INVOKANA (Canagliflozin)

What is this medication? 

INVOKANA (Canagliflozin)
Antidiabetic Agent; Sodium-Glucose Cotransporter 2 (SGLT2) Inhibitor 

INVOKANA (Canagliflozin) is indicated for the treatment of Diabetes mellitus type 2.

ALERT: WARNING
An increased risk of lower limb amputations associated with canagliflozin use versus placebo was observed in CANVAS (5.9 vs 2.8 events per 1,000 patient-years) and CANVAS-R (7.5 vs 4.2 events per 1,000 patient-years), 2 large, randomized, placebo-controlled trials in patients with type 2 diabetes who had established cardiovascular disease or were at risk for cardiovascular disease. Amputations of the toe and midfoot were most frequent; however, amputations involving the leg were also observed. Some patients had multiple amputations, some involving both limbs. Before initiating, consider factors that may increase the risk of amputation, such as a history of prior amputation, peripheral vascular disease, neuropathy, and diabetic foot ulcers. Monitor patients receiving canagliflozin for infection, new pain or tenderness, sores or ulcers involving the lower limbs, and discontinue if these complications occur.

How does this medication work? 

SGLT2 is in the proximal renal tubules of the nephron (a functional unit of the kidney) and is the main site of reabsorption of filtered glucose.  INVOKANA (Canagliflozin) inhibits this transporter which lowers glucose reabsorption and lowers the renal threshold for glucose resulting in its urinary excretion thereby lowering plasma glucose concentrations.

How should I take this medication?

Oral: Take 100-300mg once daily.

How to Take: Follow instructions provided by physician/pharmacy label, take consistently at same time each day usually in the morning due to diuretic effect unless otherwise directed, ideally 30 minutes prior to first meal to prevent post prandial hyperglycemia due to delayed absorption.  Monitor blood pressure when initiating due to diuretic effect.

You Need to Avoid: Do not skip standard diabetic foot care regimen.  Must monitor for wounds or signs of new infection, ulcers, sores or new pain or tenderness.  Avoid volume depletion or dehydration due to diuretic effect of this medication.

What should I watch for while using this medication? 

Before starting INVOKANA (Canagliflozin), make sure your physician is aware of any allergies, medications you currently take, if you have kidney disease, a history of diabetic ketoacidosis, have had bariatric surgery, are pregnant or breastfeeding.

What if I miss a dose?

If you miss a dose of medication, try to take it as soon as possible. However, if it is almost time for your next dose, take only that scheduled dose. Do not take double or extra doses.

How should I store this medication?

Keep out of the reach of children at all times. Store at room temperature, 59 to 86° F (15 to 30° C). Protect from light. Keep the container tightly closed. Properly dispose of any unused medication after the expiration date.

What are the possible side effects of using this medication? 

Urinary tract infection, increased urine output, genitourinary fungal infection, nausea, thirst, hypotension.

Note this is not a complete list of side effects for INVOKANA (Canagliflozin), only common ones.