Invokana (Canagliflozin)

Product Review





Invokana (Canagliflozin)

Product Review



Invokana (Canagliflozin) is a prescription drug which is used to treat type 2 diabetes. Moreover, Invokana is a brand name under which generic drug Canagliflozin is sold. It is an oral drug. It is prescribed by the doctor along with diet and exercise for glycemic control, above all.

How It Works

This drug relates to a group of medicines known as sodium-glucose transport protein 2 (SGLT 2) inhibitors. Moreover, Kidney filters the glucose out of the blood. However, the glucose gets reabsorbed due to SGLT 2 proteins. SGLT 2 inhibitors prevent the glucose from being absorbed back into the blood. Similarly, it removes the access of glucose from the body through urination. It also helps in losing weight as many calories are removed from the body with glucose. This is how Invokana helps to remove excess sugar from the blood, thus maintaining blood sugar levels.


  • Not recommended for children below 18 years.
  • Adult Dosage: Initial dose of 100 mg once daily before breakfast.
  • Increase in dose to 300 mg once daily depending on tolerability.
  • Maximum dose of 300 mg once daily is recommended.
  • Dosage for Patients with Renal Impairment:
  • A standard dose of 100 mg once daily.
  • Not for patients having serious renal impairment

Common Side Effects

  • Serious Side Effects:
  • Lower Limb Amputation
  • Allergic Reactions
  • Genital Infection: Symptoms are,
  1. Frequent Urination
  2. Burning while urinating
  3. Dark and cloudy urine
  4. A strong odour of urine
  5. Pelvic Pain
  6. White Discharge from the vagina
  7. Vaginal odour and itching
  8. Swelling of the penis
  9. Discharge from the penis
  • Dehydration: Symptoms are,
  1. Dizziness
  2. Weakness
  • Ketoacidosis: Symptoms are,
  1. Nausea
  2. Vomiting
  3. Stomach pain
  • Hypoglycemia
  • Hypotension
  • Fracture
  • Common Side Effects:
  • Mild genital infection
  • More urination
  • Thirst
  • Constipation

These are some side effects of Invokana. However, if you notice any symptoms, get immediate medical help.

How to Take This Medication

  • Take this medication as and when prescribed by the doctor.
  • Read the instructions carefully.
  • Take it once daily before breakfast.
  • If you miss a dose, don’t take 2 doses at once.
  • If you overdose, contact your doctor consequently.
  • Follow this medication with diet and exercise, above all.

Warnings and Precautions

  • Important Warnings:
  • Lower Limb Amputation: Invokana (Canagliflozin) may increase the risk of lower limb amputation in patients.
  • Genital Infection: Patients may suffer from a severe genital infection.
  • Other Warnings and Precautions:
  • Don’t take this drug if you have/are,
  1. Kidney Problems
  2. On Dialysis
  3. Heart problems
  • Inform your doctor if you have/are,
  1. Diabetic foot ulcer
  2. Kidney problems
  3. Diabetic Ketoacidosis
  4. Nerve problems in limbs
  5. Blood circulation problems in limbs
  6. Liver disease
  7. Heart disease
  8. Bladder Infection
  9. Problem with Pancreas
  10. On a low salt diet
  11. Pregnant or planning for a child
  12. Breastfeeding
  13. Going to have a surgery
  14. On other medication
  • Not recommended for children under 18 years.

Frequently Asked Questions

  1. How quickly does Canagliflozin work?

    Canagliflozin reaches steady-state levels in the body within 4 to 5 days, but its clinical effectiveness can vary widely among individuals, depending on various factors like age, weight, and concurrent medications.

  2. Is Canagliflozin safe for patients with heart conditions?

    Canagliflozin is often prescribed to lower the risk of cardiovascular problems in patients with type 2 diabetes, including those with heart disease. However, patients with specific heart conditions should discuss potential risks with their healthcare provider.

  3. What are the potential side effects of canagliflozin?

    Common side effects include urinary tract infections, increased urination, and risk of genital infections. More serious risks include ketoacidosis, dehydration, serious urinary tract infections, and lower limb amputation.

  4. Can Canagliflozin be used with metformin?

    Yes, Canagliflozin can be combined with metformin, especially in patients who need additional glucose control. This combination is common and may enhance the overall effectiveness of diabetes management.

  5. Does Canagliflozin have any risks during pregnancy?

    Canagliflozin is not recommended during the second and third trimesters of pregnancy due to insufficient data on safety in pregnant women and potential risks noted in animal studies.

  6. How does Canagliflozin affect kidney function?

    While Canagliflozin is used to protect against worsening kidney function and end-stage kidney disease in patients with type 2 diabetes and significant kidney issues, it may increase the risk of other kidney problems. Monitoring kidney function is crucial during treatment.

  7. Can Canagliflozin cause weight gain?

    Unlike many diabetes medications, Canagliflozin typically does not cause weight gain. In fact, it is often associated with weight loss. However, individual responses can vary, and a few cases might experience weight gain.

  8. What is Canagliflozin used for?

    Canagliflozin is primarily used to improve blood sugar control in adults with type 2 diabetes as part of a treatment plan that includes diet and exercise. It’s also used to lower the risk of cardiovascular events like heart attack and stroke in diabetic patients who have existing heart or kidney disease.

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Canagliflozin [package insert].Titusville, NJ: Janssen Pharmaceuticals; 2016.

Dr. Conor Sheehy, PharmD, BCPS is a practicing clinical pharmacist that works in primary care. He supports other members of the healthcare team including physicians, mid-level providers, nurses, and other clinical staff. He also likes to use his drug knowledge to inform his patients and the public about the benefits and risks they can expect from their medications. His clinical specialties include: anticoagulation, diabetes management, and psychiatric care.
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