All About Invokana
If you have type 2 diabetes, your doctor may recommend Invokana as a treatment option. It’s a prescription medication that’s used in adults with type 2 diabetes to:
- help manage blood sugar levels, along with a balanced diet and exercise
- People with cardiovascular disease have a lower risk of serious cardiovascular problems.
- lower the risk of certain complications from diabetic nephropathy (kidney damage caused by diabetes)
Your doctor may prescribe Invokana for these uses only in certain situations. To learn more about how Invokana is used, see “What is Invokana used for?” below.
Invokana contains the active drug canagliflozin. It belongs to a group of drugs called sodium-glucose transport protein 2 (SGLT2) inhibitors.
You can take Invokana by mouth. It’s not currently available in generic form.
“Invokana’s side effects, dosage, and cost are provided in this article.”
Invokana may cause mild or serious side effects. Some of the more common side effects of Invokana are described below. All possible side effects are not included in these lists.
Side effects of a drug can depend on other factors.
- Your age.
- You have other health conditions.
- You take other drugs.
The doctor or the pharmacy can tell you more about the side effects of Invokana. They can suggest ways to reduce side effects.
Mild side effects
Here’s a short list of some of the mild side effects that Invokana can cause. To learn about other mild side effects, talk with your doctor or pharmacist, or read Invokana’s prescribing information.
Mild side effects of Invokana have been reported.
- genital yeast infections*
- Increased urination.
- Urinary tract infections are caused by infections in the urinary tract.
- Increased thirst.
- It is a problem of the colon.
The side effects of many drugs can be gone in a few days. If they become intolerable, talk to your doctor or pharmacist.
The side effect focus section gives more information about this side effect.
Serious side effects
Serious side effects from Invokana can occur, but they aren’t common. If you have serious side effects from Invokana, call your doctor right away. If you think you’re having a medical emergency, you should call 911 or your local emergency number.
There have been serious side effects of Invokana.
- serious UTIs, such as:
- severe kidney infection
- urosepsis (an infection that spreads from your urinary tract into your blood)
- dehydration (low fluid level), which can cause low blood pressure and kidney damage
- diabetic ketoacidosis (high levels of ketones in your blood or urine)*
- “Fournier’s gangrene.” (tissue death in the genital area due to lack of blood flow)*
- increased risk of lower limb amputation (surgical removal)*
- increased risk of broken bones
- allergic reaction*
The side effect focus section gives more information about this side effect.
Side effect focus
Some of the side effects of Invokana may be discussed.
Invokana may increase your risk of needing a lower limb amputation. This was rare in studies, though.
“Lower limb amputation is the removal of a leg, foot, or toe. If you have a wound that doesn’t heal or an infection that doesn’t get better with medication, this may be needed.”
If you have diabetes, which Invokana is used to treat, you have a higher risk of lower limb infections and amputation. This is because diabetes can damage your blood vessels and lead to poor blood flow in your lower legs and feet. This makes it harder for your body to heal wounds and infections, and they can become serious.
Diabetes can cause damage to your nerves and cause a reduced feeling in your legs and feet. You may not notice injuries until they become more severe.
Lower limb amputation is more likely if you have:
- peripheral vascular disease (poor blood flow in your legs and feet)
- peripheral neuropathy (nerve damage in your legs and feet)
- diabetic foot ulcers (sores)
- A history of amputation.
What can help?
While you take Invokana, there are a few things you can do lower your risk for wounds and infections that might lead to lower limb amputation. Following your diabetes treatment plan to keep your blood sugar well-managed is important.
It’s also important to take good care of your feet, especially if you have nerve damage or poor blood flow. This article has tips for foot care with diabetes.
If you have wounds, infections, or blisters on your legs or feet, you should see your doctor immediately. Symptoms may include:
- There is a new pain in your foot or leg.
- The skin on your foot or leg can be warm.
- There are wounds on your foot or leg.
If you have a wound, ulcer, or an infection on your feet, your doctor may recommend stopping Invokana until it heals.
There are yeast infections. and “Fournier’s gangrene.”
Invokana may increase your risk of genital yeast infections. These are usually mild.
Invokana may also increase your risk for a rare but serious infection called “Fournier’s gangrene.”. With this condition, tissue in the genital area dies due to lack of blood flow.
“It is worth noting that having diabetes increases your risk of genital yeast infections and Fournier’s gangrene.”
There are yeast infections.
In studies, genital yeast infections were among the more common side effects reported with Invokana.
Symptoms of a vaginal yeast infection may include:
- There are irritations, burning, itching, or sore areas around the vagina.
- It is a thick, white vaginal discharge.
- vaginal burning, stinging, or sore during sex or urination
Symptoms of a penile yeast infection can include:
- There was redness, irritation, and burning around the head of the penis.
- The foreskin has trouble pulling back.
- The discharge from the penis might have an odor.
With Invokana, genital yeast infections are more common in females* than in males.* They’re also more common in people who’ve had past genital yeast infections, and in males who haven’t been circumcised.
* In this article, we use the terms “male” and “female” to refer to someone’s sex assigned at birth. For information about the difference between sex and gender, see this article.
In studies, “Fournier’s gangrene.” was reported rarely with Invokana.
“Fournier’s gangrene.” is a serious infection that affects the perineum (the area between the genitals and the anus). It sometimes requires surgical treatment, and it can be life-threatening. Symptoms can include:
- There are some things that can be painful in the genitals or perineum.
- The genitals or perineum can be warm, redness, or discolored.
- There is a high degree of fever.
- Generally feeling unwell.
What can help?
There are some things you can do to help prevent genital infections, such as avoiding tight clothing. This article has some tips.
If you have symptoms of a genital yeast infection while taking Invokana, talk with your doctor or pharmacist. They can recommend a treatment, such as miconazole (Monistat) cream, to put on the area.
If your yeast infections are still bothering you after a week, see your doctor. You may need a different medication to treat the problem. If you get yeast infections often, you should talk to your doctor about taking medication.
If you have symptoms of “Fournier’s gangrene.” while taking Invokana, see your doctor right away. This infection usually needs urgent treatment with prescribed antibiotics. In some cases, you may need treatment in hospital or surgery to remove the infected tissue. Your doctor will likely recommend that you stop taking Invokana.
Invokana may rarely cause a serious side effect called diabetic ketoacidosis. This is a life-threatening medical emergency that needs to be treated in a hospital.
Diabetic ketoacidosis occurs when cells in your body use fat for energy instead of sugar. When your body breaks down fats too quickly, high levels of acidic chemicals called ketones can build up in your blood.
There are symptoms of diabetes.
- The breath is fruity.
- Nausea and vomiting.
- There is belly pain.
- Increased thirst.
- The breath was very thin.
- It is a problem of tiredness.
- feeling unwell
Your risk for diabetic ketoacidosis may be higher if you’ve had pancreatitis (inflammation in your pancreas). It’s also higher if you have a There is a high degree of fever., have surgery, drink large amounts of alcohol, or if you eat less than usual.
What can help?
To help lower your risk of diabetic ketoacidosis with Invokana, avoid drinking large amounts of alcohol. Tell your doctor right away if you have a There is a high degree of fever., or you’re eating less than usual (such as if you’re feeling sick or fasting).
If you need to stop taking Invokana before your surgery, you should ask your doctor. Your doctor will tell you when to start taking Invokana again if you stop.
If you have symptoms of ketoacidosis, stop taking Invokana and call your doctor right away. If your symptoms feel life-threatening, call 911 or your local emergency number. Diabetic ketoacidosis needs to be treated in a hospital.
Some people may have an allergic reaction to Invokana. This wasn’t very common in studies of the drug.
A mild allergic reaction can include some symptoms.
- There is a skin rash.
- It is itchy.
- flushing (temporary warmth, redness, or deepening of skin color)
A more severe allergic reaction is not uncommon. A severe allergic reaction can cause swelling under your skin, which can be seen in your eyes, lips, hands, and feet. They can include swelling of your mouth, throat, and tongue, which can cause trouble breathing.
If you have an allergic reaction to Invokana, call your doctor. If you think you have a medical emergency, call the emergency number.
Your doctor will recommend the dosage of Invokana that’s right for you. Below are commonly used dosages, but always take the dosage your doctor prescribes.
You can take Invokana by mouth.
Strength: 100 mg and 300 mg
The two strengths of Invokana are 100 and 300.
The recommended dose of Invokana is one tablet per day.
The dosage your doctor prescribes may depend on You take other drugs.. It may also depend on your kidney function, which is called renal dosing. You’ll have a blood test to check your kidney function before starting Invokana. Invokana may not be recommended if your kidney function is below a certain level.
If the recommended dosage doesn’t work well enough for your blood sugar levels and your kidney function is normal, your doctor may increase your dose up to the maximum dose. Your doctor can tell you what the drug’s maximum dose is and provide details.
Questions about Invokana’s dosage
- What if I miss a dose of Invokana? If you miss a dose, take it as soon as possible — unless it’s almost time for your next dose. In this case, skip the missed dose and take your next scheduled dose as usual. Don’t take two doses together to make up for a missed dose. This could cause serious side effects.
- Will I need to use Invokana long term? Yes, Invokana is meant to be used as a long-term treatment. If you and your doctor agree that your treatment is going well, you’ll likely take the drug long term.
- How long does Invokana take to work? Invokana starts to work within a few hours after taking your first dose. But it might take a few weeks before your A1C level improves. (A1C is a measure of your blood sugar levels over the past 3 months.) It’s not known how long Invokana takes to lower the risk of complications or heart and blood vessel problems or kidney damage.
Find out what the answers are to some questions.
What alternatives does Invokana have?
There are other treatment options for Invokana. You can choose from a variety of options, including your health history and why you are taking Invokana.
Invokana is used in adults with type 2 diabetes to help manage blood sugar levels. It’s also used to prevent certain complications of cardiovascular (heart and blood vessel) disease or diabetic nephropathy. It belongs to a group of drugs called sodium-glucose transport protein 2 (SGLT2) inhibitors.
There are alternatives for managing blood sugar levels.
- other SGLT2 inhibitors, such as dapagliflozin (Farxiga) and empagliflozin (Jardiance)
- glucagon-like peptide-1 (GLP-1) receptor agonists, such as semaglutide (Ozempic) and dulaglutide (Trulicity)
There are alternatives to prevent the problems of diabetes.
- Farxiga is one of the other SGLT2 inhibitors.
- angiotensin II receptor (ARB) blockers, such as losartan (Cozaar) and irbesartan (Avapro)
- angiotensin-converting enzyme (ACE) inhibitors, such as captopril
If you’re interested in an alternative to Invokana, talk with your doctor. To read more about how Invokana compares with Farxiga and Jardiance, see “What should I know about Invokana vs. Jardiance?” and “What should I know about Invokana vs. Farxiga?” below.
How does Invokana work?
The drug Invokana makes your kidneys remove more sugar, salt, and water from your blood. Your body excretes the substances from your urine.
Invokana can help manage blood sugar levels by helping your body get rid of excess sugar.
By removing sodium and water from your blood, Invokana can reduce strain on your heart, blood vessels, and kidneys. This, along with well-managed blood sugar, lowers the risk of certain cardiovascular complications of diabetes. These include A heart attack., heart failure, and stroke. Invokana also helps prevent worsening kidney function in people with diabetic nephropathy.
Is Invokana used for weight loss?
Invokana is not used for weight loss. Some people taking Invokana lose weight. The medication helps your body excrete excess sugar through urine. Your body stores sugar as fat.
For helping to manage blood sugar levels, Invokana is prescribed with a balanced diet and exercise. This can also lead to weight loss during Invokana treatment.
“People with type 2 diabetes can benefit from weight loss. You shouldn’t take Invokana for weight loss. Talk to your doctor about how to maintain a healthy weight.”
What should I know about stopping Invokana? Will I have withdrawal symptoms?
Invokana is meant to be used for a long time. You should keep taking it if your doctor recommends it.
If you and your doctor decide you should stop taking Invokana, you won’t have to taper (slowly lower) your dosage. Invokana doesn’t cause withdrawal symptoms (effects that occur after stopping a drug that your body has become dependent on).
Your blood sugar levels can increase if you stop Invokana. After stopping treatment, your risk of problems may increase.
If you are considering stopping Invokana, you should talk to your doctor. They can help you figure out the best treatment plan for diabetes.
Does Invokana cause hair loss, pancreatitis, or joint pain?
No, this isn’t likely. Hair loss and joint pain weren’t reported in studies of Invokana.
Pancreatitis (inflammation of the pancreas) was rarely reported in studies. But this side effect also occurred at a similar rate in people who took a placebo.* So it’s unlikely that Invokana caused pancreatitis in these studies.
Joint pain or pancreatitis can be a side effect of certain other diabetes drugs. The Food and Drug Administration issued a
But Invokana doesn’t belong to this group of medications. Instead, it belongs to a group of drugs called SLGT2 inhibitors.
If you are concerned about your risk of hair loss, you should talk to your doctor.
A placebo is a treatment that does not have an active drug.
Can I view images of Invokana or reviews from people who’ve taken it?
You can find images of Invokana tablets online. It is possible to find online reviews from people who have taken Invokana. Each person taking Invokana may have a different experience.
If you want to see images of Invokana or learn more about taking it, you should talk to your doctor or pharmacist. They can show you the drug. They can discuss how your health history may affect your treatment with Invokana.
Invokana and Jardiance belong to the same group of drugs, called sodium-glucose transport protein 2 inhibitors. They have similar uses and side effects, but there are some differences between them.
Talk with your doctor about whether Invokana or Jardiance is right for you. To learn more about these drugs, see this detailed comparison.
There are many factors that affect the prices of prescription drugs. What your insurance plan covers is one of the factors.
If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. You can also visit the Invokana manufacturer’s website to see if they have support options.
You can also check out this article to learn more about saving money on prescriptions.
Invokana and Farxiga belong to the same group of drugs, called sodium-glucose transport protein 2 (SGLT2) inhibitors. They have similar uses and side effects, but there are some differences between them.
To read more about how these medications compare, see this article. Also, check with your doctor to see which drug is better for your condition.
Invokana is a medication that’s prescribed for use in certain adults with type 2 diabetes. It’s used to:
- Help manage blood sugar levels, along with a balanced diet and exercise.
- Lower the risk of serious cardiovascular (heart and blood vessel) problems in people who also have cardiovascular disease. These problems include:
- There is a cardiovascular problem that is responsible for the death.
- Lower the risk of certain complications of diabetic nephropathy (kidney damage caused by diabetes). For this use, Invokana is used in people with a high level of a protein called albumin in their urine. These complications include:
- worsening kidney function
- hospitalization for heart failure
- There is a cardiovascular problem that is responsible for the death.
Invokana helps manage blood sugar levels by helping your body excrete excess sugar, salt and fluid through your urine. This reduces strain on your heart, blood vessels, and kidneys.
Note: Your doctor will not prescribe Invokana:
- If you have severe kidney problems. The medication may not be effective for managing blood sugar levels if your estimated glomerular filtration rate (eGFR) is less than 30. (eGFR is a measure of your kidney function.)
- To treat type 1 diabetes. If you have type 1 diabetes, Invokana could increase your risk of diabetic ketoacidosis (high levels of ketones in your blood or urine), which can be life-threatening.
Your doctor will explain how Invokana works. They will explain how much to take and how often. Follow their instructions.
You may wonder when to take your daily dose of Invokana. It is best to take Invokana before breakfast.
Taking Invokana with other drugs
Your doctor might prescribe Invokana along with other drugs for type 2 diabetes. For example, Invokana is commonly taken with metformin (Riomet, Glumetza, Fortamet).
Questions about taking Invokana
- Can Invokana be chewed, crushed, or split? No, Invokana should be swallowed whole. If you have trouble swallowing the tablet whole, see this page for some tips.
- Should I take Invokana with food? No. You should take Invokana just before your first meal of the day.
Questions for your doctor
You may have questions about your treatment plan. Discuss your concerns with your doctor.
Here are a few tips that might help you.
- Before your appointment, write down questions such as:
- How will Invokana affect my lifestyle?
- Bring someone with you to your appointment to make you feel more comfortable.
- “If you don’t understand something, ask your doctor to explain it.”
“Your doctor and other healthcare professionals are available to help you. They want you to get the best care possible. Don’t be afraid to ask questions or give feedback on your treatment”
Before prescribing Invokana, your doctor will consider other medical conditions you may have and You take other drugs.. They’ll also consider the effect Invokana may have on your overall health. Here are some of the things you and your doctor will likely discuss.
Taking a medication with certain vaccines, foods, and other things can affect how the medication works. These effects are called interactions.
Before taking Invokana, you should tell your doctor about all your medication. You should also describe any vitamins, herbs, or supplements you use. Your doctor or pharmacist can tell you about any interactions these items may cause.
Interactions with drugs or supplements
Invokana can interact with a lot of drugs. If your doctor prescribes any of these medications, they may adjust your dosages or monitor you more carefully while you are taking Invokana. These drugs are used.
- other diabetes drugs, particularly insulin or a group of drugs called sulfonylureas (such as glipizide [Glucotrol]), as these medications can lead to hypoglycemia (low blood sugar levels) if taken with Invokana
- The drugs that affect blood pressure are listed.
- Certain drugs.
- certain asthma drugs
- corticosteroid drugs (medications used to reduce inflammation)
- diuretic drugs (also called “water pills,” drugs used for high blood pressure or excess fluid in the body)
- the heart condition drug digoxin (Lanoxin)
- the seizure drugs phenytoin (Dilantin) and phenobarbital
- the antibiotic rifampin (Rifadin, Rimactane)
- the HIV drug ritonavir (Norvir)
Some drugs that may interact with Invokana are not on this list. Your doctor or pharmacist can tell you more about the interactions that may occur with Invokana.
Talk with your doctor before taking herbs or supplements with Invokana. Some herbs and supplements can affect your blood sugar levels, so they could affect your Invokana treatment.
Invokana will cause your urine to test positive for glucose (sugar). You shouldn’t use urine glucose tests while taking this drug.
If you have a medical condition that affects your health, Invokana may not be right for you. Before you take Invokana, talk to your doctor about your health history. The factors to consider are listed below.
- Allergic reaction. If you’ve had an allergic reaction to Invokana or any of its ingredients, your doctor will likely not prescribe Invokana. Ask your doctor what other medications are better options for you.
- Use of certain diabetes medications. Certain diabetes drugs can increase your risk of hypoglycemia while taking Invokana. These include insulin and a group of drugs called sulfonylureas, such as glipizide (Glucotrol). Your doctor will likely adjust the dosage of your other diabetes medications to lower this risk.
- Kidney problems. If you have kidney problems, Invokana may not work as well for you. It may also worsen your kidney problems or increase your risk of certain side effects, such as dehydration (low fluid level). If you have severe kidney problems, or you’re having dialysis treatment, your doctor will likely not prescribe Invokana. Ask your doctor what other medications might be better for you.
- Severe liver problems. Invokana hasn’t been studied in people with severe liver problems. Your doctor may not prescribe Invokana if you have severe liver problems. Ask what other medications may be better for you.
- History of pancreatitis (inflammation in your pancreas). Invokana can cause a serious side effect called diabetic ketoacidosis (high levels of ketones in your blood or urine). You may have a higher risk for this side effect if you’ve had pancreatitis in the past. Talk with your doctor about whether Invokana is right for you.
- Older age. If you’re age 65 years or older, you may have a higher risk for certain side effects with Invokana. These include dehydration, dizziness, and low blood pressure. Talk with your doctor about whether this medication is right for you.
For information about conditions that can increase the risk of certain side effects with Invokana, see “What are Invokana’s side effects?” above.
Invokana and alcohol
You shouldn’t drink large amounts of alcohol while taking Invokana. This means regularly drinking alcohol on several days per week or drinking a lot of alcohol at once.
Drinking large amounts of alcohol can raise your risk for certain serious side effects of Invokana. These include dehydration and diabetic ketoacidosis. See “What are Invokana’s side effects?” above to read more about these side effects. Alcohol can also increase your risk of hypoglycemia.
If you drink alcohol, ask your doctor how much you should drink while taking Invokana.
Pregnancy and breastfeeding
It’s not known if Invokana is safe to take during pregnancy. Your doctor will likely not prescribe Invokana during pregnancy, especially during the second or third trimesters. If you’re pregnant or planning to become pregnant, talk with your doctor about the best way to treat your diabetes.
It is not known if Invokana enters breast milk. It may harm a child who is breastfed. You should not be breastfeeding while taking Invokana. Your doctor can suggest other ways to feed your child.
“Don’t take more Invokana than your doctor prescribes. Side effects can be serious if you use more than this.”
What to do in case you take too much Invokana
Call your doctor if you think you’ve taken too much Invokana. You can also call 800-222-1222 to reach the American Association of Poison Control Centers, or use its online resource. If you have severe symptoms, immediately call 911 or your local emergency number. Or, go to the nearest emergency room.
Invokana is a treatment option for certain adults with type 2 diabetes, especially if you have a risk of cardiovascular (heart or blood vessel) or kidney complications. If you have questions about this medication, talk with your doctor. Examples of questions you might want to ask include:
- How effective is Invokana for managing blood sugar levels and preventing cardiovascular or kidney problems?
- “What are my risks if I don’t take Invokana?”
- Do I need to check my blood sugar levels while taking Invokana?
- Do I have a high risk of side effects?
- Can I take Invokana with my other drugs?
Your doctor can help you make a decision. They can discuss other treatment options with you. Some articles might be helpful for your discussion.
- A complete list of diabetes medication.
- “A doctor’s guide to a good appointment for type 2 diabetes.”
For tips on managing type 2 diabetes, subscribe to Healthline’s type 2 diabetes newsletter. To stay up to date on heart health information, you can sign up for Healthline’s heart health newsletter.
Does Invokana come in other forms besides a pill?
Invokana is a whole tablet. If you have trouble swallowing the whole thing, talk to your doctor. They can suggest ways to take Invokana tablets. They may prescribe a different medication that you can take.
Patricia Weiser, PharmDAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.