Generic Name: canagliflozin (KAN a gli FLOE zin)
Brand Name: Invokana
What is Invokana?
Invokana (canagliflozin) is an oral diabetes medicine that helps control blood sugar levels. Canagliflozin works by helping the kidneys get rid of glucose from your bloodstream.
Invokana is used together with diet and exercise to improve blood sugar control in adults with type 2 diabetes.
Invokana is not for treating type 1 diabetes.
You should not use Invokana if you have severe kidney disease (or if you are on dialysis). Invokana is not for treating type 1 diabetes.
Before taking this medicine
You should not use Invokana if you are allergic to canagliflozin, or if you have:
severe kidney disease or if you are on dialysis.
To make sure Invokana is safe for you, tell your doctor if you have ever had:
bladder infections or other urination problems;
blood circulation problems;
nerve problems caused by diabetes;
a diabetic foot ulcer or amputation;
an electrolyte imbalance (such as high levels of potassium in your blood);
high cholesterol levels;
diabetic ketoacidosis (call your doctor for treatment with insulin);
if you are on a low salt diet; or
if you use insulin or other oral diabetes medicines.
It is not known whether Invokana will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.
It is not known whether canagliflozin passes into breast milk or if it could harm a nursing baby. You should not breast-feed while using this medicine.
Invokana is not approved for use by anyone younger than 18 years old.
How should I take Invokana?
Invokana is usually taken once per day. Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not take this medicine in larger or smaller amounts or for longer than recommended.
Invokana is usually taken once per day, before the first meal of the day.
You may have very low blood pressure while taking this medicine. Call your doctor if you are sick with vomiting or diarrhea, or if you are sweating more than usual. Drink plenty of liquids while you are taking Invokana.
Low blood sugar (hypoglycemia) can happen to everyone who has diabetes. Symptoms include headache, hunger, sweating, irritability, dizziness, nausea, fast heart rate, and feeling anxious or shaky. To quickly treat low blood sugar, always keep a fast-acting source of sugar with you such as fruit juice, hard candy, crackers, raisins, or non-diet soda.
Your doctor can prescribe a glucagon emergency injection kit to use in case you have severe hypoglycemia and cannot eat or drink. Be sure your family and close friends know how to give you this injection in an emergency.
Also watch for signs of high blood sugar (hyperglycemia) such as increased thirst or urination, blurred vision, headache, and tiredness.
Blood sugar levels can be affected by stress, illness, surgery, exercise, alcohol use, or skipping meals. Ask your doctor before changing your insulin dose or schedule.
Invokana is only part of a complete treatment program that may also include diet, exercise, weight control, regular blood sugar testing, and special medical care. Follow your doctor's instructions very closely.
Invokana can cause positive results with certain lab tests for glucose (sugar) in the urine. Tell any doctor who treats you that you are using Invokana.
Store at room temperature away from moisture and heat.
Invokana dosing information
Usual Adult Dose for Diabetes Type 2:
Initial dose: 100 mg orally once daily
Maximum dose: May increase to 300 mg orally once daily in patients with an eGFR of 60 mL/min/1.73 m2 or greater, tolerating therapy with 100 mg, and requiring additional glycemic control
-Do not initiate in patients with an eGFR less than 45 mL/min/1.73 m2 as this drug will not be effective.
-If used in combination with insulin or an insulin secretagogue, a lower dose of insulin or the insulin secretagogue should be considered to reduce the risk of hypoglycemia.
Use: As an adjunct to diet and exercise to improve glycemic control in patients with type 2 diabetes mellitus.
What happens if I miss a dose?
Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
What should I avoid while taking Invokana?
Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.
Invokana side effects
Get emergency medical help if you have signs of an allergic reaction to Invokana: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have:
a light-headed feeling, like you might pass out;
pain or burning when you urinate;
signs of a genital infection (penis or vagina), such as pain, burning, itching, redness, swelling, odor, or discharge;
new pain, tenderness, sores, ulcers, or infections in your legs or feet;
high potassium - nausea, slow or unusual heart rate, weakness, loss of movement;
ketoacidosis (too much acid in the blood) - nausea, vomiting, stomach pain, confusion, unusual drowsiness, or trouble breathing;
kidney problems - little or no urination; swelling in your feet or ankles; feeling tired or short of breath; or
dehydration symptoms - feeling very thirsty or hot, being unable to urinate, heavy sweating, or hot and dry skin.
You may be more likely to have bone fractures (even after only a minor impact trauma) while you are taking Invokana. Talk with your doctor about how to avoid the risk of fractures.
Side effects may be more likely to occur in older adults.
Common Invokana side effects may include:
genital infections; or
urinating more than usual.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
See also: Side effects (in more detail)
What other drugs will affect Invokana?
Tell your doctor about all your current medicines and any you start or stop using, especially:
a diuretic or "water pill";
seizure medication - phenobarbital, phenytoin.
This list is not complete. Other drugs may interact with canagliflozin, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.
More about Invokana (canagliflozin)
Other Invokana documents
Where can I get more information?
- Your pharmacist can provide more information about Invokana.
- Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Invokana only for the indication prescribed.
- Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
Copyright 1996-2017 Cerner Multum, Inc. Version: 3.01. Revision Date: 2017-05-26, 2:28:51 PM.