If you have type 2 diabetes, your doctor may recommend Invokana as a treatment option. It’s a prescription medication that’s used in adults with type 2 diabetes to:

  • help manage blood sugar levels, along with a balanced diet and exercise
  • lower the risk of serious cardiovascular (heart and blood vessel) problems in people who also have cardiovascular disease
  • lower the risk of certain complications from diabetic nephropathy (kidney damage caused by diabetes)

Your doctor may prescribe Invokana for these uses only in certain situations. To learn more about how Invokana is used, see “What is Invokana used for?” below.

Invokana basics

Invokana contains the active drug canagliflozin. It belongs to a group of drugs called sodium-glucose transport protein 2 (SGLT2) inhibitors.

Invokana comes as a tablet that you take by mouth. It’s not currently available in generic form.

In this article we provide more information about Invokana, including its side effects, dosage, and cost.

Like most drugs, Invokana may cause mild or serious side effects. The lists below describe some of the more common side effects that Invokana may cause. These lists don’t include all possible side effects.

Keep in mind that side effects of a drug can depend on:

  • your age
  • other health conditions you have
  • other medications you take

Your doctor or pharmacist can tell you more about the potential side effects of Invokana. They can also suggest ways to help reduce side effects.

Mild side effects

Here’s a short list of some of the mild side effects that Invokana can cause. To learn about other mild side effects, talk with your doctor or pharmacist, or read Invokana’s prescribing information.

Mild side effects of Invokana that have been reported include:

Mild side effects of many drugs may go away within a few days to a couple of weeks. But if they become bothersome, talk with your doctor or pharmacist.

* For more information about this side effect, see the “Side effect focus” section below.

Serious side effects

Serious side effects from Invokana can occur, but they aren’t common. If you have serious side effects from Invokana, call your doctor right away. If you think you’re having a medical emergency, you should call 911 or your local emergency number.

Serious side effects of Invokana that have been reported include:

* For more information about this side effect, see the “Side effect focus” section below.

Side effect focus

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

Amputation

Invokana may increase your risk of needing a lower limb amputation. This was rare in studies, though.

Lower limb amputation is surgery to remove all or part of a leg, foot, or toe. This may be needed if you have a wound that doesn’t heal, or a serious infection that doesn’t get better with medication.

If you have diabetes, which Invokana is used to treat, you have a higher risk of lower limb infections and amputation. This is because diabetes can damage your blood vessels and lead to poor blood flow in your lower legs and feet. This makes it harder for your body to heal wounds and infections, and they can become serious.

Diabetes can also damage your nerves and lead to reduced feeling in your lower legs and feet. So you may not notice injuries, sores, or ulcers until they become severe.

Your risk of lower limb amputation is also higher if you have:

What might help

While you take Invokana, there are a few things you can do lower your risk for wounds and infections that might lead to lower limb amputation. Following your diabetes treatment plan to keep your blood sugar well-managed is important.

It’s also important to take good care of your feet, especially if you have nerve damage or poor blood flow. This article has tips for foot care with diabetes.

See your doctor right away if you have symptoms of wounds, ulcers, or infections on your legs or feet. Symptoms may include:

  • new pain or tenderness in your leg or a foot
  • warmth, redness, or discoloration of the skin on your leg or foot
  • ulcers, blisters, or other wounds on your leg or foot

If you have a wound, ulcer, or infection on your legs or feet, your doctor may recommend stopping Invokana until it heals.

Genital yeast infections and Fournier’s gangrene

Invokana may increase your risk of genital yeast infections. These are usually mild.

Invokana may also increase your risk for a rare but serious infection called Fournier’s gangrene. With this condition, tissue in the genital area dies due to lack of blood flow.

It’s worth noting that having diabetes also increases your risk of genital yeast infections and Fournier’s gangrene.

Genital yeast infections

In studies, genital yeast infections were among the more common side effects reported with Invokana.

Symptoms of a vaginal yeast infection may include:

  • irritation, burning, itching, or soreness in and around the vagina
  • thick, white vaginal discharge that doesn’t usually have an odor
  • vaginal burning, stinging, or soreness during sex or urination

Symptoms of a penile yeast infection can include:

  • redness, irritation, and burning around the head of the penis and under the foreskin
  • trouble pulling back the foreskin
  • thick white discharge from the penis, which might have an odor

With Invokana, genital yeast infections are more common in females* than in males.* They’re also more common in people who’ve had past genital yeast infections, and in males who haven’t been circumcised.

* In this article, we use the terms “male” and “female” to refer to someone’s sex assigned at birth. For information about the difference between sex and gender, see this article.

Fournier’s gangrene

In studies, Fournier’s gangrene was reported rarely with Invokana.

Fournier’s gangrene is a serious infection that affects the perineum (the area between the genitals and the anus). It sometimes requires surgical treatment, and it can be life-threatening. Symptoms can include:

  • pain, tenderness, or swelling in the genitals or perineum
  • warmth, redness, or discoloration of the genitals or perineum
  • fever
  • generally feeling unwell

What might help

There are some things you can do to help prevent genital infections, such as avoiding tight clothing. This article has some tips.

If you have symptoms of a genital yeast infection while taking Invokana, talk with your doctor or pharmacist. They can recommend a treatment, such as miconazole (Monistat) cream, to put on the area.

If your yeast infection symptoms haven’t cleared up after a week, see your doctor. You may need a different medication to treat the infection. If you get yeast infections often, consider talking with your doctor about medication to prevent this.

If you have symptoms of Fournier’s gangrene while taking Invokana, see your doctor right away. This infection usually needs urgent treatment with prescribed antibiotics. In some cases, you may need treatment in hospital or surgery to remove the infected tissue. Your doctor will likely recommend that you stop taking Invokana.

Diabetic ketoacidosis

Invokana may rarely cause a serious side effect called diabetic ketoacidosis. This is a life-threatening medical emergency that needs to be treated in a hospital.

Diabetic ketoacidosis occurs when cells in your body use fat for energy instead of sugar. When your body breaks down fats too quickly, high levels of acidic chemicals called ketones can build up in your blood.

Symptoms of diabetic ketoacidosis can include:

Your risk for diabetic ketoacidosis may be higher if you’ve had pancreatitis (inflammation in your pancreas). It’s also higher if you have a fever, have surgery, drink large amounts of alcohol, or if you eat less than usual.

What might help

To help lower your risk of diabetic ketoacidosis with Invokana, avoid drinking large amounts of alcohol. Tell your doctor right away if you have a fever, or you’re eating less than usual (such as if you’re feeling sick or fasting).

Also, ask your doctor if you’ll need to stop taking Invokana before any planned surgeries. If you do stop Invokana, your doctor will tell you when to start taking it again after the surgery.

If you have symptoms of ketoacidosis, stop taking Invokana and call your doctor right away. If your symptoms feel life-threatening, call 911 or your local emergency number. Diabetic ketoacidosis needs to be treated in a hospital.

Allergic reaction

Some people may have an allergic reaction to Invokana. This wasn’t very common in studies of the drug.

Symptoms of a mild allergic reaction can include:

  • skin rash
  • itchiness
  • flushing (temporary warmth, redness, or deepening of skin color)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include swelling under your skin, typically in your eyelids, lips, hands, or feet. They can also include swelling of your tongue, mouth, or throat, which can cause trouble breathing.

Call your doctor right away if you have an allergic reaction to Invokana. But if you think you’re having a medical emergency, call 911 or your local emergency number.

Your doctor will recommend the dosage of Invokana that’s right for you. Below are commonly used dosages, but always take the dosage your doctor prescribes.

Form

Invokana comes as a tablet that you take by mouth.

Strength: 100 mg and 300 mg

Invokana is available in two strengths: 100 milligrams (mg) and 300 mg.

Recommended dosage

Invokana’s recommended dosage for all of the drug’s uses is one tablet, once per day.

The dosage your doctor prescribes may depend on other medications you take. It may also depend on your kidney function, which is called renal dosing. You’ll have a blood test to check your kidney function before starting Invokana. Invokana may not be recommended if your kidney function is below a certain level.

If the recommended dosage doesn’t work well enough for your blood sugar levels and your kidney function is normal, your doctor may increase your dose up to the maximum dose. Your doctor can tell you what the drug’s maximum dose is and provide details.

Questions about Invokana’s dosage

  • What if I miss a dose of Invokana? If you miss a dose, take it as soon as possible — unless it’s almost time for your next dose. In this case, skip the missed dose and take your next scheduled dose as usual. Don’t take two doses together to make up for a missed dose. This could cause serious side effects.
  • Will I need to use Invokana long term? Yes, Invokana is meant to be used as a long-term treatment. If you and your doctor agree that your treatment is going well, you’ll likely take the drug long term.
  • How long does Invokana take to work? Invokana starts to work within a few hours after taking your first dose. But it might take a few weeks before your A1C level improves. (A1C is a measure of your blood sugar levels over the past 3 months.) It’s not known how long Invokana takes to lower the risk of complications or heart and blood vessel problems or kidney damage.

Find answers to some commonly asked questions about Invokana.

What alternatives does Invokana have?

There are other treatment options for each of Invokana’s uses. The options available to you will depend on various factors, including your health history and why you’re taking Invokana.

Invokana is used in adults with type 2 diabetes to help manage blood sugar levels. It’s also used to prevent certain complications of cardiovascular (heart and blood vessel) disease or diabetic nephropathy. It belongs to a group of drugs called sodium-glucose transport protein 2 (SGLT2) inhibitors.

For managing blood sugar levels and preventing cardiovascular problems, alternatives include:

To prevent complications of diabetic nephropathy, alternatives include:

If you’re interested in an alternative to Invokana, talk with your doctor. To read more about how Invokana compares with Farxiga and Jardiance, see “What should I know about Invokana vs. Jardiance?” and “What should I know about Invokana vs. Farxiga?” below.

How does Invokana work?

Invokana’s mechanism of action (the way the drug works) is to make your kidneys remove more sugar, sodium (salt), and water from your blood. Your body then gets rid of these substances in your urine.

By helping your body get rid of excess sugar from your blood, Invokana can help manage blood sugar levels.

By removing sodium and water from your blood, Invokana can reduce strain on your heart, blood vessels, and kidneys. This, along with well-managed blood sugar, lowers the risk of certain cardiovascular complications of diabetes. These include heart attack, heart failure, and stroke. Invokana also helps prevent worsening kidney function in people with diabetic nephropathy.

Is Invokana used for weight loss?

No, Invokana isn’t used for weight loss. But some people taking Invokana do lose weight. This is because the medication helps your body get rid of excess sugar through your urine. This reduces the amount of sugar that your body stores as fat.

For helping to manage blood sugar levels, Invokana is prescribed with a balanced diet and exercise. This can also lead to weight loss during Invokana treatment.

Weight loss can be beneficial for people with type 2 diabetes. But you shouldn’t take Invokana specifically for weight loss. Talk with your doctor about how to reach or maintain a weight that’s healthy for you.

What should I know about stopping Invokana? Will I have withdrawal symptoms?

Invokana is meant to be used as a long-term treatment. You should not stop taking it without your doctor’s recommendation.

If you and your doctor decide you should stop taking Invokana, you won’t have to taper (slowly lower) your dosage. Invokana doesn’t cause withdrawal symptoms (effects that occur after stopping a drug that your body has become dependent on).

But stopping Invokana can cause your blood sugar levels to increase. Your risk of complications from heart, blood vessel, or kidney problems may increase after stopping treatment.

If you’re considering stopping Invokana, talk with your doctor first. They can determine the best diabetes treatment plan for you.

Does Invokana cause hair loss, pancreatitis, or joint pain?

No, this isn’t likely. Hair loss and joint pain weren’t reported in studies of Invokana.

Pancreatitis (inflammation of the pancreas) was rarely reported in studies. But this side effect also occurred at a similar rate in people who took a placebo.* So it’s unlikely that Invokana caused pancreatitis in these studies.

Joint pain or pancreatitis can be a side effect of certain other diabetes drugs. The Food and Drug Administration issued a warning about joint pain occurring with a group of diabetes drugs called dipeptidyl peptidase-4 (DPP-4) inhibitors. These drugs can also cause pancreatitis.

But Invokana doesn’t belong to this group of medications. Instead, it belongs to a group of drugs called SLGT2 inhibitors.

If you’re concerned about your risk of hair loss, pancreatitis, or joint pain, talk with your doctor.

* A placebo is a treatment with no active drug.

Can I view images of Invokana or reviews from people who’ve taken it?

It’s possible to find images of Invokana tablets online. It’s also possible to find online reviews from people who’ve taken Invokana. But keep in mind that each person taking Invokana may have a different experience.

If you’re interested in viewing images of Invokana or finding out what to expect when taking this medication, it’s best to talk with your doctor or pharmacist. They can show you what the drug looks like. They can also talk with you about how your health history may affect your treatment with Invokana.

Invokana and Jardiance belong to the same group of drugs, called sodium-glucose transport protein 2 inhibitors. They have similar uses and side effects, but there are some differences between them.

Talk with your doctor about whether Invokana or Jardiance is right for you. To learn more about these drugs, see this detailed comparison.

Prices of prescription drugs can vary depending on many factors. These factors include what your insurance plan covers and which pharmacy you use. To find current prices for Invokana tablets in your area, visit GoodRx.com.

If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. You can also visit the Invokana manufacturer’s website to see if they have support options.

You can also check out this article to learn more about saving money on prescriptions.

Invokana and Farxiga belong to the same group of drugs, called sodium-glucose transport protein 2 (SGLT2) inhibitors. They have similar uses and side effects, but there are some differences between them.

To read more about how these medications compare, see this article. Also, check with your doctor to see which drug is better for your condition.

Invokana is a medication that’s prescribed for use in certain adults with type 2 diabetes. It’s used to:

Invokana helps manage blood sugar levels by helping your body get rid of excess sugar, sodium (salt), and fluid through your urine. This reduces strain on your heart, blood vessels, and kidneys, and lowers your risk of cardiovascular or kidney complications.

Note: Your doctor will not prescribe Invokana:

Your doctor will explain how you should take Invokana. They’ll also explain how much to take and how often. Be sure to follow their instructions.

Taking Invokana

You may wonder when to take your daily dose of Invokana. In general, it’s best to take Invokana in the morning, before breakfast.

Taking Invokana with other drugs

Your doctor might prescribe Invokana along with other drugs for type 2 diabetes. For example, Invokana is commonly taken with metformin (Riomet, Glumetza, Fortamet).

Questions about taking Invokana

  • Can Invokana be chewed, crushed, or split? No, Invokana should be swallowed whole. If you have trouble swallowing the tablet whole, see this page for some tips.
  • Should I take Invokana with food? No. You should take Invokana just before your first meal of the day.
Questions for your doctor

You may have questions about Invokana and your treatment plan. It’s important to discuss all your concerns with your doctor.

Here are a few tips that might help guide your discussion:

  • Before your appointment, write down questions such as:
    • How will Invokana affect my body, mood, or lifestyle?
  • Bring someone with you to your appointment if doing so will help you feel more comfortable.
  • If you don’t understand something related to your condition or treatment, ask your doctor to explain it to you.

Remember, your doctor and other healthcare professionals are available to help you. And they want you to get the best care possible. So, don’t be afraid to ask questions or offer feedback on your treatment.

Before prescribing Invokana, your doctor will consider other medical conditions you may have and other medications you take. They’ll also consider the effect Invokana may have on your overall health. Here are some of the things you and your doctor will likely discuss.

Interactions

Taking a medication with certain vaccines, foods, and other things can affect how the medication works. These effects are called interactions.

Before taking Invokana, be sure to tell your doctor about all medications you take, including prescription and over-the-counter types. Also describe any vitamins, herbs, or supplements you use. Your doctor or pharmacist can tell you about any interactions these items may cause with Invokana.

Interactions with drugs or supplements

Invokana can interact with several types of drugs. If your doctor prescribes any of these medications for you, they may adjust your dosages or monitor you more carefully while you’re taking Invokana. These drugs include:

  • other diabetes drugs, particularly insulin or a group of drugs called sulfonylureas (such as glipizide [Glucotrol]), as these medications can lead to hypoglycemia (low blood sugar levels) if taken with Invokana
  • blood pressure drugs
  • certain antipsychotic drugs
  • certain asthma drugs
  • corticosteroid drugs (medications used to reduce inflammation)
  • diuretic drugs (also called “water pills,” drugs used for high blood pressure or excess fluid in the body)
  • the heart condition drug digoxin (Lanoxin)
  • the seizure drugs phenytoin (Dilantin) and phenobarbital
  • the antibiotic rifampin (Rifadin, Rimactane)
  • the HIV drug ritonavir (Norvir)

This list does not contain all types of drugs that may interact with Invokana. Your doctor or pharmacist can tell you more about these interactions and any others that may occur with use of Invokana.

Other interactions

Talk with your doctor before taking herbs or supplements with Invokana. Some herbs and supplements can affect your blood sugar levels, so they could affect your Invokana treatment.

Invokana will cause your urine to test positive for glucose (sugar). You shouldn’t use urine glucose tests while taking this drug.

Warnings

Invokana may not be right for you if you have certain medical conditions or other factors that affect your health. Talk with your doctor about your health history before you take Invokana. Factors to consider include those in the list below.

  • 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 are better options for you.
  • Use of certain diabetes medications. Certain diabetes drugs can increase your risk of hypoglycemia while taking Invokana. These include insulin and a group of drugs called sulfonylureas, such as glipizide (Glucotrol). Your doctor will likely adjust the dosage of your other diabetes medications to lower this risk.
  • Kidney problems. If you have kidney problems, Invokana may not work as well for you. It may also worsen your kidney problems or increase your risk of certain side effects, such as dehydration (low fluid level). If you have severe kidney problems, or you’re having dialysis treatment, your doctor will likely not prescribe Invokana. Ask your doctor what other medications might be better for you.
  • Severe liver problems. Invokana hasn’t been studied in people with severe liver problems. Your doctor may not prescribe Invokana if you have severe liver problems. Ask what other medications may be better for you.
  • History of pancreatitis (inflammation in your pancreas). Invokana can cause a serious side effect called diabetic ketoacidosis (high levels of ketones in your blood or urine). You may have a higher risk for this side effect if you’ve had pancreatitis in the past. Talk with your doctor about whether Invokana is right for you.
  • Older age. If you’re age 65 years or older, you may have a higher risk for certain side effects with Invokana. These include dehydration, dizziness, and low blood pressure. Talk with your doctor about whether this medication is right for you.

For information about conditions that can increase the risk of certain side effects with Invokana, see “What are Invokana’s side effects?” above.

Invokana and alcohol

You shouldn’t drink large amounts of alcohol while taking Invokana. This means regularly drinking alcohol on several days per week or drinking a lot of alcohol at once.

Drinking large amounts of alcohol can raise your risk for certain serious side effects of Invokana. These include dehydration and diabetic ketoacidosis. See “What are Invokana’s side effects?” above to read more about these side effects. Alcohol can also increase your risk of hypoglycemia.

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

Pregnancy and breastfeeding

It’s not known if Invokana is safe to take during pregnancy. Your doctor will likely not prescribe Invokana during pregnancy, especially during the second or third trimesters. If you’re pregnant or planning to become pregnant, talk with your doctor about the best way to treat your diabetes.

It’s not known if Invokana passes into breast milk. But if it does, it may harm a child who’s breastfed. For this reason, you should not breastfeed while taking Invokana. Your doctor can recommend other ways to feed your child.

Don’t take more Invokana than your doctor prescribes. Using more than this can lead to serious side effects.

What to do in case you take too much Invokana

Call your doctor if you think you’ve taken too much Invokana. You can also call 800-222-1222 to reach the American Association of Poison Control Centers, or use its online resource. If you have severe symptoms, immediately call 911 or your local emergency number. Or, go to the nearest emergency room.

Invokana is a treatment option for certain adults with type 2 diabetes, especially if you have a risk of cardiovascular (heart or blood vessel) or kidney complications. If you have questions about this medication, talk with your doctor. Examples of questions you might want to ask include:

  • How effective is Invokana for managing blood sugar levels and preventing cardiovascular or kidney problems?
  • What are my risks for cardiovascular or kidney problems if I don’t take Invokana?
  • Do I need to check my blood sugar levels while taking Invokana?
  • Do I have a high risk of side effects with Invokana?
  • Can I take Invokana with my other medications?

Your doctor can help you decide if Invokana might be right for you. They can also talk with you about other treatment options. Below are some articles that might be helpful for your discussion:

For tips on managing type 2 diabetes, subscribe to Healthline’s type 2 diabetes newsletter. To stay up to date on heart health information, you can sign up for Healthline’s heart health newsletter.

Disclaimer: Healthline 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.