9 mins read

Overview: Invokana is used for type 2 diabetes and to lower the risk of a heart attack, stroke, or death in people who also have heart disease. It is also used to lower the risk of worsening kidney and heart problems in people with both type 2 diabetes and kidney disease. Invokana works to lower blood sugar levels by helping your body get rid of sugar when you pee. Common side effects include yeast infections, urinary tract infections, and peeing more than usual. Contact your health care provider right away or seek medical care if you have trouble breathing, dizziness, confusion, pain or swelling in your genital area, or pee that is dark, bloody, or smells foul.

Uses

What is Invokana used for?

Invokana (canagliflozin) is commonly used for the following conditions.

  • To help lower blood sugar levels in people with type 2 diabetes 
  • To lower the risk of major cardiovascular problems (heart attack, stroke, or death) in people who have both type 2 diabetes and heart disease 
  • To reduce the risk of worsening kidney function, kidney failure, hospital admission for heart failure, and cardiovascular death in certain people who have both type 2 diabetes and kidney disease

Invokana may also be used for other conditions as determined by your health care 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 serious heart and kidney problems by helping your body get rid of extra sugar, salt, and water.

How is Invokana supplied (dosage forms)?

Brands and other names

  • Invokana

Dosage forms and strengths

  • 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 and 77 F (20 C and 25 C). It can be exposed to temperatures between 59 F and 86 F (15 C and 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 health care 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 health care 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 (800-332-1088). 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 or skin rash
  • Bumps on the skin called hives that can be red, pink, white, or brown depending on your skin tone
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Diabetic Ketoacidosis (DKA). Invokana may cause diabetic ketoacidosis, which is 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 or vomiting
  • Stomach pain
  • Feeling very tired, woozy, or confused
  • Trouble breathing
  • Your breath smells fruity or sweet
  • Very high blood sugar levels (greater than 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 health care 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 usual
  • Swelling in your legs, ankles, and feet
  • Loss of appetite
  • Trouble catching your breath or chest pain
  • Seizures
  • Extreme thirst

Kidney Infections. 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 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. Your health care provider may adjust the dose of your other diabetes medicine to reduce your risk. Do not take Invokana and call your health care 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, which is an aggressive infection of the skin and underlying tissue that causes some of the tissue 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, discoloration, tenderness, or swelling around the anus or genitals
  • Fever
  • General feeling of illness or discomfort

Amputations. People who take Invokana may be more likely to have an amputation (for example, removal of a toe, foot, or part of the leg) than people who do not take Invokana. 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 health care 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). Talk with your health care provider about your risk of bone fracture.

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 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 health care provider may do tests to check 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 health care 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 control your diabetes. Talk to your health care provider if you have any of these conditions to decide if your medicine needs to be changed.

Talk to your health care 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 health care 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 health care 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 health care 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 health care provider before using Invokana?

Tell your health care 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 know if Invokana is right for you.

In particular, make sure that you discuss any of the following.

Risk of DKA. Tell your health care provider if you have any of the following risk factors for diabetic ketoacidosis (DKA) or had DKA in the past. Your health care provider may monitor you more closely or choose a different medicine for you.

  • Type 1 diabetes. Your health care 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 health care provider may suggest you change your diet or 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

Genital Yeast Infections. Tell your health care provider if you have a history of genital (penis or vagina) yeast infections. This may raise the chance of having yeast infections of the vagina or penis while taking Invokana. Your health care provider may choose a different medicine for you.

Other Current and Past Health Conditions. Tell your health care provider if you have any of the following.

  • Kidney problems
  • Liver problems
  • Kidney or bladder infections that keep coming back or trouble peeing
  • Amputation, nerve damage, or blood flow problems
  • Have surgery scheduled

Other Medicines and Supplements. Invokana may interact with other medicines and supplements. Before taking Invokana, tell your health care 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 a fetus.  Tell your health care provider if you are or plan to become pregnant. If you become pregnant, contact your health care provider right away.

Breastfeeding. It is not known if Invokana passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed. Your health care provider will let you know 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 drugmaker's website at 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 not known if drinking alcohol will affect Invokana in other ways, but alcohol may affect blood sugar levels in people with diabetes. It is best to limit the amount of alcohol you drink.

Does Invokana interact with other medicines (drug interactions)?

Always tell your health care 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.

  • Any 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 health care 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 health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

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.