If you have type 2 diabetes, your doctor may prescribe canagliflozin (Invokana) to help keep your blood sugar levels under control. It works best when you take it along with a well-balanced diet and exercise.
Here are six key things you should know about canagliflozin.
Conditions Canagliflozin (Invokana) Treats
Diabetes and heart problems often go hand in hand. In fact, research shows that people with type 2 diabetes are twice as likely to get heart disease or heart failure than those who don’t have the condition.
Canagliflozin belongs to a class of medications called sodium-glucose cotransporter 2 (SGLT2) inhibitors. It’s designed to reduce the amount of sugar your body reabsorbs through your pee. This can help lower your overall blood sugar levels.
In adults who have type 2 diabetes along with cardiovascular disease, or show signs of it, the FDA has approved the use of canagliflozin to lower your overall risk for major heart-related conditions like heart attacks, strokes, and death.
This drug can also lower your risk for:
- End-stage kidney disease
- Worsening kidney function
- Hospitalization due to heart failure
- Hospitalization from diabetic kidney disease (nephropathy)
Canagliflozin isn’t for people with type 1 diabetes. You also can’t take this drug if you have severe kidney problems.
How Do You Take Canagliflozin (Invokana)?
It’s a pill that you take by mouth once a day, usually before your first meal.
You can take it along with other drugs, such as metformin. But sometimes those drugs might interact with each other. That may make them less effective or cause certain side effects. Tell your doctor about all the medications and supplements you take.
Your doctor may need to adjust your canagliflozin dose.
Store the drugs in a closed container at room temperature. Avoid heat, moisture, or direct sunlight. If the medications have expired, dispose of them safely.
Canagliflozin Recommended Dosage
Your doctor might start you with a 100-milligram capsule. They may slowly raise your daily dosage to 300 milligrams to better control your blood sugar levels. If you miss a dose, take one as soon as you can. But if you skip it very close to your next dose, don’t double up. Just try to resume your regular schedule.
Potential Side Effects of Canagliflozin
In some people, canagliflozin might cause mild, moderate, or severe side effects.
These can include:
Urinary tract infections. The common signs include a burning sensation when you pee, lower tummy pain, an urgent need to pee, and blood in the urine.
Low blood sugar (hypoglycemia). If you’re taking other medications along with canagliflozin, your blood sugar levels may dip too low. Watch out for symptoms like dizziness, headache, sweating, shaking, and a racing heartbeat, among others.
Rare bacterial infection(necrotizing fasciitis) around the genitals. The infection damages the tissue under the skin around the anus and your genitals. It can spread quickly. Severe cases may require surgery or cause death. If you notice any signs like tenderness, pain, or swelling in the area, get medical help as soon as possible.
Allergic reaction. For some people, the drug might cause a severe allergic reaction. This could look like a rash, swelling, hives, or intense itching. Get medical help right away.
Bone fractures. Research shows that canagliflozin might raise your odds of breaking bones.
More serious side effects of canagliflozin might include:
- Eye problems like vision loss, blurry vision, eye pain, or tunnel vision. You might also see halos or lights around objects.
- Heart problems like shortness of breath, a fast or irregular heartbeat, dizziness, or passing out
- Slurred speech
- Loss of coordination or trouble walking due to stiff muscles, or weak arms and legs
- Intense sweating, fever, or tremors
If you notice such side effects, call 911 right away or head to the nearest hospital.
Are There Warnings or Safety Issues With Canagliflozin (Invokana)?
It’s unclear if canagliflozin might raise your risk of lower limb (feet and leg) amputations. This is a rare complication. But it’s important to be aware if you have such risk factors as a history of amputations, infections, or foot ulcers.
Canagliflozin can lead to diabetic ketoacidosis (DKA) in some people with type 2 diabetes. DKA can be deadly. It happens when your body doesn’t have enough insulin to convert the sugar in your blood into energy.
To make up for this, your body begins to burn fat to produce energy instead. This, in turn, produces ketones – a type of chemical – in your blood. An overload of ketones in your blood can make it acidic, poison your body, and make you feel very sick. This can be extremely dangerous and, in severe cases, lead to a diabetic coma or death.
Early signs of DKA might include feeling very thirsty or peeing a lot. It’s often a warning sign that your diabetes is out of control. DKA can happen to anybody with diabetes, but it’s rare if you have type 2 diabetes.
To avoid DKA, talk to your doctor about how you can keep your insulin in check and try to keep your blood sugar levels within a healthy range.
If you’re scheduled for surgery, you should stop taking this medication 3 days before to lower the risk for DKA. Your doctor will have to closely monitor your blood sugar levels during this time and manage it.
Who Should Not Use Canagliflozin (Invokana)?
Doctors don’t recommend canagliflozin to manage your blood sugar levels if you:
- Have severe liver problems (hepatic impairment)
- Are pregnant
- Are breastfeeding
- Are under 18 years of age
- Have serious allergic reactions to the drug, like anaphylaxis or angioedema (swelling caused by fluid buildup)
- Are on kidney dialysis. It’s a procedure to remove waste, toxins, and excess fluid from the blood.
Before you take this drug, check with your doctor to see if it’s the right medication to help manage your diabetes.
