If you’ve been diagnosed with type 2 diabetes, along with changes to your diet and lifestyle, your doctor might prescribe medications like canagliflozin (Invokana) to help you manage your blood sugar levels.
Here are some most commonly asked questions about this medication.
What Is Canagliflozin (Invokana)?
It’s a medicine that comes in yellow, capsule-shaped tablets. You take it by mouth once a day before your first meal. It’s designed to lower your risk for end-stage kidney disease, worsening kidney problems, and major heart-related problems such as a heart attack, stroke, or death.
You cannot use canagliflozin if you have a more rare, genetic form of diabetes called type 1.
How Does Canagliflozin Work?
This drug belongs to a class of medicines called sodium-glucose transport protein 2 (SGLT2) inhibitors. It helps your kidneys flush sugar (glucose) from your body through your urine. This lowers your blood sugar levels.
Basically, canagliflozin blocks certain proteins in your kidneys to stop them from absorbing too much sugar back into your body.
When you have type 2 diabetes, your kidneys must work hard to filter all the sugar. This increased pressure can harm your organs. Canagliflozin can ease the pressure on the kidneys and slow down kidney damage.
Does Canagliflozin Cause Weight Loss?
While this isn’t the intended use of the drug, researchers have found that canagliflozin might help you lose a few pounds. This might happen if you take canagliflozin alone or with other diabetes medications, such as metformin.
The weight loss varies from person to person and might depend on the drug dosage. On average, you might lose anywhere from 2% to 3% of your body weight. If you’re taking canagliflozin, check with your doctor before you start a new diet or exercise program.
What Is the Brand Name of Canagliflozin?
In the U.S., canagliflozin is sold under only one brand name, Invokana. Currently, there’s no generic version of Invokana sold in the U.S.
Can Canagliflozin Cause Hypoglycemia?
In some people, this medicine may cause their blood sugar levels to drop very low (hypoglycemia). Your odds of hypoglycemia go up if you take canagliflozin along with other diabetes medications like insulin, glipizide, or glyburide.
Hypoglycemia symptoms can include:
- Shaking
- A racing heartbeat
- Sweating
- Feeling nervous or anxious
- Dizziness
- Hunger
- Confusion
In severe cases, it could cause you to pass out. But symptoms vary from person to person. If you’re taking canagliflozin and think you might have low blood sugar, tell your doctor right away.
Does Canagliflozin Reduce the Risk for Major Adverse Cardiovascular Events (MACE)?
Studies have shown that if you have diabetic kidney disease along with type 2 diabetes, taking 100 milligrams of canagliflozin once a day can lower your risk of major heart-related problems like stroke, cardiovascular disease, and heart attack.
What Are the Risks of Taking Canagliflozin (Invokana)?
As with any medication, in some people, canagliflozin can cause mild, moderate, or severe side effects.
In pregnant people, especially if you’re in the second or third trimester, taking canagliflozin might harm your baby’s health. It’s unclear if the drug also can affect your child through breast milk. So it may be best to avoid canagliflozin if you’re breastfeeding. If you plan to become pregnant, let your doctor know as soon as possible.
There’s conflicting data that in rare cases, for some people, canagliflozin might increase your odds of lower leg amputation. That usually involves the toe or some part of the foot. But in severe cases, doctors might need to amputate the leg below or above your knee. Even so, the benefits of taking canagliflozin outweigh the risks. Check with your doctor to see if it’s right for you.
Risk factors for amputation can include:
- Previous history of amputation
- Cardiovascular disease
- Nerve damage outside the brain and spinal cord (neuropathy)
- Peripheral vascular disease
- Diabetic foot ulcers
- Being 65 or older
- Lack of preventive foot care
To avoid amputation, keep a close eye on any sores, ulcers, foot pain or tenderness, or signs of infection on your legs. If you notice signs, tell your doctor right away.
Canagliflozin is also not suitable for people with severe kidney and liver problems, as it can worsen your condition.
Can Canagliflozin (Invokana) Be Taken With Metformin?
Yes. Metformin is designed to help your stomach absorb less sugar, get rid of stored sugars in your liver, and help your body to use sugar better.
In some cases, your doctor might prescribe just one pill that combines canagliflozin and metformin. The brand name for this drug is Invokamet.
It’s available in two forms. One (Invokamet XR) is a once-daily tablet that’s slowly absorbed. It’s also called an extended-release tablet. The other type (Invokamet) is one you take twice a day that enters your body more quickly.
How Much Does Canagliflozin Cost?
Your costs will depend on whether you have health insurance, the type of your coverage, out-of-pocket costs, copays, and deductibles.
In terms of out-of-pocket costs, a 30-day supply of once-daily 100-milligram canagliflozin tablets will cost you upwards of $600 at your local pharmacy. Speak to your doctor or pharmacist about drugmaker coupons that could lower your costs.
For certain people with private health insurance, the drugmaker might offer discounts or free medications for a short period of time. Check directly with the drugmaker or its website to see if you qualify.
If you have Medicare and have a Part D prescription drug plan, canagliflozin is covered. visit Medicare.gov or call 800-MEDICARE (800-633-4227) to get information on all of your options.
Coverage for canagliflozin under Medicaid, the state-federal health plan for people with lower incomes, is more limited and varies by state.
Is Canagliflozin FDA-Approved?
The FDA approved it to manage type 2 diabetes in 2013.
