b '¿Cuáles son los peligros / riesgos de Invokana?' - Professor Arievaldo

b ‘¿Cuáles son los peligros / riesgos de Invokana?’

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b ‘¿Cuáles son los peligros / riesgos de Invokana?’

Important Points

  • Some of the leading cautions related to Invokana (canagliflozin) treatment are the likelihood of amputation of a lower life expectancy limb, dehydration and low blood pressure, genital yeast conditions in both women and men, major allergic reactions and renal issues. There are other severe problems with Invokana that you need to consult with your doctor.
  • While you can find hazards, the majority of negative effects take place in tiny variety of clients and several clients tolerate Invokana well. It is vital to remember that without treatment type 2 diabetes may cause serious illnesses including cardiovascular system and kidney illness, blindness, nerve damage, and death.
  • The most typical complication youll probably come across with Invokana is actually a genital yeast infection, in both people. Urinary tract problems and frequent urination are other common reactions.

Invokana (canagliflozin) is a prescription medication combined with diet and exercise to reduce blood sugar in grownups with diabetes. It belongs to a category of medications called sodium-glucose cotransporter-2 (SGLT2) inhibitors. SGLT2 inhibitors lower blood glucose by preventing a certain protein and resulting in the kidneys to remove glucose through the human anatomy through urine.

Warnings regarding Invokana


Invokana (canagliflozin) holds a Boxed Caution for an increased threat of lower limb amputations. A Boxed alert is the FDA’s most strict caution for drugs.

Two clinical studies (CANVAS, CANVAS-R demo) in clients with diabetes and heart problems (or in danger of heart problems) revealed that amputations occurred when it comes to twice more frequently when it comes to those clients taking Invokana as in clients treated with a sedentary placebo.

  • When you look at the CANVAS learn, 3.3% of clients (95 of 2886) receiving both the 100 mg or 300 mg dose of Invokana had an amputation versus 1.5per cent of clients (22 of 1441) having a sedentary placebo. The total wide range of amputations had been 162 for Invokana and 33 when it comes down to placebo group.
  • Amputations of the bottom and middle in the foot happened to be the most frequent; but amputations relating to the lower body, either below or over the knee, also happened. Some patients had multiple amputation and a few involved numerous limbs.
  • The threat for amputation occurred with both 100 mg and 300 mg dosage of Invokana.
  • This Boxed caution in addition relates to Invokamet and Invokamet XR, combo items that include canagliflozin and metformin.

Your threat for amputation are higher for those who have heart disease or are in danger for cardiovascular disease, experienced blocked or narrowed bloodstream, often when you look at the leg, neurological damage (neuropathy), diabetic foot ulcers (lesions), or a history of past amputation. Make sure to tell your medical practitioner should you decide end up in some of these classes.

Get hold of your medical practitioner at once in the event that you establish any brand-new discomfort or inflammation, lesions or ulcers, or infections within feet or foot. The doctor can determine if youll want to stop using Invokana.

Read about and practice appropriate base care when you have type 2 diabetes.

Dehydration, Low Blood Pressure

Invokana leads to increased urination, which might place you susceptible to dehydration (the loss of extreme human anatomy liquid).

Dehydration may make you think dizzy, lightheaded faint, or weak, specially when you remain true (orthostatic hypotension). This could can also increase your own risk for a fall.

For the 300 mg dose of Invokana, are 75 yrs old or more mature, or take a loop diuretic (instance furosemide), maybe you are at greater likelihood of dehydration.

Check with the doctor exactly how much substance you will want to take in every single day to help decrease your danger for dehydration.

Youll probably be at risk of dehydration any time you:

  • have reasonable blood pressure
  • take medication to reduce your own blood pressure
  • are on a reduced sodium diet
  • have kidney problems
  • are 65 yrs old or older.

Low hypertension (hypotension) could happen with Invokana therapy. This may take place if youre dehydrated, also.

Inform your medical practitioner if:

  • you really have kidney troubles are 65 decades or older
  • you have actually a brief history of reduced blood pressure
  • you simply take some medicines for blood pressure levels, instance diuretics (drinking water products), ACE inhibitors, or Angiotensin receptor blockers.

Yeast infections

Genital yeast infections tend to be detailed as a common side effects with SGLT2 inhibitors, such as Invokana, and take place more frequently in women. 

Signs and symptoms of a genital candidiasis in females (also known as vulvovaginitis or candidiasis):

  • vaginal itching
  • vaginal odor
  • white or yellow release that may be uneven or appear like bungalow cheese
  • vaginal burning pain or burning up while urinating
  • painful sexual activity.

In Invokana scientific studies, the overall incidence of genital yeast-based infections in women had been 10.6% (using the 100 mg dosage), 11.6percent (making use of 300 mg dosage) and 2.8percent (sedentary placebo). How many women that needed to end treatment for this side effects was reduced: 0.7percent of those obtaining Invokana when compared with 0% in placebo class.

Warning signs of a yeast-based infection of penis in guys (balanitis or balanoposthitis):

  • redness, irritation, or puffiness associated with the dick rash or lesions about penis
  • foul smelling release from penis
  • pain in the skin across the penis
  • tight, shiny skin on the head of ones penis
  • painful urination or otherwise not having the ability to urinate
  • swollen glands near your own groin.

Some men who are not circumcised might have puffiness of penis which makes it tough to pull back our skin round the tip regarding the dick. Balanitis is likely to occur in males whove a taut foreskin definitely difficult to pull-back, or with poor hygiene. An allergy to condoms or spermicides could also aggravate balanitis due to fungus.

In males, genital yeast-based infections (age.g., candidal balanitis, balanoposthitis) occurred in 4.2percent (together with the 100 mg amount). 3.8percent (with all the 300 mg dosage) and 0.7percent (inactive placebo).

Confer with your physician about what to do if you should get an infection from yeast. That is treatable and few clients quit therapy as a result of this side-effect. Oral prescription or non-prescription topical antifungal treatment could be treatment plans.


Ketoacidosis actually is when you yourself have increased ketones inside blood or urine, and may take place during therapy with Invokana. This is a significant situation, might need treatment in a medical facility and will result in passing. Ketoacidosis can occur with Invokana regardless if the blood sugar levels is under 250 mg/dL. You are at better likelihood of ketoacidosis if you find yourself sick or undergoing surgery.

Stop using Invokana and contact the doctor straight away when you get the after symptoms:

  • nausea
  • tiredness
  • vomiting
  • trouble breathing
  • stomach region (abdominal) pain.

If you can get some of these symptoms during therapy with Invokana, if at all possible, look for ketones inside urine, no matter if your blood sugar is actually around 250 mg/dL.

Urinary system infections

Serious urinary system infections (UTIs) could be a threat with Invokana treatment and other SGLT2 inhibitors. Some UTIs have actually lead to hospitalization.

In clinical studies, UTIs took place 5.9percent of patients receiving the 100 mg dose of Invokana, 4.4percent of customers receiving the 300 mg amount and 3.8% of these from the sedentary placebo.

Prior to beginning therapy with Invokana, inform your doctor when you yourself have a brief history of urinary system infections or complications with urination. Should you get some of the after signs, inform your medical practitioner instantly:

  • burning up feeling whenever passing urine
  • a need certainly to urinate often
  • the want to urinate immediately discomfort for the lower section of the stomach (pelvis)
  • blood within urine
  • a temperature, back pain, nausea, or vomiting.

Sudden kidney problems

Sudden (extreme) renal damage is a potential severe side effects with Invokana. Your physician may need to temporarily stop your own treatment.

Contact towards doctor at once should you decide:

  • lower the total amount of food or liquid you drink assuming you may be sick or cannot eat
  • you start to get rid of fluids out of your human body including, from sickness, diarrhoea or becoming under the sun as well long.

If you have got kidney illness, your medical professional may need to lower dose of Invokana when you start taking Invokana. Be sure to tell your medical practitioner when you have a history of renal issues.

Your medical professional follows your kidney purpose during treatment with Invokana.

Minimal blood sugar (hypoglycemia)

Low blood glucose can happen for Invokana with another medication that can cause low blood glucose, instance sulfonylureas (glipizide, glimepiride) or insulin. Your treatment doses must be adjusted.

Signs or symptoms of reasonable blood sugar can include:

  • headache
  • drowsiness
  • weakness
  • confusion
  • dizziness
  • irritability
  • hunger
  • fast heartbeat
  • sweating
  • shaking or sensation jittery

Necrotizing Fasciitis of the Perineum (Fournier’s Gangrene)

Fournier’s Gangrene is a rare but significant infection that causes injury to the muscle beneath your skin (necrotizing fasciitis) in the region between and all over rectum and genitals (perineum). This could take place in men and women. Could need hospitalization, multiple surgeries, and might result in passing.

Request medical attention straight away when you yourself have fever or if you are experiencing very weakened, tired or unpleasant along with these symptoms in the area between and around your rectum and genitals:

  • pain
  • tenderness
  • swelling
  • redness of the skin (erythema)

Other adverse side effects with Invokana could include:

  • serious allergies, that might integrate redness, rash, irritation, hives, and angioedema (a puffiness under your skin which can happen around your vision, mouth, arms, throat, tongue, foot and/or genitals). When you yourself have any observeable symptoms of a life threatening hypersensitive reaction, stop taking Invokana and call your medical professional quickly or go right to the closest healthcare facility emergency room.
  • high potassium levels within blood, that may affect the cardiovascular system and may even end up being serious
  • bone fractures (busted limbs)
  • increase in cholesterol

Drug interactions

Invokana is also associated with some drug communications. Some connections can impact your dosage of Invokana and you may require a dose adjustment. Be sure to tell your doctor and pharmacist about all of the medications you are taking, such as prescription and non-prescription drugs, vitamins, and herbs. Especially tell your physician and pharmacist if you take:

  • diuretics (liquid products)
  • rifampin (for tuberculosis)
  • phenytoin or phenobarbital (for seizures)
  • ritonavir (for HIV infection)
  • digoxin (for heart related illnesses).

Pregnancy and Breastfeeding

Tell the doctor if you are expecting or want to get pregnant while having Invokana. Invokana may damage the developing fetus.

Invokana might move to your breast dairy. Dont breastfeed while taking Invokana.

Consult with your medical professional about the most effective way to control the blood glucose while you are pregnant. In addition discuss the best way to nourish your baby if you should be having Invokana.

Try not to simply take Invokana:

  • if you have a significant allergic reaction to canagliflozin or any component in Invokana
  • if you have got severe kidney impairment or take dialysis
  • if you really have sort 1 diabetes
  • if you may have serious liver disease
  • to treat ketoacidosis
  • if you might be breastfeeding

Speak your doctor if you think you fall into these groups.

Bottom Line

  • There are many essential warnings and side effects available prior to beginning therapy with Invokana. Many leading problems feature amputations, dehydration, reduced blood circulation pressure, and vaginal fungus infections.
  • Your pharmacist offers a Medication Guide when you fill your own prescription for Invokana. You should re-read it with each brand-new refill in the eventuality of new or updated information.
  • Always talk to your physician before starting treatment with any medicine about cautions, negative effects and medicine relationships might impact your health.

It is not all the info you must know about Invokana (canagliflozin) for safe and effective usage. Review the complete Invokana info right here, and confer with your health professional for those who have questions or concerns.


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