Canagliflozin/ACE Inhibitors; ARBs Interactions

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Moderate. These medicines may cause some risk when taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

Both of your medicines can cause dehydration and they can both affect your kidneys. Canagliflozin can also increase the amount of potassium in your blood.

What might happen:

You may develop dehydration. You may also develop problems with your kidneys. If you are taking canagliflozin, your blood levels of potassium may increase and cause serious side effects.

What you should do about this interaction:

Make sure your healthcare professionals (e.g. doctor or pharmacist) know that you are taking these medicines together, if you have any trouble with your kidneys, and/or you are on a low salt diet. Your doctor may want to check the amount of potassium in your blood. If you experience signs of high potassium, such as breathing difficulties, chest pain, irregular heartbeat, confusion, muscle weakness, signs of dehydration such as dizziness, fainting, lightheadedness, weakness, (especially when you stand up), and/or signs of kidney damage such as decreased urine production or swelling of the hands/feet, contact your doctor.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.

  • 1.Wolf MS. Personal communication: Invokana - Concomitant use with ACE/ARBs. Janssen Scientific Affairs, LLC June 9, 2014.
  • 2.USFood and Drug Administration. FDA Drug Safety Communication: FDA strengthens kidney warnings for diabetes medicines canagliflozin (Invokana, Invokamet) and dapagliflozin (Farxiga, Xigduo XR). available at: http://www.fda.gov/downloads/Drugs/DrugSafety/UCM506772.pdf June 14, 2016.
  • 3.Invokana (canagliflozin) US prescribing information. Janssen Pharmaceuticals, Inc. October 29, 2018.

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CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.