Invokana

Generic Name: canagliflozin (KAN-a-gli-FLOE-zin)
Brand Name: Invokana

Invokana is used for:

Treating type 2 diabetes in certain patients. It is used along with diet and exercise.

Invokana is a sodium-glucose cotransporter 2 (SGLT2) inhibitor. It works by decreasing the amount of sugar the body absorbs, and increasing the amount of sugar that leaves the body in the urine.

Do NOT use Invokana if:

  • you are allergic to any ingredient in Invokana
  • you have type 1 diabetes
  • you have high blood or urine ketone levels (diabetic ketoacidosis)
  • you have severe liver problems or severe kidney problems, or if you are on dialysis

Contact your doctor or health care provider right away if any of these apply to you.

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Before using Invokana:

Some medical conditions may interact with Invokana. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you have kidney or liver problems, low or high blood pressure, high cholesterol, or high potassium blood levels
  • if you have a history of yeast infections of the penis or vagina, or if you are a man who has not been circumcised
  • if you are dehydrated or if you are on a low salt (sodium) diet

Some MEDICINES MAY INTERACT with Invokana. Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Insulin or other oral diabetes medicine (eg, repaglinide, glipizide) because the risk of high or low blood sugar may be increased
  • Angiotensin-converting enzyme (ACE) inhibitors (eg, lisinopril), angiotensin receptor blockers (ARBs) (eg, losartan), or diuretics (eg, furosemide, hydrochlorothiazide, spironolactone) because the risk of low blood pressure or high potassium levels may be increased
  • Phenytoin, phenobarbital, rifampin, or ritonavir because they may decrease Invokana's effectiveness
  • Digoxin because the risk of its side effects may be increased by Invokana

This may not be a complete list of all interactions that may occur. Ask your health care provider if Invokana may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Invokana:

Use Invokana as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • Invokana comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get Invokana refilled.
  • Take Invokana by mouth before the first meal of the day, unless your doctor tells you otherwise.
  • Check with your doctor to see if you should drink extra fluids while taking Invokana.
  • Take Invokana on a regular schedule to get the most benefit from it. Taking Invokana at the same time each day will help you remember to take it.
  • Continue to take Invokana even if you feel well. Do not miss any doses.
  • If you miss a dose of Invokana, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Invokana.

Important safety information:

  • Dizziness may occur while you take Invokana. This effect may be worse if you take it with alcohol or certain medicines. Use Invokana with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
  • Invokana may cause dizziness, light-headedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects.
  • Carry an ID card at all times that says you have diabetes.
  • Follow the diet and exercise program given to you by your health care provider. Proper diet, regular exercise, and regular blood sugar testing are important for best results with Invokana.
  • Check your blood sugar levels as directed by your doctor. If they are often higher or lower than they should be and you take Invokana exactly as prescribed, tell your doctor.
  • Do NOT take more than the recommended dose without checking with your doctor.
  • It may be harder to control your blood sugar during times of stress such as fever, infection, injury, or surgery. Talk with your doctor about how to control your blood sugar if any of these occur. Do not change the dose of your medicine without checking with your doctor.
  • Be careful not to become dehydrated, especially during hot weather or while you are being active. Dehydration may increase the risk of Invokana's side effects.
  • If vomiting or diarrhea occurs, you will need to take care not to become dehydrated. Contact your doctor for instructions.
  • Tell your doctor or dentist that you take Invokana before you receive any medical or dental care, emergency care, or surgery.
  • Invokana usually does not cause low blood sugar. However, low blood sugar may occur when it is used along with certain other medicines for diabetes (eg, insulin, sulfonylureas). Low blood sugar may make you anxious, sweaty, weak, dizzy, drowsy, or faint. It may also make your heart beat faster; make your vision change; give you a headache, chills, or tremors; or make you hungrier. It is a good idea to carry a reliable source of glucose (eg, tablets or gel) to treat low blood sugar. If this is not available, you should eat or drink a quick source of sugar like table sugar, honey, candy, orange juice, or nondiet soda. This will raise your blood sugar level quickly. Tell your doctor right away if this happens. To prevent low blood sugar, eat meals at the same time each day and do not skip meals.
  • Invokana will cause your urine to test positive for glucose. Be sure your doctor and lab personnel know you are taking Invokana.
  • Lab tests, including kidney function, fasting blood glucose, hemoglobin A1c, and complete blood cell counts, may be performed while you use Invokana. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
  • Use Invokana with caution in the ELDERLY; they may be more sensitive to its effects, including dizziness.
  • Invokana should be used with extreme caution in CHILDREN younger than 18 years old; safety and effectiveness in these children have not been confirmed.
  • PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Invokana while you are pregnant. It is not known if Invokana is found in breast milk. Do not breast-feed while you are taking Invokana.

Possible side effects of Invokana:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Increased urination.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, throat, or tongue; unusual hoarseness); fainting; genital (vagina or penis) discharge, itching, rash, pain, or irritation; irregular heartbeat; muscle weakness; severe or persistent headache or dizziness; symptoms of kidney problems or urinary tract infection (eg, change in the amount of urine produced, difficult or painful urination, unusual or persistent pain in the mid- to lower back, unexplained swelling); unusual tiredness or weakness.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. You may also report side effects at http://www.fda.gov/medwatch .

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately.

Proper storage of Invokana:

Store Invokana at room temperature, between 68 and 77 degrees F (20 and 25 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep Invokana out of the reach of children and away from pets.

General information:

  • If you have any questions about Invokana, please talk with your doctor, pharmacist, or other health care provider.
  • Invokana is to be used only by the patient for whom it is prescribed. Do not share it with other people.
  • If your symptoms do not improve or if they become worse, check with your doctor.
  • Check with your pharmacist about how to dispose of unused medicine.

This information should not be used to decide whether or not to take Invokana or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about Invokana. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to Invokana. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your health care provider for complete information about the risks and benefits of using Invokana.

Issue Date: September 3, 2014
Database Edition 14.3.1.003
Copyright © 2014 Wolters Kluwer Health, Inc.

Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.

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