Invokana: Uses, Dosage , Side effects and Interactions

Overview

What is Invokana?

Invokana is the trade name for prescription medication to treat Type 2 diabetes (diabetes mellitus) in adults. Doctors prescribe Invokana to Type 2 diabetic patients with the correct diet and exercise to control blood sugar levels, reduce the possibility of heart problems, and lower the risk of kidney damage associated with persistent diabetes.

However, health professionals might also prescribe Invokana for other purposes not mentioned above.

Facts of Invokana

• In 2013, the FDA (The Food and drug administration, United States) approved Invokana for glycemic control in type 2 diabetes.
• Invokana is the third line medication after the first (primary medication) viz; metformin. First-line medication is the treatment that doctors prescribe first to treat a disease. If the first-line medication fails to give desirable results, he prescribes second and third-line medications.
• Invokana is not available as a generic medication. A generic drug replicates the active drug in the trade name medication.
• FDA has not approved Invokana for treating type 1diabetes ¹Overview| Researched based study from Nlm.nih.gov

Category of drug

Invokana contains canagliflozin as the active ingredient. It belongs to the drug class called sodium-glucose transport protein 2(SGLT2) inhibitors.

The drug class is the group of medications that works similarly ²Overview| Researched based study from Sciencedirect.com

Mode of action of Invokana

• Invokana works by lowering the glucose level in the blood. It makes the kidney remove the excess sugar, salt, and water through the urine. By removing surplus salt and water, Invokana decreases the risk of damage to blood vessels, the heart, and the kidney. Thus, Invokana, besides controlling sugar, reduces the chance of diabetic complications viz; heart attack, stroke, and kidney failure ³Overview| Researched based study from Nlm.nih.gov

Uses

Uses of Invokana

Management of Type 2 Diabetes

FDA has approved Invokana to treat adult Type 2 diabetes. Invokana is used to manage the following conditions:

• To control blood sugar levels besides exercise and a well-balanced diet
• To decrease the risk of cardiovascular issues that can lead to stroke (a situation when the brain’s blood vessel ruptures) and heart attack
• To reduce the risk of diabetic nephropathy (chronic kidney disease) that can lead to elevated creatinine in blood, kidney malfunctioning, heart failure, and death ⁵Uses| Researched based study from Nlm.nih.gov

Dosage

Dosage & Forms of Invokana

Formulation of Invokana

Invokana comes in tablet form that one can swallow with plain water

Invokana is available in two powers (strength)

• 100 mg (milligram)
• 300 mg ⁷Dosage| Researched based study from Nlm.nih.gov

Taking Invokana

• Take Invokana as the doctor recommends.
• One can take Invokana with or without food, but doctors often advise to take before breakfast to avoid after-meal blood sugar spikes

Dosage of Invokana

The Invokana dosage depends on the estimated glomerular filtration rate (eGFR) measurement (eGFR is a measurement to identify how well the kidneys are working)

Dosage for individuals with mild or no loss of kidney function (eGFR=60)

• Initial dose-100 mg daily
• Depending on the patient’s need, the doctor might increase the dose to 300 mg daily.

Dosage for moderate loss of kidney function (eGFR =30 to 59)

• Dose-100 mg daily

Dosage for severe loss of kidney function (eGFR< 30)

• Doctors do not recommend Invokana for such patients. However, for patients who are already using Invokana and are losing a specific amount of albumin in urine, the doctor might allow them to continue depending on the need ⁴Dosage| Researched based study from Nlm.nih.gov

However, one must follow the amount as prescribed by the doctor.

Missed dose

• In case of missed doses, take the amount instantly when you remember.
• However, never take two doses all together, which can have severe side effects.
• One who needs to be certain of taking or skipping the dose must talk to the physician.

Overdose

Overdose toxicity of Invokana

Taking Invokana more than the recommended dose can lead to serious side effects. However, if one has accidentally overdosed on the drug, in that case, one should straight away call the emergency medical number based on the geographical locality or hurry to the nearest emergency room.

Some of the overdose symptoms are as follows:

• Severe low blood sugar levels in the body
• Diarrhea
• Nausea and vomiting
• Kidney failure ⁸Overdose| Researched based study from Nlm.nih.gov

Side effects

Side Effects of Invokana

Common side effects

• Urinary tract infection
• Vaginal yeast infection
• Yeast infection in the penis
• More urination than usual

Mild side effects

• Urinary tract infection
• Thirstiness
• Dry mouth
• Constipation
• Nausea and vomiting
• Vaginal itching
• Vaginal yeast infection
• Yeast infection in the penis
• Weight loss
• More urination than usual

Serious side effects

• Hives
• Itching
• Dehydration
• Low blood pressure
• Low blood sugar (hypoglycemia)
• Increased risk of bone fractures
• Swelling in the lips, mouth, tongue and throat
• Swelling of eyelids, feet ,and hands
• Trouble breathing
• Elevated ketones (acidic chemicals) in blood and urine
• Severe infection in the genitals (rare case)
• Kidney failure
• Serious urinary tract infection
• Surgical removal of body parts such as toe and foot (lower limb amputation) ⁶Side effects| Researched based study from Nlm.nih.gov

Contraindications

Contraindications

Invokana might not be appropriate for people with the following health conditions:

• Allergic to Invokana or any of the component of the drug
• Kidney disease
• Liver disease
• Kidney cancer
• Alcoholism(addicted to alcohol)
• People on diabetic medication such as sulfonylureas
• People with a risk of lower limb amputation
• People with a history of pancreatitis (pain and swelling of the pancreas) ¹⁰Contraindications| Researched based study from Nlm.nih.gov .
• Pregnant and nursing women should avoid using Invokana due to the lack of information on the safety and efficiency of these groups ⁹Contraindications| Researched based study from Nlm.nih.gov

Interactions

Interactions of Invokana

Invokana can interact with numerous medicines.

Some of the drugs that Invokana can interact with are as follows:

• Other diabetic drugs viz glucotrol, januvia, insulin
• Anti-inflammatory drugs (corticosteroid)
• Diuretic medication(Diuril, Microzide)
• Antidepressant medication(Prozac, Emsam)
• Blood pressure medication(Zestril, Cozaar)
• Heart medication(Lanoxin)
• Anti-seizure medication(Dilantin)
• Antibiotic(Rifadin)
• Human immunodeficiency virus (HIV) medication(Norvir)

Supplements and herbs that Invokana can interact with are as follows:

• Chromium
• Alpha-lipoic acid
• Gymnema
• Prickly pear cactus
• Bitter melon ¹¹Interactions| Researched based study from Nlm.nih.gov

However, interactions might occur with additional drugs not listed above. So, patients with health issues must always report to the doctor about it ahead of taking the medication.

Storage

Storage & Disposal of Invokana

Storage suggestions

• Store Invokana in a tightly sealed container at room temperature 20 to 25 degrees centigrade.
• Keep Invokana out of reach of youngsters and kids.
• Avoid keeping Invokana in damp places, such as the bathroom

Disposal

• Dispose of unused medications in a disposal container such as sharps container, to avoid accidental overdose or demises of animals or pets.
• Discard the tablets whose termination date has crossed.

Alternatives

Alternatives to Invokana

Other drugs are also accessible to treat Type 2 diabetes, similar to Invokana. Some may suit better. One deciding for alternative drug must discuss it with the physician to get the finest suit.

Alternative drugs for lowering blood sugar in Type 2 diabetic patients

• Farxiga
• Jardiance
• Tanzeum
• Januvia
• Actos ¹²Alternatives| Researched based study from Nlm.nih.gov
• Amaryl
• Glyset

Alternative drugs for reducing the risk of heart issues in Type 2 diabetic patients

• Victoza
• Jardiance
• Crestor
• Lipitor

Alternative drugs for reducing the risk of kidney problems (diabetic nephropathy) in Type 2 diabetic patients

• Irbesartan
• Lisinopril

Takeaway

Key Takeaways

• Invokana is an FDA-approved prescription for managing Type 2 diabetes in adults and associated diabetic complications such as heart and kidney.
• People with a health condition must notify their physician before taking Invokana to avert unwanted complications.
• Invokana has possible side effects. So, one must follow the exact doses as permitted by the physician.