Invokana Side Effects

• Genital Yeast Infection, Urinary Tract Infection (UTI), and changes in urination are most common side effect: Yeast infections can occur in men or women and any changes in urination or signs of infection should be reported to your physician immediately.
• Severe Kidney Injury: Sudden kidney injury has happened to people taking INVOKANA^®. Talk to your doctor right away if you: 1) reduce the amount of food or liquid you drink, if you are sick, or cannot eat or 2) you start to lose liquids from your body from vomiting, diarrhea, or being in the sun too longHypertension 
• Ketoacidosis: Ketoacidosis can be life threatening and has occurred in patients with Type 1 and Type 2 diabetes. Ketoacidosis can happen even if your blood sugar is less than 250 mg/dL. Stop taking INVOKANA^® and call your doctor right away if you get any of the following symptoms: nausea, vomiting, stomach-area pain, tiredness, or trouble breathing
• Hyperkalemia:  Too much Potassium in the blood.
• Severe Kidney Infections
• Hypoglycemia: When used with Insulin or drugs that stimulate Insulin secretion, Invokana can increase the likelihood for hypoglycemia (low blood sugar).
• Fractures / Broken Bones: These have been reported in people taking Invokana. Check with your physician for factors that contribute to broken bones.

Warnings & Recalls for Invokana

FDA strengthens kidney warnings for diabetes medicines canagliflozin (Invokana, Invokamet) and dapagliflozin (Farxiga, Xigduo XR)

• Hypotension: INVOKANA^® causes intravascular volume contraction. Symptomatic hypotension can occur after initiating INVOKANA^® , particularly in patients with impaired renal function (eGFR <60 mL/min/1.73 m²), elderly patients, patients on either diuretics or medications that interfere with the renin‐angiotensin‐aldosterone system, or patients with low systolic blood pressure. Before initiating in patients with ≥1 of these characteristics, volume status should be assessed and corrected. Monitor for signs and symptoms after initiating.
• Ketoacidosis: Reports of ketoacidosis, a serious life-threatening condition requiring urgent hospitalization, have been identified in patients with type 1 and 2 diabetes mellitus receiving SGLT2 inhibitors, including INVOKANA^® . Before initiating INVOKANA^® , consider factors in patient history that may predispose to ketoacidosis, including pancreatic insulin deficiency, caloric restriction disorders, and alcohol abuse. In patients treated with INVOKANA^® , consider monitoring for ketoacidosis and temporarily discontinuing in clinical situations known to predispose to ketoacidosis (eg, prolonged fasting due to acute illness or surgery).
• Acute Kidney Injury and Impairment in Renal Function: INVOKANA^® causes intravascular volume contraction and can cause renal impairment. Postmarketing reports of acute kidney injury, some requiring hospitalization and dialysis, were reported; some reports involved patients younger than 65 years of age. Before initiation, consider factors that may predispose patients to acute kidney injury including hypovolemia, chronic renal insufficiency, congestive heart failure and concomitant medications. Consider temporarily discontinuing INVOKANA® in any setting of reduced oral intake or fluid losses; monitor patients for signs and symptoms of acute kidney injury. If acute kidney injury occurs, discontinue promptly and institute treatment.INVOKANA® increases serum creatinine and decreases eGFR. Patients with hypovolemia may be more susceptible to these changes. Renal function abnormalities can occur after initiation. Renal function should be evaluated prior to initiation and periodically thereafter. Dose adjustment and more frequent renal function monitoring are recommended in patients with an eGFR <60 mL/min/1.73 m².
• Hyperkalemia: INVOKANA^® can lead to hyperkalemia. Patients with moderate renal impairment who are taking medications that interfere with potassium excretion or medications that interfere with the renin‐angiotensin‐aldosterone system are more likely to develop hyperkalemia. Monitor serum potassium levels periodically in patients with impaired renal function and in patients predisposed to hyperkalemia due to medications or other medical conditions.
• Urosepsis and Pyelonephritis: There have been reports of serious urinary tract infections, including urosepsis and pyelonephritis, requiring hospitalization in patients receiving SGLT2 inhibitors, including INVOKANA^® . Treatment with SGLT2 inhibitors increases this risk. Evaluate patients for signs and symptoms and treat promptly.
• Hypoglycemia With Concomitant Use With Insulin and Insulin Secretagogues: INVOKANA^® can increase the risk of hypoglycemia when combined with insulin or an insulin secretagogue. A lower dose of insulin or insulin secretagogue may be required to minimize the risk of hypoglycemia when used in combination with INVOKANA^® .
• Genital Mycotic Infections: INVOKANA^® increases risk of genital mycotic infections. Patients with history of these infections and uncircumcised males were more likely to develop these infections. Monitor and treat appropriately.
• Hypersensitivity Reactions: Hypersensitivity reactions, including angioedema and anaphylaxis, were reported with INVOKANA^® ; these reactions generally occurred within hours to days after initiation. If reactions occur, discontinue INVOKANA^® , treat per standard of care, and monitor until signs and symptoms resolve.
• Bone Fracture: Increased risk of bone fracture, occurring as early as 12 weeks after treatment initiation, was observed in patients using INVOKANA^® . Consider factors that contribute to fracture risk prior to initiating INVOKANA^® .
• Increases in Low‐Density Lipoprotein (LDL‐C): Dose‐related increases in LDL‐C can occur with INVOKANA^® . Monitor LDL-C and treat per standard of care after initiating.

Invokana Treatment and Use

Invokana (canagliflozin) also prescribed with metformin as Invokamet (canagliflozin/metformin) is given to those with Type 2 Diabetes to help lower blood sugar. The drug is marketed as a once a day pill for treating diabetes type 2. The drug is stated to help lower A1C levels. The manufacturer, Jansenn Pharmaceuticals, states that in the majority of major trials Invokana has lowered the A1C level for most patients below the 7% goal suggested by the American Diabetes Association.

Invokana works by assisting the body in removing sugar through urination.  It has also been known to help lower the weight of patients taking it on average by 3%.  Invokana is not used for the treatment of hypertension but it has been known to lower the systolic blood pressure in those taking it.

 

Other Names for Invokana

Canagliflozin

Canagliflozin/Metformin

Lawsuits & Legal Information for Invokana

From March 2013, when canagliflozin was approved, to October 2015, FDA received reports of 101 confirmable cases* of acute kidney injury, some requiring hospitalization and dialysis, with canagliflozin or dapagliflozin use... This number includes only reports submitted to FDA, so there are likely additional cases about which we are unaware. Lawsuits have been filed by patients who developed ketoacidosis, serious urinary (kidney) complications and cardiovascular problems while taking Invokana.