Invokana (canagliflozin) is a prescription brand-name medication. The Food and Drug Administration (FDA) has approved it for the following uses in adults with type 2 diabetes:

For each of the uses above, Invokana is typically taken long term.

Here are some fast facts about Invokana:

Like other drugs, Invokana can cause side effects. Read on to learn about potential common, mild, and serious side effects, as well as possible complications. For a general overview of Invokana, including details about its uses and its limitations, see this article.

Invokana can cause certain adverse effects, some of which are more common than others. These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.

These are some of the more common side effects reported by people who took Invokana in clinical trials:

* To learn more information about this side effect, see “Side effect specifics” below.

Mild side effects can occur with Invokana. This list doesn’t include all possible mild side effects of the drug. For more information, you can refer to Invokana’s prescribing information.

Mild side effects that have been reported with Invokana include:

These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks side effects of the medication. If you develop a side effect while taking Invokana and want to tell the FDA about it, visit MedWatch.

* To learn more information about this side effect, see “Side effect specifics” below.

Invokana may cause serious side effects. The list below may not include all possible serious side effects of the drug. For more information, you can refer to Invokana’s prescribing information.

If you develop serious side effects while taking Invokana, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Serious side effects that have been reported and their symptoms include:

* To learn more information about this side effect, see “Side effect specifics” below.
† In a study of people with moderate kidney problems, those taking Invokana were more likely to have hyperkalemia. For other people who took Invokana and developed hyperkalemia, this group usually already had increased potassium levels before treatment. Or they were taking other drugs that could increase potassium levels.

Learn more about some of the side effects that Invokana may cause.

Hyperkalemia

Hyperkalemia (high blood potassium level) may occur with Invokana. This side effect was not common in clinical trials, and it isn’t usually serious.

In clinical trials, people who took the higher dose of Invokana (300 milligrams [mg]) were more likely to have hyperkalemia than people who took the lower dose (100 mg). In fact, taking the lower dose of Invokana didn’t increase people’s risk of hyperkalemia. (For more information about Invokana dosage, see this article.)

In a study of people with moderate kidney problems, those taking Invokana were more likely to have hyperkalemia. For other people who took Invokana and developed hyperkalemia, this group usually already had increased potassium levels before treatment. Or they were taking other drugs that could increase potassium levels.

Mild hyperkalemia doesn’t cause symptoms in most people. However, in rare or serious cases, it can cause symptoms such as:

What you can do

You should contact your doctor if you notice symptoms of hyperkalemia.

While you’re taking Invokana, your doctor may monitor your blood potassium levels along with other lab test results. If your levels are high, they may decrease your Invokana dose. Or they may have you stop taking the drug until your levels return to normal. They may also have you completely stop taking Invokana.

Your doctor may also recommend treatment for hyperkalemia. This would depend on your potassium levels and whether you’re having any symptoms.

Increased risk of foot and leg amputation

Taking Invokana may increase the risk of foot and leg amputation. (Amputation is surgical removal of a part of the body.)

Amputations of a toe and at the midfoot (arch) were the most common amputations in clinical trials. Below- and above-the-knee leg amputations were also reported.

The most common causes for needing amputation were:

Certain factors can increase your risk of foot and leg amputations while taking Invokana. Your risk may be higher if you have neuropathy (nerve pain) or a history of amputation or diabetic foot ulcers. It may also be higher if you have peripheral vascular disease (restricted blood flow to the limbs), heart disease, or have risk factors of heart disease.

What you can do

While taking Invokana, you can lower your risk of foot and leg amputation by taking proper care of your feet. Talk with your doctor to learn about proper diabetic foot care. Some tips include:

  • checking your feet every day for cuts, sores, blisters, and other changes to your skin or nails
  • washing your feet with warm water every day, but not soaking them
  • wearing shoes that fit well
  • avoiding being barefoot

You should call your doctor right away if you have problems with your leg or foot while taking Invokana. These include new pain or tenderness, ulcers, or infection. Your doctor may have you stop taking Invokana completely or for a short time.

Yeast infection

Treatment with Invokana can cause yeast infection of the vagina or penis. This was the most common side effect reported in clinical trials.

Symptoms of a vaginal yeast infection can include:

Symptoms of yeast infection of the skin around the penis can include:

You may be at a higher risk of yeast infection of the penis if you have an uncircumcised penis or had a yeast infection of the penis in the past.

What you can do

If you develop symptoms of a yeast infection, contact your doctor. They can recommend treatment. This may include taking an over-the-counter or prescription antifungal medication.

Allergic reaction

As with most drugs, Invokana can cause an allergic reaction in some people. Allergic reactions occurred in clinical trials, but they weren’t common.

Symptoms can be mild or serious and can include:

  • skin rash
  • itching
  • flushing
  • swelling under your skin, typically in your lips, eyelids, feet, or hands
  • swelling of your mouth, tongue, or throat, which can make it hard to breathe

What you can do

For mild symptoms of an allergic reaction, call your doctor right away. They may recommend ways to ease your symptoms and determine whether you should keep taking Invokana. However, if your symptoms are serious and you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Invokana may cause several side effects. Here are some frequently asked questions about the drug’s side effects and their answers.

Do people lose weight while taking Invokana?

It’s possible to experience weight loss while taking Invokana. In clinical trials, people who took Invokana lost more weight than people who took a placebo (treatment with no active drug).

Invokana isn’t approved to help people lose weight. Among other uses, Invokana is approved to lower blood sugar levels in adults with type 2 diabetes. The drug is prescribed as part of a treatment plan that includes diet and exercise. This treatment plan may lead to weight loss for some people.

Talk with your doctor if you’re concerned about weight loss while taking Invokana. They can discuss ways to help you maintain a moderate weight.

Can stopping Invokana treatment cause side effects of withdrawal?

No, stopping Invokana isn’t known to cause withdrawal side effects. (Withdrawal side effects can happen when you stop taking a drug that your body has become dependent on.)

However, it’s important to note that your blood sugar levels may increase if you stop taking Invokana. This can worsen your diabetes symptoms. Starting another diabetes treatment after stopping Invokana can help prevent this from happening.

You should not stop taking Invokana without first talking with your doctor. If you both decide you should stop Invokana, your doctor will likely recommend other treatments to manage your blood sugar levels.

Is lactic acidosis a side effect of Invokana?

No, lactic acidosis isn’t a known side effect of Invokana. (With lactic acidosis, the body produces too much lactic acid). This side effect wasn’t reported in clinical trials.

Metformin is a different diabetes drug that can cause lactic acidosis. Invokana does not contain metformin. Its active drug is called canagliflozin. However, other drugs that contain both metformin and canagliflozin can cause lactic acidosis. These drugs are called Invokamet and Invokamet XR.

Talk with your doctor or pharmacist if you’re concerned about lactic acidosis and your diabetes treatment plan.

Are any side effects specific to the 300-mg strength of Invokana?

No, there weren’t any side effects specific to the 300-milligram (mg) strength of Invokana in clinical trials. However, certain conditions or factors may increase the risk of side effects from the 300-mg strength.

For example, the higher strength of Invokana is more likely to cause dehydration if you:

To view a complete list of side effects from each strength of Invokana, see the drug’s full prescribing information. You can also talk with your doctor or pharmacist.

Should I expect joint pain during Invokana treatment?

No, joint pain wasn’t a reported side effect in Invokana’s clinical trials.

A certain group of diabetes medications called dipeptidyl peptidase-4 (DPP-4) inhibitors can cause severe joint pain. However, Invokana isn’t a DPP-4 inhibitor. Instead, it’s classified as a sodium-glucose co-transporter 2 inhibitor.

If you’re concerned about joint pain and your diabetes treatment plan, talk with your doctor or pharmacist.

Be sure to talk with your doctor about your health history before you take Invokana. This drug may not be the right treatment for you if you have certain medical conditions or other factors that affect your health. The conditions and factors to consider include:

Blocked or narrowed blood vessels. If you have blocked or narrowed blood vessels, you may be have an increased risk of foot or leg amputation. This is a rare but serious side effect of Invokana. Your doctor can help determine whether Invokana is a safe treatment for you. (For more information on this side effect, see “Side effect specifics” above.)

Certain other diabetes drugs. Taking certain other diabetes medications with Invokana can increase your risk of low blood sugar levels. These medications include insulin, and a drug class called sulfonylureas, such as glipizide (Glucotrol). Talk with your doctor about other medications you take before you begin Invokana treatment. They may adjust the dose of your other diabetes medications.

Diabetic neuropathy. If you have diabetic neuropathy, you may be at increased risk of foot or leg amputation. This is a rare but serious side effect of Invokana. Your doctor can help determine whether Invokana is safe for you to take.

Heart disease. Having heart disease may increase your risk of side effects from Invokana. This includes serious side effects such as increased risk of leg and foot amputations. Your doctor can advise you on how to watch for and help prevent this side effect. They may also monitor you more closely than usual if you have existing heart disease.

History of amputation. If you’ve had an amputation in the past, you may have a higher risk of leg and foot amputations if you take Invokana. Your doctor can help determine whether Invokana is a safe treatment for you to take.

History of diabetic foot ulcers. Having a history of diabetic foot ulcers can increase your risk of leg and foot amputations if you take Invokana. Your doctor can help determine whether Invokana is safe for you.

Liver problems. Invokana may not be safe for people with liver problems. If you have a liver problem, tell your doctor before taking Invokana. They’ll check to see if your liver is healthy enough for you to take the drug safely. If it is, they may prescribe a lower Invokana dose than usual. If your liver problems are severe, your doctor likely won’t prescribe this medication to you.

Kidney problems. If you have kidney problems, you may have a higher risk of certain side effects from Invokana. Examples include dehydration, low blood pressure, and hyperkalemia. If you have kidney problems, talk with your doctor about these risks before taking Invokana. Depending on your kidney function, they’ll likely prescribe a lower dose for you. However, if you’re receiving dialysis, your doctor won’t prescribe Invokana for you.

Past urinary tract infection (UTI). Treatment with Invokana can increase your risk of a UTI. If you’ve had a UTI before, or if you often have UTIs, you may be at higher risk of this side effect. Your doctor may monitor you more closely than usual for this side effect while you’re taking Invokana.

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 may be better options for you.(For more information on this side effect, see “Side effect specifics” above.)

Alcohol and Invokana

You should avoid drinking large amounts of alcohol in a short period of time while taking Invokana.

Drinking large amounts of alcohol can increase your risk of diabetic ketoacidosis (buildup of ketones in your urine and blood). This is a rare but serious side effect of Invokana. (For information, see the “Serious side effects of Invokana” section above.)

If you drink alcohol, talk with your doctor about how much is safe to drink while you’re taking Invokana.

Pregnancy and breastfeeding while taking Invokana

Below is some information about taking Invokana while pregnant or breastfeeding.

Pregnancy. It’s not recommended to take Invokana during the second or third trimester of pregnancy. However, there haven’t been enough studies to determine whether Invokana is safe to take at any time during pregnancy. In animal studies, Invokana may have increased the risk of kidney problems in offspring. However, animal studies don’t always predict what will happen in people. Talk with your doctor about other diabetes treatments to take while pregnant.

Breastfeeding. Taking Invokana while breastfeeding isn’t recommended. It’s unknown whether the drug passes into breast milk or could cause side effects in a child who’s breastfed. In animal studies, the drug was found in breast milk. For these reasons, your doctor may recommend other treatments to lower your blood sugar levels while breastfeeding.

Invokana can cause some side effects, but they’re usually mild. Most mild side effects of the drug go away with time and don’t require medical attention. However, serious side effects are possible, as with most medications.

If you develop any symptoms of serious side effects, you should contact your doctor right away. See “Serious side effects of Invokana” above for details.

If you’d like to learn more about Invokana, talk with your doctor or pharmacist. They can help answer any questions you have about side effects of taking the drug.

Besides talking with your doctor, you can do some research on your own. These articles might help:

Disclaimer: Medical News Today 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.