Drug Description:

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legitimate doctor’s prescription for every order of prescription Invokana.

The manufacturer of Invokana is Janssen- Cilag and Janssen Pharmaceutical.

Indications

Invokana is a prescription medication indicated:

• Along with diet and exercise to lower blood sugar (glucose) in adults with type 2 diabetes
• To reduce the risk of major cardiovascular events such as heart attack, stroke, or death in adults with type 2 diabetes who have known cardiovascular disease
• To reduce the risk of end-stage kidney disease (ESKD), worsening kidney function, cardiovascular death, and hospitalization for heart failure in adults with type 2 diabetes and diabetic kidney disease with a certain amount of protein in the urine

This drug, which is classified as a sodium-glucose co-transporter 2 (SGLT2) inhibitor, blocks some of the sugar and sodium reabsorption in the kidneys and works with the body to flush sugar away in your urine.

Dosage and Administration

The dose of Invokana your healthcare provider prescribes will vary depending on the individual and condition being treated. Follow all your healthcare provider’s instructions and read packaging labels carefully to ensure the best results throughout treatment.

The recommended dosage of Invokana is 100 mg once daily, taken before the first meal of the day.

For additional glucose control, the dosage of Invokana may be increased to the maximum recommended dosage of 300 mg once daily.

Dosage recommendations for persons with kidney impairment are based on estimated glomerular filtration rate (eGFR), a measure of how well your kidneys are working.

• Swallow Invokana tablets whole
• If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medication at the next regularly scheduled time
• Do not stop taking Invokana without first talking to your healthcare provider
• Do not take more than your prescribed dose or double the dose
• Take this medication the morning before eating
• Invokana will cause your urine to test positive for glucose

Side Effects

Invokana may cause certain side effects to develop while lowering your glucose levels. Speak with your healthcare provider for more information regarding any symptoms you may encounter while taking Invokana.

The most common side effects associated with Invokana are:

• Female genital yeast infections
• Urinary tract infections
• Increased urination

Serious Side Effects

Certain serious side effects may occur when taking Invokana. Stop taking this medication and contact your healthcare provider if you develop any of the following side effects:

• Ketoacidosis in people with diabetes mellitus (symptoms include nausea, vomiting, stomach pain, tiredness, trouble breathing)
• Dehydration (loss of body water and salt), which may cause you to feel dizzy, faint, lightheaded, or weak, especially when you stand up
• Vaginal yeast infection (symptoms include vaginal odor, white or yellowish discharge, vaginal itching)
• Yeast infection of the skin around the penis (symptoms include redness/itching/swelling, foul odor, rash of the penis, pain in the skin around penis)
• Urinary tract infections (symptoms include burning while urinating, need to urinate often, lower stomach pain, bloody urine)
• Low blood sugar (hypoglycemia) in people with diabetes mellitus (symptoms include headache, drowsiness, weakness, dizziness, confusion, irritability, hunger, fast heartbeat, sweating, shaking, feeling jittery)
• A rare but serious bacterial infection that causes damage to the tissue under the skin (necrotizing fasciitis) in the area around the anus and genitals (symptoms include weakness, tiredness, discomfort around anus and genital areas, pain or tenderness, swelling, or skin redness in affected areas)

Invokana may increase your risk of lower limb amputations. Amputations mainly involve removal of the toe or part of the foot; however, amputations involving the leg, below and above the knee, have also occurred.

Call your healthcare provider right away if you have new pain or tenderness, any sores, ulcers, or infections in your leg or foot.

You may be at a higher risk of lower limb amputation if you have or have had:

• History of amputation
• Heart disease or are at risk for heart disease
• Blocked or narrowed blood vessels, usually in your leg
• Damage to the nerves (neuropathy) in your leg
• Diabetic foot ulcers or sores

Allergic Reactions

Do not take Invokana if you are allergic to canagliflozin or any of the other listed tablet ingredients. If you develop signs of an allergic reaction, stop taking Invokana and call your healthcare provider.

Invokana allergy symptoms may include:

• Rash, hives
• Swelling of face, lips, mouth, tongue, or throat

Difficulty breathing or swallowing

Warnings and Precautions

Invokana should not be taken by anyone with type 1 diabetes.

Invokana should not be used to lower blood sugar in adults with type 2 diabetes with severe kidney problems.

Invokana may increase your risk of bone fracture within 12 weeks of treatment.

To ensure your safety when taking Invokana, tell your healthcare provider if you:

• Have type 1 diabetes or have had diabetic ketoacidosis
• Have a serious infection
• Have a history of infection of the vagina or penis
• Have a history of amputation
• Have had blocked or narrowed blood vessels, usually in your leg
• Have damage to the nerves (neuropathy) in your leg
• Have had diabetic foot ulcers or sores
• Have kidney problems
• Have liver problems
• Have a history of urinary tract infections or urinary problems
• Are on a low-sodium diet
• Have a scheduled surgery
• Have pancreatic problems, including surgery or pancreatitis
• Drink alcohol often
• Are pregnant or plan to become pregnant
• Are breastfeeding

Some drugs may interact with Invokana and cause unwanted effects. Tell your healthcare provider about all the medications you take, including over-the-counter medicines, and any of the following:

• Insulin
• Sulfonylurea
• Rifampin
• Phenytoin
• Phenobarbital
• Ritonavir
• Digoxin
• Lithium

Form and Strength

This medication is available in tablet form.

Invokana tablet strengths:

• 100mg
• 300mg

FAQs

How do I know if Invokana is working?

It’s important to keep track of your blood sugar levels as directed by your healthcare provider. Consider keeping a journal and share your progress at your next appointment. Your healthcare provider will check your diabetes with regular blood tests, including tests of your blood sugar levels, your A1C, and tests to measure your kidney function.

If Invokana helps my body get rid of some sugar, can it also help me lose weight?

Although Invokana is not a weight-loss medicine, and each person is different, and people can experience reduction in weight, on average 2–3%. Results may vary by dose and when used alone or with certain other diabetes medications.

How can I avoid yeast infections while taking Invokana?

Yeast infections of the vagina may be minimized by avoiding douches, tight undergarments, and scented hygiene products. Yeast infections of the penis may be minimized by regular washing with soap and water, including under the foreskin if you are uncircumcised. Talk to your healthcare provider about what to do if you get symptoms of a yeast infection of the vagina or penis.

Resources

1. https://www.janssenlabels.com/package-insert/product-monograph/prescribing-information/INVOKANA-pi.pdf
2. https://www.invokana.com/about-invokana/FAQs