Blog Diabetes 101 Insulin Medications

Special Spotlight On Diabetes Insulins: Invokana (canagliflozin)

Medically reviewed by Zara Risoldi Cochrane, PharmD, MS, FASCP on April 24, 2019 — Written by Victor Nguyen, PharmD, MS.

Republished with permission from Healthline.

In a particular partnership, dLife is proud to convey our readers an informative new collection on the varied kinds of insulin available on the market, courtesy of Healthline’s Medical Community.

We hope you discover this collection helpful. Healthline has made every effort to make certain that each one info is factually right, complete, and up-to-date.

Nevertheless, this article should not be used as an alternative to the information and experience of a licensed healthcare professional.

It is best to all the time consult your physician or healthcare professional before taking any medicine.

Contents

What’s Invokana?

Invokana is a brand-name prescription treatment. It’s used to improve blood sugar levels in adults with Sort 2 diabetes. Docs prescribe Invokana in addition to eating regimen and train.

Invokana accommodates the drug canagliflozin. This medicine belongs to a class of medicine referred to as sodium-glucose co-transporter 2 (SGLT-2) inhibitors.

Research results have proven that Invokana decreased the danger of coronary heart attack, stroke, and demise in adults with sort 2 diabetes and heart disease by 14 %.

Invokana comes as a tablet you’re taking by mouth. It’s obtainable in two strengths: 100 mg (a yellow tablet) and 300 mg (a white pill).

Invokana Generic

Invokana is on the market solely as a brand-name treatment. It’s not presently out there in generic type.

Invokana accommodates one lively drug ingredient: canagliflozin. This medicine is a sodium-glucose co-transporter 2 (SGLT-2) inhibitor.

Invokana Aspect Results

Invokana may cause delicate or critical unwanted side effects. The following listing accommodates a few of the key unwanted effects which will occur whereas taking Invokana. This record doesn’t embrace all potential negative effects.

To study extra concerning the potential unwanted side effects of Invokana or find out how to manage them, speak together with your doctor or pharmacist.

Extra widespread negative effects:
The extra widespread unwanted effects of Invokana can embrace:

  • urinary tract infections
  • urinating more typically than regular
  • thirstiness
  • constipation
  • nausea
  • yeast infections in men and ladies
  • vaginal itching
  • Most of those negative effects might go away inside a number of days or a couple of weeks. In the event that they’re more severe or don’t go away, speak together with your doctor or pharmacist.

You also needs to name your physician in the event you assume you’ve gotten a urinary tract an infection or yeast an infection.

Critical Aspect Results

Critical unwanted side effects from Invokana aren’t widespread, however they will happen. Name your physician instantly if in case you have critical unwanted side effects. Call 911 if your symptoms feel life-threatening or in the event you assume you’re having a medical emergency.

For extra detailed info on critical unwanted side effects, see “Side effect details” under. Critical negative effects and their signs can embrace the following:

  • Dehydration, which may trigger low blood strain.

Symptoms can embrace:

  • dizziness
  • feeling faint
  • lightheadedness
  • weak spot, especially whenever you get up
  • Diabetic ketoacidosis (increased levels of ketones in your blood or urine).
  • Signs can embrace: excessive thirst
  • urinating extra typically than regular
  • nausea
  • vomiting
  • abdomen ache
  • tiredness
  • weak spot
  • shortness of breath
  • breath that smells fruity
  • confusion
  • Kidney injury.
  • urinating less typically than normal
  • swelling in your legs, ankles, or ft
  • confusion
  • fatigue
  • nausea
  • chest ache or strain
  • irregular heartbeat
  • seizures
  • Hypoglycemia (low blood sugar)
  • drowsiness
  • headache
  • confusion
  • weak spot
  • starvation
  • irritability
  • sweating
  • feeling jittery
  • fast heartbeat
  • Fournier’s gangrene (extreme infection near the genitals). Symptoms can embrace: pain, tenderness, swelling, or reddening in your genital or rectal space
  • fever
  • malaise (general feeling of discomfort)
  • Severe allergic reaction. Symptoms can embrace: rash
  • itchy pores and skin
  • flushing (heat and redness in your pores and skin)
  • swelling
  • hassle respiration
  • Bone fractures. Signs can embrace: ache
  • swelling
  • tenderness
  • bruising
  • deformity
  • Increased cholesterol levels
  • Amputation of lower limbs
  • Aspect effect particulars
  • You could marvel how typically sure unwanted side effects occur with this drug. Here’s some element on sure unwanted effects this drug might cause.

Allergic Reaction

As with most medicine, some individuals can have an allergic response after taking Invokana. In medical research, up to 4.2 % of people taking Invokana reported having delicate allergic reactions. Symptoms of a light allergic response can embrace:

  • Skin rash
  • Itchiness
  • Flushing (heat and redness in your skin)
  • A extra extreme allergic response is rare but potential. Just a few sufferers in medical studiesreported extreme allergic reactions whereas taking Invokana. Symptoms of a extreme allergic reaction can embrace:
  • angioedema (swelling underneath your skin, sometimes in your eyelids, lips, palms, or ft)
  • swelling of your tongue, mouth, or throat
  • hassle respiration
  • Name your doctor instantly if in case you have a severe allergic response to Invokana. Call 911 if your signs really feel life-threatening or when you assume you’re having a medical emergency.

Amputation

Invokana has a boxed warningTrusted Supply for the amputation of lower limbs. A boxed warning is probably the most critical warning the Food and Drug Administration (FDA) requires.

Two studies found an increased danger for decrease limb amputation in people who took Invokana and had:

  • Sort 2 diabetes and coronary heart disease, or Sort 2 diabetes and have been at risk for heart illness
  • Up to 3.5 % of the people who took Invokana had an amputation. In comparison with people who didn’t get the drug,
  • Invokana doubled the danger of amputation. The toe and the midfoot (arch area) have been the most typical areas of amputation. Some leg amputations have been additionally reported.

Before you start taking Invokana, speak together with your physician concerning the attainable risks. That is especially essential should you’ve had an amputation prior to now. It’s also necessary when you have a blood circulation or nerve disorder, or diabetic foot ulcers.

Name your doctor immediately and cease taking Invokana when you:

  • Really feel new foot pain or tenderness
  • have foot sores or ulcers
  • get a foot infection
  • Name 911 if your signs feel life-threatening or when you assume you’re having a medical emergency.

Fournier’s Gangrene

Fournier’s gangrene is a uncommon an infection of the world between your genitals and rectum.

Individuals in medical trials of Invokana didn’t get Fournier’s gangrene. However after the FDA accredited the drug, some individuals reported getting Fournier’s gangrene while taking Invokana or different medicine in the same class. Extra critical instances of the condition have led to hospitalization, multiple surgical procedures, or demise.

For those who assume you might have developed Fournier’s gangrene, name your doctor instantly. They could need you to stop taking Invokana. They may even advocate remedy for the an infection.

Yeast Infection

Taking Invokana increases your danger for a yeast an infection. This is true for both males and ladies, in response to knowledge from medical trials. Up to 11.6 % of the ladies and 4.2 % of the lads within the medical trials had a yeast infection.

You’re extra more likely to develop a yeast infection in the event you’ve had one prior to now or when you’re an uncircumcised male.

When you get a yeast infection while taking Invokana, speak together with your physician. They will recommend ways to treat it.

Diabetic Ketoacidosis

Though it’s uncommon, some people who take Invokana can develop a critical condition referred to as diabetic ketoacidosis. This occurs when the cells of your body don’t get the glucose (sugar) they need for power. With out this sugar, your body makes use of fat for power. This will cause high ranges of acidic chemical compounds referred to as ketones in your blood.

In severe instances, this situation may cause coma or demise. Should you assume you might have diabetic ketoacidosis, call your physician immediately. In case your signs are extreme, name 911 or go to the nearest emergency room.

Kidney Injury

Taking Invokana can improve your danger of kidney injury. After the FDA accepted the drug, some individuals taking Invokana reported that their kidneys worked poorly. When these individuals stopped taking Invokana, their kidneys started to work usually again.

You’re more more likely to have kidney issues for those who:

  • are dehydrated
  • have kidney or heart problems
  • take different drugs that affect your kidneys
  • are older than age 65
  • Before you start taking Invokana, your physician will check how properly your kidneys are working. When you’ve got kidney issues, chances are you’ll not be capable of take Invokana.

Your physician may additionally check how your kidneys are working throughout your remedy with Invokana. In the event that they detect any kidney problems, they could change your dose or cease your remedy with the drug.

Bone Fractures

In a medical research, some people who took Invokana skilled bone fracture (a damaged bone). The fractures weren’t often severe.

In case you’re at excessive danger for a fracture or when you’re involved about breaking a bone, speak together with your physician. They will recommend ways to assist forestall this aspect effect.

Falls

In 9 medical trials, up to 2.1 % of people who took Invokana had a fall. There was a better danger of falls within the first few weeks of remedy.

When you have a fall whereas taking Invokana or in the event you’re involved about falling, speak together with your physician. They will recommend ways to assist forestall this aspect impact.

Hair loss (not a aspect impact)

Hair loss wasn’t a aspect effect of Invokana in any medical trials.

Should you’re involved about hair loss, speak together with your physician. They may help you identify what’s inflicting it and ways to treat it.

Pancreatitis (not a aspect effect)

Pancreatitis (infected pancreas) was extraordinarily uncommon in medical trials. Rates of pancreatitis have been comparable between people who took Invokana and people who took a placebo (remedy without lively medicine). Because of these comparable results, it’s unlikely that Invokana prompted pancreatitis.

Joint pain (not a aspect effect)

Joint pain wasn’t a aspect impact of Invokana in any medical trials.

Nevertheless, some other diabetes medicine might cause joint pain. The FDA launched a security announcement. Trusted Supply for a unique class of diabetes drug referred to as dipeptidyl peptidase-Four (DPP-Four) inhibitors. The announcement stated that DPP-Four inhibitors might cause extreme joint pain.

Invokana belongs to a class of medicine referred to as sodium-glucose co-transporter-2 (SGLT2) inhibitors.

Invokana Dosage

The Invokana dosage your doctor prescribes will rely upon a number of elements.

These embrace:

  • The sort and severity of the condition you’re using Invokana to deal with your age different medical circumstances you’ll have
    Sometimes, your doctor will start you on a low dosage. Then they’ll modify it over time to succeed in the amount that’s best for you. Your doctor will finally prescribe the smallest dosage that provides the desired effect.

The following info describes dosages which might be commonly used or beneficial. Nevertheless, make sure you take the dosage your doctor prescribes for you. Your physician will decide one of the best dosage to fit your wants.

Drug Varieties and Strengths

Invokana comes as a tablet. It’s out there in two strengths: 100 mg (a yellow tablet) and 300 mg (a white tablet).

Dosage for Sort 2 diabetes

In case you have sort 2 diabetes, the really helpful beginning dose is 100 mg once a day. It’s greatest to take your dose earlier than breakfast.

What if I miss a dose?

When you miss a dose of Invokana, take it as soon as you keep in mind. If it’s virtually time on your next dose, skip the missed dose and take the subsequent dose on the normal time. Don’t try to catch up by taking two doses directly. This could trigger dangerous uncomfortable side effects.

Using a reminder device may also help you keep in mind to take Invokana day-after-day.

You’ll want to take Invokana only as your physician prescribes.

Will I want to make use of this drug long run?
For those who and your physician agree that Invokana is working nicely for you, you’ll probably use it long run.

Options to Invokana

There are different medicine out there that can deal with Sort 2 diabetes. Some could also be higher fitted to you than others. When you’re all for discovering an alternative choice to Invokana, speak together with your physician about different drugs which will work nicely for you.

Examples of other medicine that could be used to treat Sort 2 diabetes embrace:

  • sodium-glucose co-transporter 2 (SGLT-2) inhibitors, akin to:empagliflozin (Jardiance)
  • dapagflozin (Farxiga)
  • ertugliflozin (Steglatro)
  • incretin mimetics/glucagon-like peptide-1 (GLP-1) receptor agonists, comparable to:dulaglutide (Trulicity)
  • exenatide (Bydureon, Byetta)
  • liraglutide (Victoza)
  • lixisenatide (Adlyxin)
  • semaglutide (Ozempic)
  • albiglutide (Tanzeum)
  • metformin (Glucophage, Glumetza, Riomet)
  • dipeptidyl peptidase-Four (DPP-4) inhibitors, comparable to:alogliptin (Nesina)
  • linagliptin (Tradjenta)
  • saxagliptin (Onglyza)
  • sitagliptin (Januvia)
  • thiazolidinediones, akin to:pioglitazone (Actos)
  • rosiglitazone (Avandia)
  • alpha-glucosidase inhibitors, akin to:acarbose (Precose)
  • miglitol (Glyset)
  • sulfonylureas, similar to:chlorpropamide
  • glimepiride (Amaryl)
  • glipizide (Glucotrol)
  • glyburide (Diabeta, Glynase PresTabs)

Invokana vs. Different Medicine

You could marvel how Invokana compares to different drugs which might be prescribed to treat sort 2 diabetes. Under are comparisons between Invokana and certain drugs.

Invokana vs. Jardiance

Invokana and Jardiance (empagliflozin) are both in the identical class of medicines: sodium-glucose co-transporter 2 (SGLT-2) inhibitors. Which means they work in the same option to treat sort 2 diabetes.

Invokana incorporates the drug canagliflozin. Jardiance incorporates the drug empagliflozin.

Makes use of

Both Invokana and Jardiance are FDA-approved to:

  • Improve blood sugar levels in adults with Sort 2 diabetes
  • Scale back the danger of coronary heart attack, stroke, and dying in individuals with Sort 2 diabetes and heart disease
  • Drug varieties and administration
  • Each Invokana and Jardiance come as tablets that you simply take by mouth in the morning.

You’ll be able to take each medicine with or with out food, nevertheless it’s greatest to take Invokana before breakfast.

Uncomfortable side effects and risks

Invokana and Jardiance are from the same drug class and act in comparable ways inside the physique. Because of this, they trigger very comparable uncomfortable side effects. Under are examples of these uncomfortable side effects.

Extra widespread unwanted effects

These lists include examples of more widespread unwanted effects that can occur with Invokana, with Jardiance, or with each medicine (when taken individually).

  • Can happen with Invokana: thirst, constipation
  • Can occur with Jardiance: joint ache
  • Can happen with both Invokana and Jardiance: urinary tract infections
  • urinating extra typically than normal
  • nausea
  • vaginal itching
  • yeast infections in men and ladies
  • larger cholesterol levels
  • Critical unwanted side effects

These lists include examples of great uncomfortable side effects that can happen with Invokana, with Jardiance, or with both medicine (when taken individually).

  • Can happen with Invokana: amputation of a decrease limb
    bone fractures
  • Can occur with Jardiance: few unique critical uncomfortable side effects
  • Can happen with both Invokana and Jardiance: dehydration, which may trigger low blood strain
    diabetic ketoacidosis (elevated levels of ketones within the blood or urine)
    kidney injury*
  • critical urinary tract infections
  • hypoglycemia (low blood sugar)
  • Fournier’s gangrene
  • severe allergic reaction

* Both Invokana and Jardiance may cause kidney injury. In an analysis of research, individuals who took Invokana had a better danger of kidney injury than those who took Jardiance.

Effectiveness

These medicine haven’t been compared head-to-head in medical research. But studies have found both Invokana and Jardiance to be efficient for treating sort 2 diabetes.

Costs

Invokana and Jardiance are both brand-name medicine. They don’t have generic types. Brand-name drugs often value more than generics.

Based on estimates from GoodRx.com, Invokana and Jardiance usually value about the identical. The actual worth you’d pay for both drug would depend on your insurance plan, your location, and the pharmacy you employ.

Invokana vs. Farxiga

Invokana and Farxiga are in the identical class of medications: sodium-glucose co-transporter 2 (SGLT-2) inhibitors. Because of this they work in the same strategy to deal with Sort 2 diabetes.

Invokana accommodates the drug canagliflozin. Farxiga incorporates the drug dapagliflozin.

Uses

Both Invokana and Farxiga are FDA-approved to improve blood sugar ranges in adults with Sort 2 diabetes. Invokana can also be permitted to scale back the danger of heart attack, stroke, and dying in individuals with sort 2 diabetes and heart disease.

Drug Types and Administration

Both Invokana and Farxiga come as tablets that you simply take by mouth within the morning. You’ll be able to take both medicine with or with out food, nevertheless it’s greatest to take Invokana before breakfast.

Aspect Effects and Dangers

Invokana and Farxiga are from the identical drug class and act in comparable ways inside the physique. Due to this, they cause very comparable uncomfortable side effects. Under are examples of those unwanted side effects.

Extra Widespread Aspect Results

These lists include examples of extra widespread negative effects that can happen with Invokana, with Farxiga, or with both medicine (when taken individually).

  • Can occur with Invokana: thirst
  • Can happen with Farxiga: respiratory infections such as the widespread chilly or the flu
    again pain or limb pain
    discomfort while urinating
  • Can happen with each Invokana and Farxiga: urinary tract infections
    urinating more typically than normal
  • nausea
  • constipation
  • vaginal itching
  • yeast infections in males and ladies
  • greater levels of cholesterol
  • Critical unwanted side effects

These lists include examples of great unwanted effects that may occur with Invokana, with Farxiga, or with each medicine (when taken individually).

  • Can happen with Invokana: amputation of a decrease limb
  • Can occur with Farxiga: few distinctive critical unwanted effects
  • Can happen with both Invokana and Farxiga: bone fractures
    dehydration, which may cause low blood strain
  • diabetic ketoacidosis (elevated ranges of ketones within the blood or urine)
    kidney injury*
    critical urinary tract infections
  • hypoglycemia (low blood sugar)
  • Fournier’s gangrene (severe an infection close to the genitals)
    severe allergic response
    * Each Invokana and Farxiga may cause kidney injury. But in an analysis of research, individuals who took Invokana had a decrease danger for kidney injury than those that took Farxiga.Effectiveness
    These medicine haven’t been compared head-to-head in medical research. However studies have discovered each Invokana and Farxiga to be efficient for treating sort 2 diabetes.

Costs

Invokana and Farxiga are both brand-name medicine. They don’t have generic types. Brand-name drugs often value more than generics.

In response to estimates from GoodRx.com, Invokana and Farxiga usually value about the identical. The actual worth you’d pay for both drug depends upon your insurance plan, your location, and the pharmacy you employ.

Invokana Value

As with all drugs, the price of Invokana can differ. To seek out present costs for Invokana in your area, take a look at GoodRx.com.

The fee you find on GoodRx.com is what you might pay without insurance. The actual worth you’ll pay is dependent upon your insurance coverage protection and the pharmacy you employ.

Financial and Insurance coverage Assistance

In the event you want financial help to pay for Invokana, assist is on the market.

Janssen Prescription drugs, Inc., the manufacturer of Invokana, provides a program referred to as Janssen CarePath Savings Program. For extra info and to seek out out when you’re eligible for help, call 877-468-6526 or go to the program web site.
Invokana makes use of The Food and Drug Administration (FDA) approves prescribed drugs corresponding to Invokana to treat sure circumstances.

Invokana for Sort 2 Diabetes

Invokana is FDA-approved to enhance blood sugar management in adults with Sort 2 diabetes. This can be a situation during which glucose (sugar) builds up in your blood.

The hormone insulin usually moves sugar out of your blood into your cells. However with Sort 2 diabetes, your physique doesn’t react to insulin correctly. And over time, your physique might cease making enough insulin.

Off-label use for Invokana

Along with the use for Sort 2 diabetes, Invokana could also be used off-label for an additional objective. Off-label drug use is when a drug that’s authorised for one use is used for a unique one that’s not accepted.

Invokana for Sort 1 Diabetes

Invokana is usually used off-label to treat sort 1 diabetes. In a single medical research, individuals with sort 1 diabetes took Invokana and insulin. For the individuals within the research, this remedy decreased:

  • their blood sugar degree
  • their hemoglobin A1c (HbA1c) degree
  • the whole amount of insulin they had to take every day
  • Don’t take Invokana for Sort 1 diabetes until your physician has prescribed it for you.
  • Invokana for weight loss
  • Whereas Invokana isn’t accredited as a weight loss medicine, weight reduction is a aspect impact of the drug.

In medical studies, individuals who took Invokana lost up to 9 kilos over 26 weeks of remedy. Due to this aspect effect, your doctor might want you to take Invokana in case you have sort 2 diabetes and are obese.

Invokana causes weight loss by sending additional glucose (sugar) from your blood into your urine. The energy from the glucose depart your body in your urine, which may result in you to shed some pounds.

Be sure you take Invokana solely as your doctor prescribes. Don’t take the drug to reduce weight or for another cause with out first talking together with your doctor.

Invokana and Alcohol

Avoid consuming an excessive amount of alcohol while taking Invokana. Alcohol can change your blood sugar degree and improve your danger for:

  • hypoglycemia (low blood sugar)
  • diabetic ketoacidosis (elevated levels of ketones in blood and urine)
  • pancreatitis (inflamed pancreas)
  • In case you drink alcohol, speak together with your physician about how a lot alcohol is protected for you when you take Invokana.
  • Invokana interactions
  • Invokana can work together with a number of different drugs. It could possibly additionally interact with sure supplements and meals.

Totally different interactions may cause totally different results. For example, some interactions can affect how properly a drug works, whereas others may cause increased unwanted effects.

Invokana and Other Drugs

Under is an inventory of medicines that can work together with Invokana. This record doesn’t include all medicine which will work together with Invokana.

Earlier than taking Invokana, be sure you tell your doctor and pharmacist about all prescription, over-the-counter, and other medicine you’re taking. Additionally inform them about any nutritional vitamins, herbs, and dietary supplements you employ. Sharing this info might help you keep away from potential interactions.

When you have questions about drug interactions which will affect you, ask your doctor or pharmacist.

Medicine that may improve the danger of hypoglycemia

Taking Invokana with certain drugs can improve your danger for hypoglycemia (low blood sugar). When you take these drugs, you could have to examine your blood sugar degree more typically. Also, your physician may have to vary the dosage of your drugs.

Examples of these drugs embrace:

  • other diabetes medicine, resembling: dulaglutide (Trulicity)
  • linagliptin (Tradjenta)
  • liraglutide (Victoza)
  • sitagliptin (Januvia)
  • glyburide (DiaBeta, Glynase, Micronase)
  • glimepiride (Amaryl)
  • glipizide (Glucotrol)
  • meal-time insulins (Humalog, Novolog)
  • metformin (Glucophage)
  • nateglinide (Starlix)
  • repaglinide (Prandin)
  • sure hypertension drugs, resembling:benazepril (Lotensin)
  • candesartan (Atacand)
  • enalapril (Vasotec)
  • irbesartan (Avapro)
  • lisinopril (Zestril)
  • losartan (Cozaar)
  • olmesartan (Benicar)
  • valsartan (Diovan)

Different drugs that may lower blood sugar levels, reminiscent of disopyramide (Norpace)

  • certain cholesterol drugs, comparable to fenofibrate (Tricor, Triglide) and gemfibrozil(Lopid)
  • sure antidepressants, akin to fluoxetine (Prozac, Sarafem) and selegiline (Emsam, Zelapar)
  • octreotide (Sandostatin)
  • sulfamethoxazole-trimethoprim (Bactrim, Septra)
  • Medicine that can improve blood sugar levels
  • Some drugs can improve the blood sugar degree in your body. For those who take these drugs, you might have to verify your blood sugar degree more typically. This will assist forestall hyperglycemia (high blood sugar). Additionally, your doctor may have to vary your dosages.

Examples of these drugs embrace:

  • albuterol (ProAir, Proventil, Ventolin)
  • certain antivirals, akin to atazanavir (Reyataz) and lopinavir/ritonavir (Kaletra)
  • certain steroids, akin to budesonide (Entocort EC, Pulmicort, Uceris), prednisone, and fluticasone (Flonase, Flovent)
  • certain diuretics, similar to chlorothiazide (Diuril) and hydrochlorothiazide (Microzide)
  • certain antipsychotics, comparable to clozapine (Clozaril, Fazaclo) and olanzapine (Zyprexa)
  • certain hormones, reminiscent of danazol (Danazol), levothyroxine (Levoxyl, Synthroid), and somatropin (Genotropin)
  • glucagon (GlucaGen)
  • niacin (Niaspan, Slo-Niacin, others)
  • oral contraceptives (contraception drugs)
  • Medicine that may lower blood strain
  • Taking Invokana with certain drugs that lower blood strain might cause your blood strain to turn into too low. It might also improve your danger of kidney injury.

Examples of these drugs embrace:

  • benazepril (Lotensin)
  • candesartan (Atacand)
  • enalapril (Vasotec)
  • irbesartan (Avapro)
  • lisinopril (Zestril)
  • losartan (Cozaar)
  • olmesartan (Benicar)
  • valsartan (Diovan)

Medicine that may improve or decrease the consequences of Invokana

Some drugs can have an effect on how Invokana works in your physique. For those who take these drugs, chances are you’ll have to examine your blood sugar degree extra typically. Additionally, your physician may have to vary your dosages.

Examples of these drugs embrace:

  • rifampin (Rifadin, Rimactane)
  • phenytoin (Dilantin)
  • phenobarbital
  • ritonavir (Norvir)
  • digoxin (Lanoxin)
  • Invokana and herbs and dietary supplements
    Taking sure herbs and dietary supplements with Invokana might improve your danger for hypoglycemia(low blood sugar).

Examples of those embrace:

  • alpha-lipoic acid
  • bitter melon
  • chromium
  • gymnema
  • prickly pear cactus
  • Invokana use with other medicine
  • Docs might prescribe Invokana alone or with different medicine to improve blood sugar ranges in individuals with sort 2 diabetes.

In diabetes remedy, typically one drug alone doesn’t enhance blood sugar levels enough. In these instances, it’s typical for individuals to take multiple medicine to regulate their blood sugar ranges.

Invokana and Victoza

Invokana and Victoza each deal with Sort 2 diabetes, but they work in several ways. The two medicine belong to separate drug courses. Invokana is a sodium-glucose co-transporter 2 (SGLT-2) inhibitor. Victoza is a glucagon-like peptide-1 (GLP-1) receptor agonist.

Docs might prescribe sure SGLT-2 inhibitors and GLP-1 receptor agonists together. This mix might help decrease blood sugar ranges and reduce the danger of heart-disease associated demise.

Different GLP-1 receptor agonists embrace:

dulaglutide (Trulicity)
exenatide (Bydureon, Byetta)
liraglutide (Victoza)
lixisenatide (Adlyxin)
semaglutide (Ozempic)
Invokana and different diabetes medicine
Examples of different diabetes medicine that can be used with Invokana embrace:

glimepiride (Amaryl)
glipizide (Glucotrol)
glyburide (DiaBeta, Glynase)
metformin (Glucophage, Glumetza, Riomet — see under)
pioglitazone (Actos)
Invokana and metformin are available as a single combination drug referred to as Invokamet or Invokamet XR. Invokana is a sodium-glucose co-transporter 2 (SGLT-2) inhibitor. Metformin is a biguanide.

Invokamet and Invokamet XR are permitted to enhance blood sugar levels in adults with Sort 2 diabetes. Docs prescribe these medicine along with food regimen and train.

Methods to take Invokana

Take Invokana as your doctor or healthcare supplier recommends.

When to Take

It’s greatest to take Invokana within the morning, before breakfast.

Taking Invokana with Meals

You possibly can take Invokana with or without food, nevertheless it’s greatest to take it before breakfast. This helps you keep away from blood sugar spikes after meals.

Can Invokana be Crushed?

No. It’s greatest to take Invokana entire.

How Invokana works

Invokana helps enhance blood sugar ranges in adults with sort 2 diabetes. This can be a situation by which glucose (sugar) builds up in your blood. The hormone insulin normally strikes sugar out of your blood into your cells. But with sort 2 diabetes, your body doesn’t react to insulin correctly. Over time, your body might cease making enough insulin.

What Invokana Does

Invokana works by decreasing the amount of glucose in your blood. As a sodium-glucose co-transporter 2 (SGLT2), Invokana prevents sugar from being absorbed back into the physique. Invokana helps sugar depart the physique by means of your urine.

How lengthy does it take to work?

Invokana starts to work right after you’re taking it. Nevertheless it’s at its only about one to 2 hours after you’re taking the drug.

Invokana and Being pregnant

There haven’t been sufficient research in people to know if Invokana is protected to use during pregnancy. Results of animal studies showed a attainable danger of kidney issues within the fetus when the mom was given the drug. Due to these studies, Invokana shouldn’t be used in the course of the second and third trimesters of pregnancy.

In the event you’re pregnant or planning to turn out to be pregnant, speak together with your physician. Collectively you possibly can weigh the potential risks and benefits of taking Invokana whereas pregnant.

Invokana and Breastfeeding

It isn’t recognized if Invokana passes into breast milk. Nevertheless, it’s greatest to wait until after you’ve finished breastfeeding earlier than you’re taking Invokana. Outcomes of animal research showed a attainable danger of kidney problems in the fetus when the mom was given the drug.

For those who’re planning to breastfeed, speak together with your doctor. The 2 of you possibly can determine whether or not you need to take Invokana or breastfeed.

Widespread questions on Invokana

Listed here are answers to some regularly requested questions on Invokana.

What’s the difference between Invokana and Invokamet?

Invokana accommodates the drug canagliflozin, which is a sodium-glucose co-transporter 2 inhibitor. Invokana is used with food regimen and train to enhance blood sugar levels in adults with Sort 2 diabetes. It’s additionally used to scale back the danger of coronary heart assault, stroke, and dying in adults with Sort 2 diabetes and heart disease.

Invokamet accommodates two medicine: canagliflozin (the drug in Invokana) and metformin, a biguanide. Like Invokana, Invokamet is used with weight loss plan and train to improve blood sugar levels in adults with Sort 2 diabetes.

Nevertheless, it’s not accredited to scale back the danger of heart-related problems akin to coronary heart attack or stroke in individuals with Sort 2 diabetes and heart disease.

Why has the Meals and Drug Administration (FDA) issued a warning on Invokana?

Knowledge from medical research showed that taking Invokana might improve the danger of leg and foot amputations. Consequently, the FDA Trusted Supply issued a press release about this danger. In addition, they now require a boxed warningTrusted Source about amputations on the Invokana label. A boxed warning is probably the most critical warning the FDA requires.

How do I know if Invokana is working?

Verify your blood sugar degree often to ensure it’s inside the objectives you and your doctor have set. The 2 of you’ll be able to monitor your progress with these checks and with blood checks, together with A1C checks. The results can show how Invokana and another diabetes medicine you’re taking are working.

Can Invokana assist me shed extra pounds?

Yes, it will possibly. Although Invokana isn’t authorised as a weight loss medicine, research outcomes have shown that shedding weight is a potential aspect effect.

Nevertheless, you’ll want to take Invokana only as your doctor prescribes. Don’t take the drug to drop a few pounds or for another cause with out first talking together with your physician.

Has Invokana Induced Amputations?

Sure, in extreme instances, amputations have occurred. In two research, up to three.5 % of the people who took Invokana had an amputation. Compared to people who didn’t get the drug, Invokana doubled the danger of amputation. The toe and the midfoot (arch space) have been the most typical areas of amputation. Some leg amputations have been additionally reported.

Invokana has a boxed warningTrusted Source about amputation of a lower limb. A boxed warning is probably the most critical warning the Meals and Drug Administration (FDA) requires.

Should you’re concerned about this aspect effect or have questions on Invokana, speak together with your physician.

If I stop taking Invokana, will I have withdrawal symptoms?
Stopping Invokana doesn’t cause withdrawal signs. Nevertheless, it might trigger your blood sugar ranges to extend, which may make your diabetes signs worse.

Don’t cease taking Invokana without talking together with your physician first. And in the event you both determine you must cease taking Invokana and you then have symptoms that concern you, be sure you tell your doctor. They will assess what’s causing them and assist you relieve or manage them.

Invokana Warnings

This drug comes with a number of warnings.

FDA warning: Danger of lower limb amputation
This drug has a boxed warning. This is probably the most critical warning from the Meals and Drug Administration (FDA). A boxed warning alerts docs and patients about drug results that could be harmful.

Two research found that taking Invokana will increase the danger of amputation of a decrease limb. The toe and the midfoot (arch area) have been the most typical areas of amputation. Some leg amputations have been additionally reported.

Before you start taking Invokana, speak together with your physician concerning the attainable dangers. That is particularly essential for those who’ve had an amputation up to now. It’s additionally essential in case you have a blood circulation or nerve disorder, or diabetic foot ulcers.

Call your physician instantly and stop taking Invokana when you:

  • really feel new foot pain or tenderness
  • have foot sores or ulcers
  • get a foot infection
  • For those who’re concerned about these negative effects or have questions about Invokana, speak together with your doctor.

Different Warnings

Earlier than taking Invokana, speak together with your physician about your well being historical past. Invokana is probably not right for you in case you have certain medical circumstances. These embrace:

Kidney disease: In case you have kidney illness, taking Invokana might worsen your condition. If this happens, you could have to cease taking Invokana. Don’t take this treatment if in case you have extreme kidney illness.

Kidney most cancers: In a single medical research, some individuals taking Invokana developed kidney cancer. However there isn’t enough info to know if this drug is the trigger. It additionally isn’t recognized if Invokana impacts present kidney cancer. Until more is understood, don’t take Invokana when you have kidney most cancers.

High ldl cholesterol: Invokana might improve your cholesterol levels. If you already have high cholesterol, your physician will possible monitor your levels intently when you take Invokana.

Word: For information about the potential destructive results of Invokana, see the “Invokana side effects” part above.

Invokana Overdose

Taking too much of this medicine can improve your danger for critical negative effects.

Overdose symptoms:

There’s very little details about the signs you may need when you take too much Invokana. Symptoms of an overdose may embrace:

  • severe hypoglycemia (extreme low blood sugar), which may cause shakiness, nervousness, and confusion
  • gastrointestinal problems, which may cause diarrhea, nausea, and vomiting
  • kidney injury
  • What to do in case of overdose
  • When you assume you’ve taken an excessive amount of of this drug, call your doctor. You may also call the American Affiliation of Poison Management Centers at 800-222-1222 or use their on-line software. But when your symptoms are extreme, name 911 or go to the closest emergency room immediately.

Invokana Expiration

Whenever you get Invokana from the pharmacy, the pharmacist will add an expiration date to the label on the bottle. This date is usually one yr from the date they distributed the treatment.

These expiration dates help guarantee the effectiveness of the treatment throughout this time. The current stanceTrusted Source of the Meals and Drug Administration (FDA) is to keep away from using expired drugs.

How long a medicine stays good can depend upon many elements, together with how and the place you retailer it.

You’ll want to store your Invokana drugs at room temperature round 77°F (25°C) in a tightly sealed container.

In case you have unused medicine that has gone previous the expiration date, ask your pharmacist whether or not you may nonetheless be capable of use it.

Skilled info for Invokana

The next info is offered for clinicians and other healthcare professionals.

Indications

Invokana is FDA-approved to enhance glycemic management in adults with Sort 2 diabetes mellitus. It’s an adjunct to food regimen and train.

It’s additionally accepted to scale back the danger of major hostile cardiovascular events in adults with sort 2 diabetes mellitus and established cardiovascular disease. These cardiovascular events embrace cardiovascular demise, nonfatal myocardial infarction, and nonfatal stroke.

Mechanism of Motion

Invokana blocks sodium-glucose co-transporter 2 (SGLT-2) within the proximal renal tubules. This prevents re-absorption of filtered glucose from the renal tubules. The result’s osmotic diuresis on account of extra excretion of urinary glucose.

Pharmacokinetics and Metabolism

After oral administration, maximum concentration happens within one to 2 hours. Invokana may be taken with or without meals. Taking Invokana with a meal containing high-fat content does not have any impact on the drug’s pharmacokinetics. Nevertheless, taking Invokana before a meal might scale back postprandial glucose modifications as a result of delayed glucose absorption in the intestines. Because of this, Invokana ought to be taken previous to the first meal of the day.

The oral bioavailability of Invokana is 65 %.

Invokana is primarily metabolized by O-glucuronidation by way of UGT1A9 and UGT2B4. Metabolism by way of CYP3A4 is considered a minor pathway.

The half-life of Invokana is about 10.6 hours for the 100-mg dose. The half-life is about 3.1 hours for the 300-mg dose.

Renal Dosing

For sufferers with an eGFR lower than 60 mL/min/1.73 m2, regulate the Invokana dose. Monitor their renal perform extra typically.

Contraindications
Invokana is contraindicated in the following patients:

  • those with a critical hypersensitivity reaction to Invokana
  • those with severe renal impairment (eGFR lower than 30 mL/min/1.73 m2) or end-stage renal illness
  • those who are on dialysis

Storage

Invokana must be stored at 77°F (25°C).

Disclaimer: Healthline has made each effort to make certain that each one info is factually right, complete, and up-to-date. Nevertheless, this text shouldn’t be used as an alternative to the information and experience of a licensed healthcare skilled. You must all the time seek the advice of your physician or another healthcare professional earlier than taking any treatment. The drug info contained herein is subject to vary and isn’t meant to cover all potential makes use of, directions, precautions, warnings, drug interactions, allergic reactions, or opposed effects. The absence of warnings or other info for a given drug doesn’t indicate that the drug or drug combination is protected, effective, or applicable for all sufferers or all specific uses.