.60–0.76), and vascular dementia (HR 0.59, 95% CI 0.49–0.70) compared to DPP-4 inhibitor use. These findings remained consistent across various sensitivity and subgroup analyses. ---
**Author:** ![RapAdmin](https://www.rapamycin.news/user_avatar/www.rapamycin.news/rapadmin/32/377_2.png) [@RapAdmin](https://www.rapamycin.news/u/RapAdmin)\ **Post date:** [March 10, 2025, 6:41am UTC](https://www.rapamycin.news/t/canagliflozin-another-top-longevity-drug/91/1443 "2025-03-10T06:41:27Z")
More generic versions of empagliflozin on the way: > Indian drug companies are set to revolutionize diabetes treatment with affordable generic versions of Empagliflozin, following the expiry of its patent. Estimated to significantly cut costs and improve access for over 10 crore diabetics > > NEW DELHI: Several domestic drug companies are set to transform diabetes therapy by launching the blockbuster drug Empagliflozin at a fraction of the innovator’s price. > Affordable generics will hit the market within days, following the expiry of Boehringer Ingelheim’s patent on Empagliflozin on March 11, industry sources told TOI. > The launch of generic Empagliflozin, used to treat diabetes, related comorbidities, including heart failure, promises to slash therapy costs, making it more accessible to millions of diabetics and easing the financial strain of this debilitating disease. Those looking to launch the drug include Mankind Pharma, Torrent, Alkem, Dr Reddy’s and Lupin. > **[Key diabetes drug to cost up to 90% less in a few days | India News - The...](https://timesofindia.indiatimes.com/india/key-diabetes-drug-to-cost-up-to-90-less-in-a-few-days/articleshow/118827351.cms)** > > India News: Indian drug companies are set to revolutionize diabetes treatment with affordable generic versions of Empagliflozin, following the expiry of its paten ---
**Author:** ![CronosTempi](https://www.rapamycin.news/user_avatar/www.rapamycin.news/cronostempi/32/2504_2.png) [@CronosTempi](https://www.rapamycin.news/u/CronosTempi)\ **Post date:** [March 10, 2025, 7:38am UTC](https://www.rapamycin.news/t/canagliflozin-another-top-longevity-drug/91/1444 "2025-03-10T07:38:05Z")
Good news on generic empagliflozin - I bought a bunch of the original brand name empagliflozin from India through Jagdish, should last me for 3-4 years. I hate to even bring it up, so forgive me, but is nobody even _slightly_ wondering if the generics are going to be 100% equivalent to the brand name originals? Over and over again we’ve had cases where that didn’t transpire to be the case. I have no reason whatsoever to suspect that the generics are not going to be 100% on the up and up, so great news. But - and this is just me - if I can easily afford the brand name originals, as I have been able so far, I don’t mind paying a bit more for peace of mind… of these companies, I’m only familiar with Dr. Reddy’s, which is sometimes in the news with dodgy drugs… the others, I don’t even recognize. I’m sticking with what I know, the original maker… pay more, fine. YMMV. ---
**Author:** ![jeanbaptiste](https://www.rapamycin.news/user_avatar/www.rapamycin.news/jeanbaptiste/32/32158_2.png) [@jeanbaptiste](https://www.rapamycin.news/u/jeanbaptiste)\ **Post date:** [March 10, 2025, 9:02am UTC](https://www.rapamycin.news/t/canagliflozin-another-top-longevity-drug/91/1445 "2025-03-10T09:02:17Z")
Generics by definition are equivalent to brand name drug, but for Indian generics, it might not be true (lower standards compared to the USA/UE). I don’t think it is a big problem for us because if the indian generic has a lower absorption rate, or a bigger Cmax or whatever, it will not the change the outcome. The therapeutic window isn’t small. [Previous page](https://www.rapamycin.news/t/canagliflozin-another-top-longevity-drug/91.md?page=71) [Next page](https://www.rapamycin.news/t/canagliflozin-another-top-longevity-drug/91.md?page=73)