Invokana (Canagliflozin)

Invokana is a diabetes drug that works by blocking sodium/glucose cotransporter 2 – a protein that helps reabsorb glucose into the blood. This reabsorption happens when blood is filtered through the kidneys. Normally, the kidneys would reabsorb glucose (sugar) and return it to the bloodstream; however, canagliflozin prevents that process from taking place, causing glucose to be expelled through the urine and lowering the patient’s blood sugar level.

In most cases, Invokana is taken in conjunction with a modified diet. It might also be prescribed for use with metformin (sold under the brand name Invokamet). It may be combined with insulin and other drugs as well, depending on various factors. Invokana is created by Janssen, a Johnson & Johnson company, and is taken by 1.5 million people annually.

Approved Uses of Invokana

The U.S. Food & Drug Administration first approved Invokana in January 2013 to treat Type 2 diabetes in adults. The recommendation came after the FDA reviewed results from more than 10,000 patients across nine different studies, showing that the drug could effectively help the kidneys reabsorb glucose into the body. Since then, the FDA has repeatedly updated Invokana’s warnings and indications, most recently requiring the addition of a black box warning on the label informing patients of an increased risk of amputation after taking the drug.

Invokana is only approved in the United States to treat adults with type 2 diabetes mellitus. Its approval is based on being taken along with a proper diet and exercise to reduce blood glucose levels. There are no other approved uses of the drug.

The FDA has explicitly stated that Invokana is not for use with individuals who have type 1 diabetes or diabetic ketoacidosis.

Invokana Drug Details

Invokana, Invokamet, Sulisent


Type 2 diabetes

Janssen Pharmaceuticals (subsidiary of Johnson & Johnson)

100 mg, 300 mg

First approved in March 2013; label updated in June 2016

Invokana Contraindications

Invokana and SGLT2 inhibitors can affect each person differently. The drug should not be taken by women who are pregnant, breastfeeding, or planning to become pregnant. You should also tell your doctor if you have a history of:

  • Alcoholism, heavy drinking, or heavy episodic drinking (binge-drinking)
  • Allergic reactions to Invokana or other SCLT2 inhibitors
  • Urinary tract infections or urination issues
  • Kidney problems
  • Liver problems
  • Low-sodium or modified diet
  • Problems with your pancreas
  • Surgical procedures

Invokana Health Risks

There are a number of safety concerns related to canagliflozin, from mild side effects to more serious conditions, which recently prompted the FDA to require a new Invokana black box warning.

Among the most serious Invokana side effects are higher risks of Kidney failure, Leg and foot amputations, and Ketoacidosis

In addition, canagliflozin can interact adversely with certain other drugs, including insulin, diuretics, digoxin (Lanoxin), rifampin, phenytoin or phenobarbital, and ritonavir (Norvir, Kaletra).

Invokana Lawsuits

Due to the dangers of canagliflozin, including the possibility of severe damage or even death from kidney failure and ketoacidosis, Invokana lawsuit claims have been made on behalf of patients who took the drug and experienced these adverse effects. The primary complaint in many of these legal actions are that Janssen and other drug manufacturers did not properly warn patients about the risk of taking drugs like Invokana and Invokamet.