Uses
What is Invokana used for?
Invokana (canagliflozin) is commonly used to help lower blood sugar levels in people with type 2 diabetes.
Invokana is also used in people with type 2 diabetes and either heart disease or kidney disease to reduce your chance of the following complications.
- Dying from heart problems
- Worsening kidney problems
- Heart attack or stroke (patients with heart disease)
- Hospital admission for heart failure (patients with kidney disease)
Invokana is not used to treat people with type 1 diabetes.
Invokana may also be used for other conditions as determined by your healthcare provider.
How does Invokana work (mechanism of action)?
Invokana lowers blood sugar levels by helping your body get rid of sugar when you pee.
Invokana lowers the risk of worsening kidney problems, death from heart problems, hospital admissions for heart failure, heart attack and stroke by helping your body get rid of extra sugar, salt, and water.
How is Invokana supplied (dosage forms)?
Invokana is available in the following dosage forms that are taken by mouth.
- 100 mg oral tablets
- 300 mg oral tablets
How should I store Invokana?
Invokana oral tablets should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place.
Side Effects
What are the most common side effects of Invokana?
The most common side effects of Invokana are listed below. Tell your healthcare provider if you have any of these side effects that bother you.
- Yeast infection of the vagina or penis
- Kidney or bladder infections
- Increased need to pee or increased amount of pee
There may be other side effects of Invokana that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.
What are the serious side effects of Invokana?
While less common, the most serious side effects of Invokana are described below, along with what to do if they happen.
Severe Allergic Reactions. Invokana may cause allergic reactions, which can be serious. Stop taking Invokana and get help right away if you have any of the following symptoms of a serious allergic reaction.
- Breathing problems or wheezing
- Racing heart
- Fever or general ill feeling
- Swollen lymph nodes
- Swelling of the face, lips, mouth, tongue, or throat
- Trouble swallowing or throat tightness
- Itching, skin rash, or pale red bumps on the skin called hives
- Nausea or vomiting
- Dizziness, feeling lightheaded, or fainting
- Stomach cramps
- Joint pain
Diabetic Ketoacidosis (DKA). Invokana may cause diabetic ketoacidosis (a serious complication of diabetes). DKA can be life threatening. Stop taking Invokana and get help right away if you have any of the following symptoms of diabetic ketoacidosis.
- Nausea/vomiting
- Stomach pain
- Feeling very tired, woozy, or confused
- Difficulty breathing
- Your breath smells fruity or sweet
- Very high blood sugar levels (>300 mg/dL)
Dehydration. Invokana may cause dehydration. Dehydration may lead to low blood pressure, especially when you stand up (orthostatic hypotension), or kidney damage. Call your healthcare provider right away if you have any of the following symptoms of dehydration, low blood pressure, or kidney damage.
- Dizziness or lightheadedness
- Weakness or unusual tiredness
- Confusion
- Unsteadiness
- Peeing less than normal
- Swelling in your legs, ankles, and feet
- Loss of appetite/nausea
- Difficulty catching your breath or chest pain/pressure
- Seizures
- Extreme thirst
Urosepsis and Pyelonephritis. Invokana may cause pyelonephritis (a kidney infection) or urosepsis (an untreated urinary tract infection that spreads to your kidney). These are serious infections and may need to be treated in the hospital. Get help right away if you have any of the following symptoms of these serious infections.
- Dark, cloudy, or bloody pee or pee that smells bad
- Fever and chills
- Loss of appetite
- Needing to pee a lot or feeling pain when you pee
- Pain in your lower back, side, or groin
- Upset stomach, nausea, and vomiting
Low Blood Sugar (Hypoglycemia). Invokana can cause low blood sugar, especially when combined with insulin or other medicines that increase your insulin levels. Low blood sugar can be serious and may lead to death. You may need a lower dose of your other diabetes medicine to reduce your risk of hypoglycemia. Do not take Invokana and call your healthcare provider right away if you have any of the following symptoms of hypoglycemia.
- Headache
- Crankiness or anxiety
- Hunger
- Dizziness or confusion
- Blurry vision
- Slurred speech
- Sweating
- Feeling jittery or shakiness
- Fast heartbeat
- Seizures
Necrotizing Fasciitis (Fournier’s Gangrene). Invokana can cause necrotizing fasciitis (an aggressive infection of the skin and the tissue underneath the skin that causes some of the tissue involved to die). Necrotizing fasciitis is rare, but very serious, can lead to death, and may require surgery to treat it. Get help right away if you have any of the following symptoms of this serious infection.
- Pain, redness, tenderness, or swelling of the perineum (of and around the anus and genitals)
- Fever
- General feeling of illness or discomfort
Amputations. People who take Invokana may be more likely to have an amputation (limb or part of a limb cut off) than people who do not take Invokana. The toe, part of the foot, or part of the leg were most often involved. Amputations seem more likely in people with diabetes, peripheral artery disease (narrowing of your blood vessels, often in your legs), diabetic foot infections, nerve damage in your legs, or who already had an amputation. Inspect your feet and legs regularly and contact your healthcare provider right away if you have sores, ulcers, or new pain or tenderness, as these may lead to the need for an amputation if not treated.
Broken Bones. Invokana may increase your risk of a fracture (broken bone). Discuss your medical history with your healthcare provider so your risk of fracture can be assessed.
Warnings & Precautions
Who should not use Invokana?
Allergies to Ingredients. People who are allergic to any of the following should not use Invokana.
- Canagliflozin
- Invokana
- Any other medicine that contains canagliflozin
- Any of the ingredients in the specific product dispensed
Your pharmacist can tell you all of the ingredients in Invokana.
Liver Problems. Invokana should not be used if your liver is not working as well as it should be. If there is a concern about the health of your liver, your healthcare provider may do tests to determine if it is working well enough to take this medicine.
What should I know about Invokana before using it?
Do not take Invokana unless it has been prescribed to you by a healthcare provider. Take it as prescribed.
Do not share Invokana with other people, even if they have the same condition as you. It may harm them.
Keep Invokana out of the reach of children.
Certain conditions that cause increased stress on your body, like fever, trauma (such as a car accident), infection, or surgery can change the amount of diabetes medicines you need to take to control your diabetes. Talk to your healthcare provider if you have any of these conditions to decide if your medicine needs to be changed.
Talk to your healthcare provider about how to prevent, recognize, and manage low blood sugar (hypoglycemia), high blood sugar (hyperglycemia), and diabetes-related problems.
People who are 65 years or older can be at greater risk for some side effects from Invokana. Talk to your healthcare provider about your risks if you are in this age group.
People who have kidney problems can be at greater risk for some side effects from Invokana. Talk to your healthcare provider about your risks if you have kidney problems.
You can take Invokana with or without food.
Invokana will cause your pee to test positive for glucose (sugar).
Your healthcare provider will run lab tests to see how well your kidneys are working and make sure you are not dehydrated before starting Invokana.
What should I tell my healthcare provider before using Invokana?
Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if Invokana is right for you.
In particular, make sure that you discuss any of the following.
Risk factors for diabetic ketoacidosis. Tell your healthcare provider if you have any of the following risk factors for diabetic ketoacidosis. Your healthcare provider may monitor you more closely or choose a different medicine for you.
- Type 1 diabetes or a history of diabetic ketoacidosis. Your healthcare provider may want you to monitor for ketones (acids made in your liver) if you are taking Invokana.
- Decrease in your insulin dose
- Serious infection
- Use a low-salt diet. Your healthcare provider may suggest you stop using a low-salt diet or change your dose of Invokana.
- Drink alcohol often or in large amounts
- Pancreas problems, including a history of pancreatitis or surgery on your pancreas.
- Dehydration
- Are eating or drinking less than normal
- Vomiting or diarrhea
Previous amputation, nerve damage, or blood flow problems. Tell your healthcare provider if you had a previous amputation, or have nerve damage, or blood flow problems. You may be more likely to need a lower limb amputation with Invokana. Your healthcare provider may choose a different medicine for you.
History of genital yeast infections. Tell your healthcare provider if you have a history of genital (penis or vagina) yeast infections. This may make it more likely that you will have yeast infections of the vagina or penis while taking Invokana. Your healthcare provider may choose a different medicine for you.
Other Current and Past Health Conditions. Tell your healthcare provider if you have any of the following.
- Kidney problems
- Liver problems
- History of kidney or bladder infections or difficulty peeing
- Have surgery scheduled
Other Medicines and Supplements. Invokana may interact with other medicines and supplements. Before taking Invokana, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.
Pregnancy. Invokana may cause harm to an unborn baby. Tell your healthcare provider if you are or plan to become pregnant. If you become pregnant, contact your healthcare provider right away.
Breastfeeding. It is not known if Invokana passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should stop breastfeeding or stop Invokana.
How can I get more information about Invokana?
For more information about Invokana, you can visit the manufacturer’s website at https://www.invokana.com/ or call them at 800-JANSSEN (800-526-7736).
Interactions
Does Invokana interact with foods or drinks?
There are no known interactions between Invokana and foods or drinks.
Being on a low-salt diet while taking Invokana may increase your risk of dehydration. See the Side Effects section for more details.
Drinking too much alcohol while taking Invokana may increase your risk of diabetic ketoacidosis. See the Side Effects section for more details. It is unknown if drinking alcohol will affect Invokana in other ways, but alcohol may affect blood sugar levels in people with diabetes. This may interfere with the effect of Invokana. It is best to limit the amount of alcohol you drink.
Does Invokana interact with other medicines (drug interactions)?
Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.
In particular, make sure that you discuss if you are using any of the following before taking Invokana.
- Other medicines for diabetes
- A diuretic, also called a water pill, which is a medicine used to reduce edema (fluid retention) and blood pressure
- Digoxin (Lanoxin), which is a medicine used to treat irregular heartbeat and some types of heart failure
- Lithium, which is a medicine for certain mental health conditions
Some other medicines may alter the blood levels of Invokana. Tell your healthcare provider about all medicines that you take or have recently taken.
This may not be a complete list of medicines that can interact with Invokana. Always check with your healthcare provider.
Overdose/Missed Dose
What should I do if I accidentally use too much Invokana?
If you or someone else has used too much Invokana, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.
What should I do if I miss a dose of Invokana?
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only take the next dose. Do not take double or extra doses.
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