Canagliflozin

1 medicine

Canagliflozin is an SGLT2 inhibitor for type 2 diabetes with a well-documented higher risk of lower-limb amputation. It should be paused before major surgery or fasting to avoid a serious complication called euglycemic diabetic ketoacidosis.

Invokana

Canagliflozin

100mg

Invokana is a diabetes medication containing Canagliflozin, available as 100mg tablets.

from $3.90 / tablet View

Key facts

  • Canagliflozin is an SGLT2 inhibitor. It blocks sugar reabsorption in the kidney so extra glucose leaves the body in urine, lowering blood sugar in type 2 diabetes.
  • It's taken once daily, before the first meal of the day, and works independently of insulin.
  • Canagliflozin has been linked to a higher risk of leg and foot amputation than other diabetes medicines in large clinical trials. Report any new foot pain, ulcer, or infection right away.
  • It can also cause a serious complication called euglycemic diabetic ketoacidosis, where blood sugar looks only mildly high but the blood turns dangerously acidic; seek urgent care for nausea, vomiting, abdominal pain, or unusual breathlessness.

What canagliflozin treats

Canagliflozin treats type 2 diabetes, used alongside diet and exercise to lower blood sugar. In some people with type 2 diabetes and existing heart disease or diabetic kidney disease, it also reduces the risk of heart failure hospitalization and slows the decline of kidney function. It does not treat type 1 diabetes, where it isn't approved.

How canagliflozin works

Your kidneys normally filter glucose from blood and then reabsorb nearly all of it back into circulation through a protein called SGLT2. Canagliflozin blocks this protein, so more glucose stays in the urine instead of returning to the bloodstream, lowering blood sugar and shedding some extra calories and fluid along with it.

Before you take it

  • Tell your prescriber about any foot ulcers, poor circulation, nerve damage, or previous amputation, since these raise the amputation risk further.
  • Your care team may pause canagliflozin before scheduled surgery or if you're eating and drinking very little, to prevent diabetic ketoacidosis.
  • Mention any history of urinary tract or genital yeast infections, kidney disease, or low blood pressure.
  • Combining it with insulin or a sulfonylurea raises the risk of low blood sugar; your doses of those may need adjusting.

Side effects

Common effects include genital yeast infections, increased urination, thirst, and mild dizziness, especially when starting.

Stop and seek urgent medical care for any of these:

  • A new foot wound, ulcer, discoloration, or pain, however minor it seems.
  • Nausea, vomiting, abdominal pain, or fast breathing, even with normal or only mildly raised blood sugar.
  • Severe pain, swelling, or redness of the genital or perineal area, a rare sign of a serious soft-tissue infection.

Safety essentials

  • Check your feet regularly and report any wound or ulcer immediately. The higher amputation risk seen with canagliflozin makes early foot care essential.
  • Stay alert for euglycemic ketoacidosis. Normal blood sugar does not rule it out if you have the symptoms above, especially around surgery, illness, or a very low-carbohydrate diet.
  • Stay well hydrated, since the medicine increases fluid loss and can worsen dehydration or low blood pressure.

This page is educational and does not replace advice from a doctor or pharmacist who knows your health history.