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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.
Product Overview
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 Invokana 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. Alternative medications such as Rybelsus, Mounjaro, Semaglutide, Januvia, Tirzepatide, Victoza, and more may be considered, with the specific choice determined by the healthcare provider. Ultimately, patients should adhere to their doctor’s recommendations for optimal results and safety.
Uses of Invokana
- 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.]
How to Use Invokana?
Dosage
Invokana (Canagliflozin) comes in the form of oral tablets and is available in two strengths:
- 100 mg
- 300 mg
Recommended Dosage for Invokana
Adult Dose 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.
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.
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.
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 depending on person to person. Discuss it with your doctor, and they’ll customize your dosage accordingly.]
How to Take It?
- 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 with 100 mg of Invokana once a day, before your first meal, to lower blood sugar. If needed, your doctor may increase it to a max of 300 mg daily.
- If you have mild or moderate kidney issues, stick to 100 mg a day. 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.
- 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.]
How Does Invokana Work?
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.
Important Safety Information
Side Effects
Common side effects of Invokana may include:
- Vaginal Yeast Infection
- Urinary Tract Infection (UTI)
- Urinating More Often Than Usual
- Indigestion
- Vomiting
- Itching of the Vagina or Genitals
- Weight Gain
- Unusual Tiredness or Weakness
Mild side effects of Invokana may include:
- Anxiety
- Headache
- Blurred Vision
- Confusion
- Chills
- Nightmares
- Dry Mouth
- Increased Hunger
- Itching Skin
- Unusually Warm Skin
- Seizures
Serious side effects of Invokana may include:
- Bladder Pain
- Decreased Frequency or Amount of Urine
- Bloody or Cloudy Urine
- Discharge with a Strong Odor from the Penis
- Painful Urination
[Note: Remember, this list may not cover all possible side effects. Always consult with your healthcare giver for medical advice about side effects.]
Warnings
- Risk of Lower Limb Amputations: Invokana comes with a serious warning about an increased risk of lower limb amputations. Both the 100 mg and 300 mg doses of Invokana have been linked to this risk, with amputations occurring at the toe, middle of the foot, and even below or above the knee.
- 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 Yeast Infections: SGLT2 inhibitors like Invokana may cause genital yeast infections. Symptoms in men include itching, vaginal odor, abnormal discharge, burning discomfort, painful urination, and swelling. Women experienced a higher incidence of these infections in clinical studies.
- 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.
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.
Missed Dose
- 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.
[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.]
Overdose
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.]
Storage
- 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.
- Dispose of expired or unused medications properly according to guidelines.
[Note: Discuss with your healthcare professional about the proper disposal of any unused medicine and any questions you may have regarding its storage.]
Invokana Interactions
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
[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.]
Invokana Alternatives
- Glucophage (metformin)
- Glumetza (metformin)
- Riomet (metformin)
- Januvia (sitagliptin)
- Victoza (liraglutide)
- Trulicity (dulaglutide)
- Farxiga (dapagliflozin)
- Jardiance (empagliflozin)
- Steglatro (ertugliflozin)
- Ozempic (semaglutide)
- Actos (pioglitazone)
- Avandia (rosiglitazone)
- Bydureon (exenatide)
- Byetta (exenatide)
- Adlyxin (lixisenatide)
- Precose (acarbose)
- Glyset (miglitol)
- Glucotrol (glipizide)
- Amaryl (glimepiride)
- Diabeta (glyburide)
- Glynase PresTabs (glyburide)
- Tradjenta (linagliptin)
- Onglyza (saxagliptin)
- Nesina (alogliptin)
- Tanzeum (albiglutide)
[Note: Your doctor will choose what’s best for you. Don’t use any of these alternative medications without consulting your healthcare provider. Taking them by yourself may cause serious side effects.]
Frequently Asked Questions
Is Invokana the same as metformin?
Invokana works with your kidneys to assist in sugar elimination via urination. Meanwhile, Metformin works to reduce the sugar produced by your liver and enhances your body’s insulin responsiveness.
Are Invokana and Jardiance identical medications?
While both Invokana and Jardiance fall within the same drug class, they are distinct pharmaceuticals. Jardiance is the brand name for empagliflozin, whereas Invokana is the brand name for Canagliflozin. It is important to note that Invokana® carries an increased risk of lower leg amputation.
Is it safe to use Invokana during pregnancy?
Using Invokana during pregnancy may pose risks to your unborn child. If you discover you are pregnant while taking Invokana, it is crucial to inform your doctor promptly. Your doctor will guide you on the most appropriate steps to manage your blood sugar effectively while pregnant. Prioritizing open communication with your healthcare team is essential to ensuring the well-being of both you and your baby during this period. Always follow your healthcare provider’s advice and closely monitor your health for a safe and healthy pregnancy journey.
What is the potential weight loss achievable with Invokana?
Invokana has demonstrated consistent weight loss effects when used independently or in conjunction with standard diabetes medications like metformin and sulfonylureas. Research indicates that individuals taking the 300 mg dose, either as a monotherapy or in combination with other diabetes drugs, may experience a weight reduction of approximately 6-9 pounds within a span of six months. It’s essential to note that individual responses can vary, and weight loss outcomes may be influenced by factors such as lifestyle, diet, and overall health. Regular consultation with a healthcare professional is crucial to monitor progress and tailor the treatment plan for optimal results.
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