Invokana (Canagliflozin) Side Effects – Diabetic Ketoacidosis

Invokana (Canagliflozin) is a popular and prescribed antidiabetic drug. There are many side effects associated with this medication, some of which can be deadly for those who suffer from diabetes or kidney problems.
Diabetes affects over 23 million people in the United States alone and it’s one of the most common causes of death among Americans under 65 years old. It has been reported that as many as 1 out 50 to 60 patients taking Invokana may have their lives cut short due to inadequate treatment, misdiagnosis, or improper monitoring by healthcare professionals. How should doctors prescribe this new type of medication? Are there any other options for treating type 2 diabetic patients?

Diabetic ketoacidosis is a dangerous condition that can happen when a person with type 2 diabetes takes Invokana. The side effects of Invokana are not well-known, but they may include nausea, vomiting, abdominal pain, and diarrhea.

Invokana (Canagliflozin) Side Effects - Diabetic Ketoacidosis

(As of February 13, 2018)

Please note that we no longer accept Invokana and Invokamet cases.

Invokana belongs to the sodium-glucose cotransporter-2 (SGLT2) inhibitor family of medicines. These medications help type 2 diabetes patients decrease their blood sugar levels, but they may also induce dangerous side effects such Ketoacidosis in Diabetics (DKA), limb amputations, and renal difficulties.

Some patients have filed lawsuits against Johnson & Johnson and other drug companies, claiming that drug makers did not sufficiently warn about these side effects.

Ketoacidosis in Diabetics (DKA)

Ketoacidosis in Diabetics (DKA) is a severe diabetes complication that occurs when the body produces high levels of blood acids called ketones.

Ketones are created when cells don’t get enough energy from glucose and start breaking down fat for fuel. The excess of ketones makes the blood acidic and may harm the body. DKA may put a patient into a diabetic coma and perhaps kill them.

The FDA issued a warning in May 2015 that Invokana and other SGLT2 inhibitors might cause DKA.

The US Food and Drug Administration (FDA) issued a warning in May 2015 that Invokana and other SGLT2 inhibitors might cause DKA. The FDA issued the warning after receiving 20 reports of DKA over a one-year period. Given that DKA is most typically seen in individuals with type 1 diabetes, this is an exceptionally high number of occurrences. All of the patients needed to be admitted to the hospital and/or visited an emergency department.

The FDA said in December 2015 that SGLT2 inhibitors would henceforth be required to include warnings concerning the risk of high blood acidity. According to the FDA, the medications must also have a warning for dangerous urinary tract infections.

The following are some of the signs and symptoms of DKA:

  • Nausea
  • Vomiting
  • Pain in the abdomen
  • Fatigue
  • Breathing problems
  • Breath that smells like fruit

Other Health Hazards of Invokana

DKA isn’t the only potentially dangerous side effect of SGLT2 inhibitors. In addition, the medicines have been associated to:

  • Failure of the kidneys
  • Stones in the kidneys
  • Cancers of the breast and bladder
  • Pancreatitis
  • Effects on the cardiovascular system
  • Fractures of the bones
  • Urinary tract infections that be severe (UTIs)
  • Infections caused by yeast

Kidney Issues

People with compromised kidney (renal) function should avoid SGLT2 inhibitors. This is because the medications stimulate urine output by acting on the kidneys.

While kidney damage and impairment are listed in the prescription material for SGLT2 inhibitors, it’s possible that makers didn’t go far enough in warning about severe renal side effects when the medications were originally released.

In a 2015 research, the Institute for Safe Medication Practices (ISMP) identified more than 450 Invokana side effects, including:

  • Failure of the kidneys or impairment
  • Fluid imbalances and dehydration
  • Stones in the kidneys

The ISMP questioned whether Invokana had been thoroughly studied and if the advantages outweighed the hazards. “The available data are inadequate to address unsolved issues expressed in FDA evaluations regarding whether long-term usage would result in a continuous deterioration in kidney function,” according to the study.

“At this time, there is insufficient evidence to say if long-term [Invokana] usage leads to a progressive deterioration in kidney function.”

In June 2016, the FDA issued a drug safety notice stating that the kidney warnings for Invokana, Invokamet, Farxiga, and Xigduo XR needed to be strengthened. The FDA made its determination based on more than 100 incidents of acute kidney injury (AKI) reported to the agency between March 2013 (when Invokana was authorized) and October 2015.

Within a month of taking the medicine, almost half of the patients had evidence of renal impairment. After they were taken off the medicine, the majority of the patients improved.

Reduced urine and edema in the legs or feet are signs of acute renal damage.

Amputations of the feet and legs

In May 2017, the FDA ordered a black box warning—its strongest advisory—for Invokana’s increased risk of Amputations of the feet and legs. Two clinical trials showed that patients with type 2 diabetes were twice as likely to need an amputation if they took Invokana than if they took a placebo.

Patients who used Invokana were twice as likely to need an amputation, according to studies.

Amputations of the toe and foot were the most prevalent, according to the FDA, although leg amputations above and below the knee were also common.

Fractures of the bones

In 2015, the FDA ordered a labeling change to Invokana over patients’ increased risk of bone fracture. A post-marketing study that the FDA ordered Janssen to conduct showed that Invokana is more likely than a placebo to cause Fractures of the bones.

Acute Pancreatitis is a condition in which the pancreas becomes inflam

Three case reports demonstrate a rare but potentially deadly Invokana side effect: Acute Pancreatitis is a condition in which the pancreas becomes inflam (inflammation of the pancreas).

A Journal of Basic and Clinical Pharmacy report details a 50-year-old man who was prescribed Invokana four days prior to being admitted to the hospital complaining of malaise, weakness, Pain in the abdomen, and vision loss. The patient stopped using Invokana and his symptoms subsided.

Another case study, in Therapeautics and Clinical Risk Management, details a similar experience with a 33-year-old woman. The woman was admitted to the emergency room with nausea, vomiting, and severe Pain in the abdomen. She discontinued Invokana and, like the male patient, subsequently recovered.

The American Journal of Therapeutics published a third instance of this kind.

The label on Invokana still doesn’t mention this possibly fatal adverse effect.

Risks of Cardiovascular Disease

Because diabetes increases the risk of heart attack, stroke, coronary artery disease, and other cardiovascular consequences, all new diabetes medicines licensed in the United States must be clinically examined for cardiovascular risk.

An apparent rise in heart attacks and strokes among clinical trial participants caused criticism at the time of Invokana’s approval. Invokana caused 13 cardiovascular events in one trial, compared to only one in the placebo group.

Eight of 15 panel members expressed concerns about Risks of Cardiovascular Disease—particularly strokes.

In a vote, eight of 15 panel members expressed concerns about Risks of Cardiovascular Disease—particularly strokes—citing insufficient data. Despite these concerns, the FDA panel voted 10-to-5 to approve Invokana. The FDA did order five post-marketing studies, including a cardiovascular outcomes trial.

Meanwhile, hundreds of thousands of patients are given Invokana, which brings in around $1.5 billion each year for medication producer Janssen.

Invokana currently has no warnings about Effects on the cardiovascular system.


Invokana is a type of medication that has been used to treat diabetes. It has also been known to cause diabetic ketoacidosis. This article will discuss the side effects of Invokana and how they can be avoided. Reference: invokana side effects weight loss.

Frequently Asked Questions

Can Invokana cause ketoacidosis?

A: No, ketoacidosis is a condition where the body produces too many acids. Invokana primarily works by suppressing appetite and decreasing insulin sensitivity– it has no effect on acid production.

Why does canagliflozin cause ketoacidosis?

Can canagliflozin cause lactic acidosis?

A: No, Lactic acidosis is a medical condition caused by excess lactate accumulation in the bloodstream.

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