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canagliflozin

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Brand names: Invokana

SGLT2 Inhibitor Rx

Invokana is a medicine used with diet and exercise to lower blood sugar in adults with type 2 diabetes. It can also help reduce the risk of heart problems and kidney disease in some patients.

Drug Pricing (NADAC)

Brand Price

$19.17/unit

Generic Available

No

JANSSEN PHARMS

Pricing data from NADAC (CMS), effective December 18, 2024. Compare all drug costs →

What it does

Invokana is used to help control blood sugar levels in adults with type 2 diabetes.

Common side effects

Yeast infections of the vagina, Urinary tract infection, Increased urination

Key warnings

Invokana can cause serious side effects, including: - Diabetic ketoacidosis (DKA): This is a serious condition where your body produces high levels of blood acids called ketones.

How It Works

Invokana is a type of medicine called an SGLT2 inhibitor. It works by preventing your kidneys from reabsorbing sugar back into your blood. This causes extra sugar to leave your body through your urine, which lowers your blood sugar levels.

How to Take It

Take Invokana once a day, before your first meal of the day. Your doctor will start you on either 100 mg or 300 mg. They may change your dose depending on how well the medicine works and your kidney function. If you are taking certain other medicines, your doctor may need to adjust your Invokana dose.

Pregnancy & Breastfeeding

Invokana is not recommended during the second and third trimesters of pregnancy because it may harm the developing baby's kidneys. Talk to your doctor if you are pregnant or plan to become pregnant. It is also not recommended to use Invokana while breastfeeding.

Missed Dose

If you miss a dose of Invokana, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and take your next dose at the regular time.

Storage

Store Invokana at room temperature, away from moisture and heat.

Side Effects (from patient reports)

Based on 16,917 FDA adverse event reports.

Diabetic ketoacidosis (high levels of ketones in the blood)
3,421
Toe amputation
2,195
Bone infection
2,163
Sudden kidney damage
1,990
Fungal infection
1,446
Weight loss
1,340
Increased blood sugar
1,227
Tissue death due to lack of blood supply
1,084
Skin infection
1,035
Urinary tract infection
1,016

FDA Adverse Event Report Analysis

Detailed analysis of 29,554 reports from the FDA Adverse Event Reporting System (FAERS). Reports span 2011–2025.

Total Reports

29,554

Death-Related Reports

678

Hospitalization Reports

10,619

Top Indication

Type 2 Diabetes Mellitus

Gender Distribution

Female 12,723 (49%)
Male 13,356 (51%)

Age Distribution

0–17 870
18–44 2,011
45–64 9,573
65–74 3,463
75+ 1,438

Most Reported Adverse Reactions (FAERS)

# Reaction Reports
1 DIABETIC KETOACIDOSIS 3,421
2 TOE AMPUTATION 2,195
3 OSTEOMYELITIS 2,163
4 ACUTE KIDNEY INJURY 1,990
5 FUNGAL INFECTION 1,446
6 WEIGHT DECREASED 1,340
7 BLOOD GLUCOSE INCREASED 1,227
8 GANGRENE 1,084
9 CELLULITIS 1,035
10 URINARY TRACT INFECTION 1,016
11 DRUG INEFFECTIVE 1,004
12 OFF LABEL USE 1,004
13 NAUSEA 997
14 DIZZINESS 839
15 DIABETIC FOOT INFECTION 834

Reactions in Death Reports

DEATH 235
ACUTE KIDNEY INJURY 80
DIABETIC KETOACIDOSIS 65
MYOCARDIAL INFARCTION 38
SEPSIS 30
CARDIAC ARREST 27
RENAL FAILURE 27
HYPOTENSION 23
LEG AMPUTATION 22
OFF LABEL USE 22

Reactions in Hospitalization Reports

DIABETIC KETOACIDOSIS 2,850
OSTEOMYELITIS 1,816
ACUTE KIDNEY INJURY 1,680
TOE AMPUTATION 1,649
GANGRENE 956
CELLULITIS 906
DIABETIC FOOT INFECTION 756
LEG AMPUTATION 668
DIABETIC FOOT 664
SEPSIS 543

Source: FDA FAERS (Adverse Event Reporting System) FDA FAERS (Adverse Event Reporting System) Reports are voluntary and do not establish causation

Serious Warnings

Invokana can cause serious side effects, including: - Diabetic ketoacidosis (DKA): This is a serious condition where your body produces high levels of blood acids called ketones. DKA can be life-threatening. - Lower limb amputation: Invokana may increase your risk of needing an amputation of your foot or leg. - Volume depletion: Invokana can cause dehydration, which can lead to kidney problems and low blood pressure. - Serious infections: Invokana can increase your risk of urinary tract infections and a rare but serious infection of the tissue under the skin in the area between and around the anus and genitals (Fournier's gangrene).

Known Drug Interactions

moderate rifampin

Examples: Rifampin, phenytoin, phenobarbital, ritonavir Insulin or Insulin Secretagogues Clinical Impact: The risk of hypoglycemia is increased when INVOKANA is used concomitantly with insulin secretagogues (e.g., sulfonylurea) or insulin.

Mechanism: Rifampin causes your body to process and remove the diabetes medicine more quickly than usual. This can make the diabetes medicine less effective at lowering your blood sugar.

What to do: Your doctor may need to check your blood sugar levels more often. They might need to increase your dose of the diabetes medicine while you are taking rifampin.

moderate phenytoin

Examples: Rifampin, phenytoin, phenobarbital, ritonavir Insulin or Insulin Secretagogues Clinical Impact: The risk of hypoglycemia is increased when INVOKANA is used concomitantly with insulin secretagogues (e.g., sulfonylurea) or insulin.

Mechanism: Phenytoin can cause your body to process canagliflozin more quickly, which may lower the amount of medicine in your system.

What to do: Your doctor may need to monitor your blood sugar more closely or adjust your dose of canagliflozin.

Examples: Rifampin, phenytoin, phenobarbital, ritonavir Insulin or Insulin Secretagogues Clinical Impact: The risk of hypoglycemia is increased when INVOKANA is used concomitantly with insulin secretagogues (e.g., sulfonylurea) or insulin.

Mechanism: Phenobarbital speeds up the breakdown of canagliflozin in your body, which can make the diabetes medicine less effective.

What to do: Monitor your blood sugar levels regularly and consult your doctor about potential dosage changes.

minor lithium

Lithium Clinical Impact: Concomitant use of an SGLT2 inhibitor with lithium may decrease serum lithium concentrations. Intervention: Monitor serum lithium concentration more frequently during INVOKANA initiation and dosage changes.

Mechanism: Canagliflozin can cause the body to remove lithium more quickly, which lowers the amount of lithium in your blood.

What to do: Your doctor should check your lithium blood levels more often when you start or change your dose of canagliflozin.

minor digoxin

Digoxin Clinical Impact: Canagliflozin increases digoxin exposure [see Clinical Pharmacology (12.3) ] . Intervention: Monitor patients taking INVOKANA with concomitant digoxin for a need to adjust the dosage of digoxin.

Mechanism: Canagliflozin can increase the amount of digoxin that stays in your body.

What to do: Your doctor should monitor you closely to see if your digoxin dose needs to be adjusted.

Common Questions

What should I do if I think I have ketoacidosis?
Stop taking Invokana and seek medical attention right away if you have symptoms like nausea, vomiting, abdominal pain, tiredness, and difficulty breathing.
Can Invokana be used for type 1 diabetes?
No, Invokana is not for people with type 1 diabetes.
Will Invokana cause low blood sugar?
Invokana can cause low blood sugar if you are also taking insulin or certain other diabetes medicines. Your doctor may need to lower the dose of your other diabetes medicines.
How often will my doctor check my kidney function?
Your doctor will check your kidney function before you start taking Invokana and regularly while you are taking it.
What if I need surgery?
Your doctor may have you stop taking Invokana for a few days before surgery.
Can Invokana cause bone problems?
Invokana may increase your risk of bone fractures. Talk to your doctor about factors that may contribute to fracture risk.
Does Invokana interact with other medications?
Yes, Invokana can interact with other medications. Tell your doctor about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.
What are the symptoms of a urinary tract infection?
Symptoms of a UTI can include burning when urinating, frequent urination, and blood in your urine. Contact your doctor if you have these symptoms.
How will I know if Invokana is working?
Your doctor will monitor your blood sugar levels to see if Invokana is working for you.
Can Invokana cause dehydration?
Yes, Invokana can cause dehydration. Drink plenty of fluids while taking Invokana, especially if you are vomiting or have diarrhea.
What are the common side effects of canagliflozin?
The most commonly reported side effects of canagliflozin include Yeast infections of the vagina, Urinary tract infection, Increased urination. Based on 16,917 FDA adverse event reports. Always consult your healthcare provider about potential side effects.
Does canagliflozin interact with other medications?
Yes, canagliflozin has 5 known drug interactions. Notable interactions include rifampin, phenytoin, phenobarbital. Always inform your doctor about all medications you are taking.
What drug class is canagliflozin?
canagliflozin belongs to the SGLT2 Inhibitor drug class. It requires a prescription (Rx). Invokana is used to help control blood sugar levels in adults with type 2 diabetes.
Is canagliflozin safe during pregnancy?
Invokana is not recommended during the second and third trimesters of pregnancy because it may harm the developing baby's kidneys. Talk to your doctor if you are pregnant or plan to become pregnant. Always consult your healthcare provider before using any medication during pregnancy or breastfeeding.

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What the FDA Data Shows for canagliflozin

The FDA label for canagliflozin (sold under brand names such as Invokana) classifies it as a prescription-only medication in the SGLT2 Inhibitor class. Invokana is used to help control blood sugar levels in adults with type 2 diabetes. Official labeling lists 3 commonly reported side effects, including Yeast infections of the vagina, Urinary tract infection, Increased urination.

Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 16,917 voluntary reports. The database also lists 5 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated moderate severity. NADAC pricing from CMS.

Report counts do not establish causation — a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history, and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice — always consult a licensed healthcare provider before starting, stopping, or changing any medication.

Data Sources

Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC).

FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.

Last updated: October 24, 2023

All federal data sources used on this page