Invokana is the brand name for the drug canagliflozin. It’s an SGLT2 inhibitor used to help lower blood sugar in adults with type 2 diabetes, usually in addition to diet and exercise. It can also provide some heart/kidney protection benefits in certain patients.
What it does
- Works by causing your kidneys to excrete more glucose in the urine, which lowers blood glucose levels.
- May help with modest weight loss and blood pressure reduction in some people.
Typical use and dosing
- Usually taken once daily, before the first meal.
- The dose is commonly started at 100 mg daily and may be increased to 300 mg daily if tolerated and if kidney function is appropriate. Your clinician will choose the right dose based on your kidney function and other meds.
- It’s not usually started if kidney function is severely reduced, and your doctor may adjust or stop the medication if kidney function worsens.
Common side effects
- Genital yeast infections (men and women) and urinary tract infections
- Increased urination, thirst
- Dehydration, dizziness, low blood pressure
- Possible changes in blood lipid levels (LDL)
Serious warnings to know
- Increased risk of serious infections of the skin and tissues around the genitals (including Fournier’s gangrene) – seek care if you have severe pain, swelling, fever, or trouble swallowing.
- Risk of diabetic ketoacidosis (DKA) even if your blood sugar isn’t very high. Seek urgent care if you have nausea/vomiting, stomach pain, trouble breathing, confusion, or unusual fatigue.
- Risk of lower limb amputations (foot or leg) in some patients, especially with prior amputation or peripheral artery disease.
- Dehydration and kidney function worsening; canagliflozin may need to be stopped if kidney function declines significantly.
- Not for use in type 1 diabetes or to treat DKA.
Who should avoid or use with caution
- Pregnant or breastfeeding people (not established as safe in pregnancy)
- People with very poor kidney function or a history of certain severe infections or amputations will be evaluated carefully
- Those taking other glucose-lowering meds (like insulin or sulfonylureas) may have a higher risk of low blood sugar; talk with your clinician about dosing and monitoring
What to monitor
- Blood sugar (A1C), kidney function (creatinine/eGFR), and electrolytes
- Blood pressure, hydration status
- Signs of infection in the genital area or urinary tract
- Signs/symptoms of DKA
If you’d like, tell me more about what you’re using Invokana for (type 2 diabetes alone, with another condition like kidney or heart disease, etc.), any other meds you’re on, and your kidney function. I can tailor the info (and compare to other SGLT2 inhibitors) or help you phrase questions for your clinician.