Invokana

Invokana (Canagliflozin) is an FDA-approved oral medication used to control blood sugar in adults with type 2 diabetes. It can also lower the risk of heart attack, stroke, and death in those with heart problems. Additionally, it helps reduce the risk of complications in diabetic nephropathy. Invokana comes in 100 mg and 300 mg strengths, with the initial dose typically starting at 100 mg once a day, increasing to 300 mg if well-tolerated. Depending on kidney function and other factors, the dose may be increased to 300 mg for better blood sugar control. It works by blocking kidney proteins that reabsorb sugar, leading to its removal in urine. Common side effects include yeast infections, urinary tract infections, and increased urination. It’s important to discuss the medication’s potential benefits and risks with a healthcare provider.

Invokana, also known by its generic name Canagliflozin, is an oral medication aimed at controlling blood sugar levels in adults diagnosed with type 2 diabetes. The primary function of this medication is to assist the kidneys in removing glucose, leading to improved sugar control when coupled with a suitable diet and regular exercise. Moreover, it has been found to reduce the risk of heart-related issues in individuals with both type 2 diabetes and heart disease.

This FDA-approved medication falls under the category of sodium-glucose cotransporter 2 (SGLT2) inhibitors, and it is available in 100 mg and 300 mg tablets, necessitating a doctor’s prescription for purchase. The prescribed dosage depends on factors such as kidney function and overall health. Invokana blocks kidney proteins responsible for sugar reabsorption, allowing more sugar to be expelled in urine. It can be used in conjunction with other diabetes medications for enhanced efficacy. Like many other medications, it has some common side effects, including yeast and urinary tract infections, increased urination, indigestion, vomiting, itching, and mild symptoms like anxiety and headaches.

However, serious side effects encompass lower limb amputations, dehydration, genital yeast infections, ketoacidosis, urinary tract infections, sudden kidney problems, low blood sugar, and a rare condition known as necrotizing fasciitis. Given its interaction potential with 368 drugs, it is crucial for patients to inform their healthcare provider about all medications they are currently taking. Ultimately, patients should adhere to their doctor’s recommendations for optimal results and safety.

This medication is used for the following purposes:

• Control your blood sugar by following a diet and exercise plan.
• Lower the chances of having a heart attack, stroke, or dying if you have heart problems.
• Lowers the risk of complications in people with diabetic nephropathy who have high levels of albumin in their urine.

[Important Warning: Invokana is not for people with type 1 diabetes.]

What Are the Forms & Strengths of Invokana?

It comes in the form of oral tablets and is available in two strengths:

• Invokana 100 mg
• Invokana 300 mg

What Are the Recommended Dosages for Invokana?

Dosage for Diabetes (Type 2)

• Start with 100 mg by mouth once a day, taken before the first meal of the day.
• If the initial dose is well-tolerated and the patient has good kidney function (eGFR ≥60 ml/1 min/1.73 m²), the dose can be increased to 300 mg once a day for better blood sugar control.

Dosage For Those with Kidney Issues (eGFR)

• eGFR ≥60 ml per min per 1.73 m²: No dosage adjustment needed.
• eGFR 30 to <60 ml/min/1.73 m²: 100 mg once a day.
• eGFR <30 ml/min/1.73 m² with albuminuria >300 mg/day: 100 mg once a day to reduce the risk of severe kidney problems and heart-related issues.
• eGFR <30 ml/min/1.73 m²: Starting this medication is not recommended.

Dosage For Those Taking UGT Enzyme Inducers

• eGFR ≥60 ml/min/1.73 m²: May increase Canagliflozin dose to 200 mg once a day if currently tolerating 100 mg/day.
• May increase Canagliflozin dose to 300 mg once a day if currently tolerating 200 mg/day.
• eGFR <60 ml/min/1.73 m²: May increase Canagliflozin dose to 200 mg once a day if currently tolerating 100 mg/day. If your blood sugar needs more control, your doctor might think about adding another antihyperglycemic agent to help with that.

Dosage For Those with Hepatic Impairment

• Mild-to-moderate: No dosage adjustment is necessary.
• Severe: Not studied, and therefore, not recommended.

[Note: Remember, these recommendations may vary from person to person. Discuss it with your doctor, and they’ll customize your dosage accordingly.]

To get the most benefit from your medication, you must know the detailed steps on how to take your medication properly. Below are some basic steps that must be followed when you consider treatment with Invokana:

• Before handling any medication, wash your hands to reduce the risk of transferring germs to the tablets.
• Get a glass of water to help you swallow the tablet.
• Start by taking an Invokana 100 mg tablet once a day before your first meal to lower your blood sugar. If needed, your doctor may increase it to a maximum of 300 mg daily. 
• If you have mild or moderate kidney issues, stick to 100 mg daily. If you’re on specific medications interacting with Invokana, your doctor might suggest 200 mg daily.
• Take the Invokana tablet whole and swallow it with water without chewing, crushing, or breaking it.
• If you cannot swallow the tablet as a whole, get help from healthcare experts. They will suggest alternate options as per your body’s needs.
• This medication is not recommended for treating type 1 diabetes mellitus or diabetic ketoacidosis.

[Note: Your doctor will decide the right amount for you based on your condition, following guidelines and studies on the drug. They’ll adjust it as needed over time.]

For people with type 2 diabetes, Invokana helps control blood sugar by blocking specific kidney proteins that usually reabsorb sugar. This means more sugar is released in your urine. Invokana can be used with other diabetes medications like metformin to help you reach your health targets.

Common side effects of Invokana: Many patients experience minimal or manageable side effects when they buy Invokana online. So, It’s important to be aware of what these reactions might include so you can discuss them with your healthcare provider if they arise. These side effects are usually temporary and can last from a few days to weeks. However, if they start to bother, talk to a medical professional. Some of the common side effects of Invokana may include:

• Vaginal Yeast Infection: Invokana can disrupt the natural balance of bacteria & yeast in the vaginal area, leading to yeast infections. Individuals taking Invokana may experience symptoms such as itching, discharge, and irritation. This side effect occurs because Invokana increases glucose excretion in the urine, creating a favorable environment for yeast growth.
• Urinary Tract Infection (UTI): Invokana may increase the risk of urinary tract infections. This occurs because the medication causes an increase in glucose in the urine, which can promote bacterial growth. Symptoms of a UTI include a burning sensation during urination, an increased urge to urinate, and cloudy urine.
• Urinating More Often Than Usual: Invokana works by aiding the kidneys in flushing out excess glucose through the urine. As a result, this process can lead to increased urination as your body attempts to eliminate the glucose. This side effect may interfere with daily activities and sleep patterns due to the frequent need to urinate.
• Indigestion: Invokana may cause digestive issues such as indigestion. Users might experience discomfort, bloating, and heartburn. These symptoms arise as the body adjusts to the medication and its effects on glucose metabolism and the digestive system.
• Vomiting: This is a potential side effect of Invokana. This can occur as the body reacts to changes in blood sugar levels and the increased workload on the kidneys to filter and excrete glucose.
• Itching of the Vagina or Genitals: Canagliflozin 100mg tablets can cause itching around the vaginal or genital area. This side effect is typically related to the increased sugar levels in your urine, which can irritate these sensitive areas and lead to discomfort and itching.
• Weight Gain: Although Invokana is typically associated with weight loss due to its glucose-excreting effects, some individuals may experience weight gain. This can occur due to fluid retention or other metabolic changes induced by the medication.
• Unusual Tiredness or Weakness: Taking Invokana may lead to feelings of unusual tiredness or weakness. This side effect can stem from the depletion of sugar, a primary energy source for the body. Additionally, the diuretic effect of frequent urination can also contribute to dehydration and fatigue.

Mild side effects of Invokana: While it is effective in its role, Invokana may cause a range of mild side effects. These side effects, while generally not severe, can affect comfort and daily activities. It is crucial for patients to be aware of these potential reactions to manage them effectively and consult healthcare providers if they persist or worsen.

• Anxiety: Patients taking Invokana may experience increased feelings of anxiety. This side effect can manifest as persistent nervousness, excessive worry, and a general sense of unease, which might interfere with daily activities.
• Headache: A common side effect of Invokana is headaches. These may range from mild to severe and may occur frequently. Patients are advised to monitor their hydration and consult a doctor if the headaches persist.
• Blurred Vision: Invokana may cause temporary blurred vision. This symptom should be monitored closely as it can impact driving and the use of machinery. Persistent vision problems should be addressed by a healthcare professional immediately.
• Confusion: Some patients on Invokana report experiencing episodes of confusion. This can involve difficulty in remembering, learning new tasks, or making decisions that were once familiar.
• Chills: Chills or a feeling of coldness without an apparent cause can occur with Invokana use. Dressing warmly and monitoring body temperature can help manage this side effect.
• Nightmares: A less common side effect of Invokana is the occurrence of nightmares. These disturbing dreams can disrupt sleep and lead to sleep deprivation.
• Dry Mouth: Invokana can reduce saliva production, leading to dry mouth. This may increase the risk of dental problems, including cavities and gum disease. Drinking water and using saliva substitutes can offer relief.
• Increased Hunger: Due to Invokana’s effects on blood sugar levels, patients may feel an unusual increase in hunger. It is advisable to eat balanced meals and discuss dietary plans with a healthcare provider.
• Itching Skin: Itching or skin irritation is another possible side effect of Invokana. Keeping the skin moisturized & avoiding irritants can help alleviate discomfort.
• Unusually Warm Skin: Some individuals might notice that their skin feels unusually warm to the touch. This is generally harmless but can be uncomfortable.

Serious side effects of Invokana: This medication is effective in controlling glucose levels, and patients must be aware of potential adverse reactions that could indicate serious health issues. Monitoring these symptoms is crucial for timely intervention. It is important to note that the below list does not contain every serious side effect of Invokana. 

• Bladder Pain with Invokana: Individuals taking Invokana may experience bladder pain, a serious side effect that demands immediate medical attention. This discomfort can be a sign of bladder inflammation or infection, conditions that are potentially aggravated by the medication. Patients experiencing such symptoms should consult their healthcare provider to assess the need for possible adjustments to their treatment plan or additional diagnostic testing.
• Decreased Frequency or Amount of Urine with Invokana: A noticeable decrease in the frequency or amount of urine can be a serious side effect of Invokana. This symptom could indicate kidney issues, such as reduced kidney function or acute kidney injury. It’s important for patients observing such changes to seek medical advice promptly to prevent potential long-term damage. Early detection & treatment are vital for maintaining kidney health while managing diabetes with Invokana.
• Bloody or Cloudy Urine with Invokana: Bloody or cloudy urine while taking Invokana is a concerning symptom that should not be ignored. It can indicate urinary tract infections or, in more severe cases, kidney damage. Immediate consultation with a healthcare expert is advised to determine the various causes and receive appropriate treatment, which may include adjustments to the medication regimen.
• Discharge with a Strong Odor from the Penis: Experiencing discharge with a strong odor from the penis during your treatment with Invokana 300mg tablets is an alarming symptom that could signal an infection. This side effect, while less common, is serious and requires prompt medical evaluation to rule out infections or other complications related to the medication. Treatment might involve antibiotics or changes to the diabetes management plan.
• Painful Urination with Invokana: Painful urination, when taking Invokana, is a significant side effect that often indicates a urinary tract infection (UTI). Since UTIs can lead to more severe complications if left untreated, patients experiencing pain during urination should seek medical attention immediately. A healthcare provider may prescribe antibiotics to treat the UTI and consider whether continuing with Invokana is the best course of action.
• Seizures: Though rare, seizures are a serious side effect associated with Invokana. Immediate medical attention is necessary if a patient experiences a seizure while on this medication.

[Note: Remember, this list may not cover all possible side effects. Always consult with your healthcare giver for medical advice about side effects.]

When you buy Invokana online, you should be aware of the various warnings associated with this medication. This includes:

• Dehydration and Low Blood Pressure: Using Invokana can lead to increased urination, potentially causing dehydration. This may result in feelings of dizziness, lightheadedness, fainting, or weakness, especially when standing up. Those taking the 300 mg dose, individuals aged 75 or older, or those using diuretics face a higher risk of dehydration. Individuals with low blood pressure, kidney problems, or following low-sodium diets are also at risk.
• Genital Mycotic Infections: If you are taking Invokana 300mg tablets, you may be at risk of developing genital mycotic infections. Patients with a history of this condition and uncircumcised males should be cautious while taking this medication. Its symptoms in men include itching, vaginal odor, abnormal discharge, burning discomfort, painful urination, and swelling. 
• Ketoacidosis: Invokana may lead to ketoacidosis, a severe condition characterized by increased ketones in the blood or urine. This can require hospitalization and can be fatal. Symptoms include nausea, tiredness, vomiting, trouble breathing, and abdominal pain.
• Urinary Tract Infections: Serious UTIs are a potential risk with Invokana tablets. Symptoms include a burning sensation during urination, frequent urination, urgent need to urinate, pelvic pain, blood in urine, fever, back pain, nausea, or vomiting.
• Sudden Kidney Problems: Acute kidney injury is a potential side effect of using Invokana tablets. Individuals with kidney disease may need a dose adjustment, and treatment might have to be temporarily discontinued if dehydration occurs.
• Low Blood Sugar (Hypoglycemia): When combined with other medications causing low blood sugar, Invokana can lead to hypoglycemia. Symptoms include headache, drowsiness, confusion, weakness, irritability, hunger, fast heartbeat, sweating, and shaking.
• Necrotizing Fasciitis of the Perineum (Fournier’s Gangrene): Although rare, Invokana carries a risk of a severe bacterial infection causing tissue damage in the perineum area. Symptoms include pain, tenderness, swelling, and redness of the skin. Immediate medical support is crucial if these signs are observed.
• Hyperkalemia: Canagliflozin may result in high potassium levels in the blood. Patients who have moderate renal issues and are taking medications that disturb potassium excretion, like potassium-sparing diuretics, are more likely to develop hyperkalemia. Therefore, patients are advised to periodically monitor their potassium levels after starting treatment with Invokana.
• Bone Fracture: Patients using this medication have higher chances of bone fracture that may occur usually 12 weeks after using Invokana. Therefore, patients are advised to be cautious of the factors leading to fracture. 
• Increases in Low-Density Lipoprotein (LDL-C): This medication can increase LDL-C in certain patients. So, if you are taking canagliflozin, closely monitor your LDL-C and treat it if needed.

What Are the FDA Boxed Warning for Invokana?

Boxed warnings are the most strict warnings issued by the FDA to alert doctors and patients about a drug’s harmful effects. These effects, if left untreated, can turn into life-threatening situations. Not every drug has such warnings, but if you are using invokana 100mg tablets, you must know the following black box warnings:

• Lower Limb Amputation: Studies have revealed that patients with type 2 diabetes mellitus who have cardiovascular disease or are at risk for such disease may have higher chances of lower limb amputations during their treatment with Invokana. If you are thinking of using this medication, consider factors that may raise the chance of amputation, especially of the toe and midfoot. Doctors are advised to monitor their patients for any infections or ulcers of the lower limbs. If suspected, discontinue the use of Invokana. 

It is important to follow certain precautions when using Invokana to avoid potential risks and side effects. Here are some key precautions:

• Make sure to check regularly how well your kidneys are doing while using Invokana. If your kidney disease is severe or you’re on dialysis, it’s better not to use Invokana.
• Invokana can make you lose fluids, leading to dehydration. This might cause low blood pressure and other issues. Drink plenty of water to avoid this situation.
• Using Invokana has been linked to a higher chance of leg amputations. If you notice anything unusual with your feet, let your doctor know right away.
• If you are a pregnant or breastfeeding mother, then ask your doctor before using this medication.
• While there is not enough information regarding this, one clinical study has reported kidney cancer in patients taking canagliflozin 100mg tablets. Moreover, it is also not known whether the medication affects kidney cancer. So, as long as there is no confirmation, avoid taking Invokana if you have kidney cancer.
• Tell your doctor beforehand if you have allergies to canagliflozin or any other ingredient present in its formulation. The product may contain specific inactive components that can cause severe allergic reactions.
• Do not forget to inform your healthcare practitioner about your medical history. Doing so will prevent you from potential risks.
• If you have any surgery or undergoing a medical procedure, inform your healthcare practitioner about the products you take, including prescription drugs, over-the-counter medications, and herbal supplements.

• If you missed a dose of Invokana (Canagliflozin), remember to take it as soon as you recall.
• If your next scheduled dose is approaching, it’s best to skip the missed dose and refrain from taking an extra one to make up for it.
• Stick to your regular dosing routine, and if you have any concerns or questions about your medication, consult with your healthcare provider for guidance.
• Use pill organizers to divide your doses weekly. This will help you take your tablets in a timely manner without skipping any medication.

[Note: If you have missed a dose of your medication and are unsure about when to take the next one, immediately consult your doctor or pharmacist.]

If you think you’ve consumed more Invokana (Canagliflozin) tablets than the recommended dose, get in touch with your doctor immediately. If it’s a severe case, call 911 or your local emergency number, or head to the nearest emergency room. Watch out for symptoms like increased side effects, such as more frequent urination. Dehydration is also a concern, as it can lead to low blood pressure and kidney damage.

[Note: If you consumed more than the recommended dose, get medical help right away or call the Poison Help line at 1-800-222-1222.]

When you buy Invokana online, you should follow Invokana’s storage guidelines. This includes:

• Store Invokana (Canagliflozin) at room temperature, between 68°F to 77°F (20°C to 25°C).
• No refrigeration is necessary.
• Keep all medications out of the reach of children and pets.
• Store your tablets somewhere safe and place safety locks, if necessary, to avoid poisoning your child.
• Do not keep the medication in moist or damp places.
• Protect the tablets from extreme heat and direct sunlight.
• Dispose of expired or unused medications properly according to guidelines.
• Ask a medical expert/pharmacist how to dispose of the medication rationally without damaging the environment.

[Note: Discuss with your healthcare professional about the proper disposal of any unused medicine and any questions you may have regarding its storage.]

Drug interactions happen when you co-administer two or more than two medications. Doing so may result in adverse reactions, as it can increase the risk of side effects. So, before considering treatment with Invokana, you must know what drug might affect the functioning of your medication. There are a total of 368 drugs that have been reported to interact with Invokana (Canagliflozin). Here are some of them: 

• Omeprazole
• Glimepiride
• Crestor
• Lisinopril
• Metformin
• Fish Oil
• Aspirin
• Atorvastatin
• Hydrochlorothiazide
• Pantoprazole
• Lantus Solostar
• Januvia
• Vitamin D3
• Gabapentin
• Lantus
• Furosemide
• Levothyroxine
• Metoprolol
• Vitamin B12
• Trulicity
• Simvastatin
• Amlodipine
• Glipizide
• Losartan
• Jardiance
• Lyrica
• Aspirin Low Strength
• Fenofibrate

What Are the Other Invokana Interactions?

Besides the above drug interactions, Invokana can also interact with certain herbs, supplements, and medical conditions. Some of them are mentioned below:

• Alpha-lipoic acid
• Bitter melon
• Chromium
• Gymnema
• Prickly pear cactus
• Liver dysfunction
• Renal dysfunction
• Hypotension
• Infections

[Note: This isn’t a complete list, and there could be other drugs that interact with Invokana. Make sure to tell your doctor about any prescription, over-the-counter medicines, and herbal products you’re taking.]

Drug interactions happen when you co-administer two or more than two medications. Doing so may result in adverse reactions, as it can increase the risk of side effects. So, before considering treatment with Invokana, you must know what drug might affect the functioning of your medication. There are a total of 368 drugs that have been reported to interact with Invokana (Canagliflozin). Here are some of them: 

• Omeprazole
• Glimepiride
• Crestor
• Lisinopril
• Metformin
• Fish Oil
• Aspirin
• Atorvastatin
• Hydrochlorothiazide
• Pantoprazole
• Lantus Solostar
• Januvia
• Vitamin D3
• Gabapentin
• Lantus
• Furosemide
• Levothyroxine
• Metoprolol
• Vitamin B12
• Trulicity
• Simvastatin
• Amlodipine
• Glipizide
• Losartan
• Jardiance
• Lyrica
• Aspirin Low Strength
• Fenofibrate

What Are the Other Invokana Interactions?

Besides the above drug interactions, Invokana can also interact with certain herbs, supplements, and medical conditions. Some of them are mentioned below:

• Alpha-lipoic acid
• Bitter melon
• Chromium
• Gymnema
• Prickly pear cactus
• Liver dysfunction
• Renal dysfunction
• Hypotension
• Infections

[Note: This isn’t a complete list, and there could be other drugs that interact with Invokana. Make sure to tell your doctor about any prescription, over-the-counter medicines, and herbal products you’re taking.]

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