If you have type 2 diabetes, your doctor might suggest Invokana (canagliflozin) as a treatment option for your condition. Invokana is a prescription drug that’s used in adults with type 2 diabetes to:

  • help manage blood sugar levels, along with diet and exercise
  • lower the risk for certain heart or blood vessel problems in people who also have heart disease
  • reduce the risk for heart problems and worsened kidney problems in people who also have kidney disease

Invokana is a tablet that you take by mouth once daily. It’s used as a long-term treatment. For more details about these uses of Invokana and certain limitations of its use, see this in-depth article on the drug.

Like other drugs, Invokana can cause mild or serious side effects. (Side effects are sometimes also called adverse effects.) Read on to learn more.

Some people may experience mild or serious side effects during their Invokana treatment. Some of the more commonly reported side effects of Invokana include:

These are just a few of the more common side effects reported by people who took Invokana in studies. These side effects can vary depending on what condition the drug is being used to treat.

* To learn more about this side effect, see “Side effects explained” below.

Invokana may cause mild side effects in some people. Examples of mild side effects that have been reported with Invokana include:

* To learn more about this side effect, see “Side effects explained” below.

In most cases, these side effects should be temporary. And some may be easily managed, too. But if you have any symptoms that are ongoing or that bother you, talk with your doctor or pharmacist. And don’t stop using Invokana unless your doctor recommends it.

Invokana may cause mild side effects other than the ones listed above. See the Invokana medication guide for details.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks side effects of the medication. If you’d like to notify the FDA about a side effect you’ve had with Invokana, visit MedWatch.

Serious side effects are less common with Invokana, but they can occur. Some serious side effects that have been reported with Invokana include:

If you develop serious side effects while taking Invokana, call your doctor right away. If the side effects seem life threatening or if you think you’re having a medical emergency, immediately call 911 or your local emergency number.

* To learn more about this side effect, see “Side effects explained” below.

Get answers to some frequently asked questions about Invokana’s side effects.

Do the side effects of Invokana vary depending on the strength I use (100 mg or 300 mg)?

No. In studies, people who took 100 milligrams (mg) of Invokana reported similar side effects to those who took 300 mg.

Does Invokana cause joint pain or muscle pain?

No, Invokana isn’t known to cause joint or muscle pain. These weren’t reported side effects in studies of Invokana.

Joint and muscle pain can be side effects of other medications you may be taking. Joint pain may be caused by a type of diabetes drug called a DPP-4 inhibitor. Examples of DPP-4 inhibitors include Tradjenta (linagliptin), Onglyza (saxagliptin), and Januvia (sitagliptin).

Muscle pain can be a side effect of statins. Statin drugs are often prescribed for people with type 2 diabetes who also have high cholesterol. They’re used to lower your cholesterol and reduce your risk for heart attack and stroke. Examples of statin drugs include Lipitor (atorvastatin), Crestor (rosuvastatin), and Zocor (simvastatin).

Could Invokana cause any feet-related side effects?

It’s possible. Taking Invokana may raise your risk for lower limb amputations (surgery to remove a toe, foot, or part of your leg). This risk may be greater if you currently have any foot problems or have had them in the past. But foot-related problems are also a complication of diabetes.

Having diabetes can lead to nerve damage. This can cause pain, tingling, or numbness in your feet. With numbness in particular, you may not notice a cut or sore on your foot or toe. This could lead to minor injuries becoming infected.

Over time, diabetes can also cause reduced blood flow in your feet. Without proper circulation, it can be hard for infections to heal. If foot infections become severe, they may not get better, even with treatment.

Lower limb amputations are sometimes the only option to help prevent life threatening infections from spreading to the rest of your body.

With diabetes, it’s important to take good care of your feet. Otherwise, you may be in danger of problems that can lead to amputation.

If you’re taking Invokana, proper foot care is especially important. This includes:

  • keeping your feet clean and toenails trimmed
  • checking your feet daily for minor injuries
  • seeing your doctor when you notice problems with your feet
  • having regular physical exams with your doctor
  • consulting a podiatrist (foot doctor) who specializes in diabetic foot care (if necessary)

Does Invokana cause any specific side effects in males, such as erectile dysfunction?

It’s not likely. Sexual side effects in males, such as erectile dysfunction (ED), weren’t reported in studies of Invokana.

But diabetes is a well-known cause of sexual problems in men and women. About half of men with diabetes develop ED.

Managing your blood sugar may help reduce your risk for ED. Ways to do this include:

  • taking your diabetes medications such as Invokana as prescribed
  • reaching or maintaining a healthy weight with a balanced diet and exercise
  • tracking your blood sugar levels regularly, if instructed by your doctor

Could using Invokana cause depression?

No, Invokana isn’t known to cause depression. This wasn’t a reported side effect in studies of Invokana.

But there may be a link between diabetes and depression. If you think you may be experiencing depression, talk with your doctor.

Will stopping my Invokana treatment cause any side effects?

No, stopping Invokana treatment doesn’t cause any side effects. But without treatment, your blood sugar levels may go up. You shouldn’t stop taking Invokana unless your doctor recommends it.

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.

Factors that increase your risk for lower limb amputation. Taking Invokana raises the risk of lower limb amputation (surgical removal of a toe, foot, or part of your leg). Certain factors increase this risk, such as:

If you have any of these risk factors, talk with your doctor before using Invokana. Your doctor may monitor you more carefully while you’re taking this drug. Or depending on your risk level, they may recommend a different treatment option.

Factors that raise your risk for dehydration. Taking Invokana can make you urinate more often than usual. Losing too much fluid can cause your body to become dehydrated. This could lead to hypotension (low blood pressure). You may have a higher risk for dehydration if one or more of the following factors apply to you:

If you have any of these risk factors, talk with your doctor. They may monitor your blood pressure more carefully while you’re taking Invokana. Or depending on your risk level, they may recommend a different treatment option.

Allergic reaction. If you’ve had an allergic reaction to Invokana or any of its ingredients, you shouldn’t take Invokana. Ask your doctor what other medications are better options for you.

Dialysis. If you’re using dialysis for end stage kidney disease, you shouldn’t take Invokana. The drug hasn’t been studied in people using dialysis for this condition. Your doctor can suggest other treatment options for your condition.

Kidney damage or cancer. Invokana isn’t recommended for people who have reduced kidney function. Also, if you have renal cell cancer or have had it in the past, talk with your doctor about whether Invokana is safe for you.

Severe liver damage. If you’ve had serious liver problems, ask your doctor if it’s safe for you to take Invokana. This drug hasn’t been studied in people who have severe liver damage.

Upcoming surgery. If you’re scheduled for a surgical procedure or operation, be sure to tell your doctor before starting Invokana. They’ll likely wait to start your Invokana treatment until after your surgery. Or they may have you temporarily stop taking Invokana at least 3 days before your surgery. This is because having surgery can raise your risk for diabetic ketoacidosis, and so can taking Invokana.

Alcohol use and Invokana

Drinking excessive amounts of alcohol during your Invokana treatment can be harmful. It can raise your risk for serious side effects from Invokana. These include dehydration from increased urination or vomiting and diabetic ketoacidosis.

If you drink alcohol, it’s recommended that you limit your alcohol use while taking Invokana. If you have questions, talk with your doctor.

Pregnancy and breastfeeding while taking Invokana

Taking Invokana isn’t recommended during the second and third trimesters of pregnancy.

In animal studies of the drug, harmful effects on the kidney development of fetuses were seen. Animal studies don’t always predict what will happen in humans. But because of this possible risk, using Invokana during the second or third trimesters of pregnancy isn’t recommended.

If you’re currently pregnant or planning to become pregnant while taking Invokana, talk with your doctor right away. They’ll likely suggest other treatments to safely manage your blood sugar during this time.

Also, animal studies showed that Invokana passes into the breast milk of rats. Because of this possible risk in humans, breastfeeding while using Invokana isn’t recommended. Your child’s kidneys are still developing during their first 2 years of life, and Invokana may be harmful to developing kidneys.

If you’re breastfeeding or planning to breastfeed, talk with your doctor about the best treatment plan for your condition.

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

Weight loss

Some people may lose weight while taking Invokana, but your results may vary. Weight changes may also depend on your dose and whether you’re using certain other diabetes medications.

It’s important to note that Invokana isn’t meant to be used as a weight-loss drug.

If you have questions about weight loss during your Invokana treatment, talk with your doctor.

What might help

Because weight loss can occur with Invokana, your doctor may recommend this drug if you could benefit from losing weight. For some people, losing weight can help them better manage their blood sugar levels.

Kidney damage

Although it’s less common, kidney damage can be a serious side effect of Invokana. Symptoms of kidney damage may include:

In reports of people using Invokana after it was released onto the market, people regained normal kidney function when they stopped taking the drug. But you shouldn’t stop taking Invokana unless your doctor recommends it.

What might help

Before you start using Invokana, your doctor will test your blood to check how well your kidneys are working. If your kidneys are healthy, you can likely take this medication. But you’ll probably need to have your blood tested regularly during your treatment to monitor your kidneys.

Staying well hydrated while taking Invokana may also reduce your risk for kidney problems during Invokana treatment. If you have questions or concerns about your risk for kidney damage with Invokana, talk with your doctor.

Yeast infection of the vagina or penis

Invokana may cause a yeast infection in the vagina or penis. In studies of Invokana, vaginal yeast infections were the most common side effect.

Genital yeast infections are more common in females* taking Invokana, but they can also occur in males* taking the drug. The risk for yeast infection is higher in uncircumcised males.

Symptoms can vary with genital yeast infections, but they usually include:

  • itching of the genitals and surrounding areas
  • painful or swollen genitals
  • thick white discharge

* 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.

What might help

If you develop symptoms of a yeast infection, call your doctor. They’ll likely recommend a treatment to clear the infection. Treatment options include over-the-counter medications such as Monistat, or prescription drugs such as Diflucan (fluconazole).

Consider adopting these healthy habits to help prevent genital yeast infections with Invokana:

  • Avoid sexual activity while you or your partner has a yeast infection. (Genital yeast infections can be sexually transmitted.)
  • Eat foods that help balance out the bacteria in your body, such as certain yogurts. Talk with your doctor to learn more.
  • Always wipe from front to back after using the bathroom. This helps prevent the spread of bacteria to the genitals.

If you have questions about your risk for yeast infections, or you have a recurring yeast infection problem, talk with your doctor.

Urinating more often than usual

In some people, using Invokana may affect urination. This side effect may occur as one or more of the following symptoms:

  • urinating more often than usual
  • increased amount of urine
  • having an urgent need to urinate
  • having to get up during the night to urinate

What might help

If you’re urinating more often than usual, your risk for dehydration increases. That’s why it’s important to drink plenty of fluids while taking Invokana.

To help reduce nighttime bathroom trips that interrupt your sleep, consider limiting your intake of fluids a few hours before bedtime.

If you’re experiencing these symptoms or have concerns about this side effect, talk with your doctor.

Allergic reaction

Like most drugs, Invokana can cause an allergic reaction in some people. In studies, mild allergic reactions were common. Severe allergic reactions to Invokana were rare in clinical studies.

Symptoms can be mild or serious and can include:

  • rash
  • itchiness
  • flushing (temporary warmth, redness, or deepening of skin color)
  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your mouth, tongue, or throat, which can make it hard to breathe

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest an over-the-counter oral antihistamine, such as Benadryl (diphenhydramine), or a topical product, such as hydrocortisone cream, to manage your symptoms.

If your doctor confirms you had a mild allergic reaction to Invokana, they’ll decide if you should continue using it.

If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If your doctor confirms you had a serious allergic reaction to Invokana, they may have you switch to a different treatment.

Keeping track of side effects

During your Invokana treatment, consider keeping notes on any side effects you’re having. Then, you can share this information with your doctor. This is especially helpful to do when you first start taking new drugs or using a combination of treatments.

Your side effect notes can include things such as:

  • what dose of drug you were taking when you had the side effect
  • how soon after starting that dose you had the side effect
  • what your symptoms were from the side effect
  • how it affected your daily activities
  • what other medications you were also taking
  • any other information you feel is important

Keeping notes and sharing them with your doctor will help your doctor learn more about how a drug affects you. And your doctor can use this information to adjust your treatment plan if needed.

Invokana is an effective treatment for managing your blood sugar with type 2 diabetes. It may also help reduce your risk for heart or kidney problems, depending on your other health conditions.

It’s common to feel concerned about side effects when you’re considering a new medication. If you have questions about Invokana’s side effects, talk with your doctor or pharmacist. Here are a few questions you might want to ask:

  • Are there other ways to help prevent side effects from Invokana?
  • Do my other medications increase my risk for side effects from Invokana?
  • Should I check my blood sugar or blood pressure at home to help watch for side effects?

For tips on healthy eating, managing your condition, and more, sign up to Healthline’s type 2 diabetes newsletter.

Q:

Can drinking cranberry juice help prevent urinary tract infections (UTIs) during my Invokana treatment?

Anonymous patient

A:

Possibly. It should be safe to drink cranberry juice during your Invokana treatment. There are mixed results showing that a chemical in cranberries may help prevent UTIs, but more studies are needed. Also, cranberry juice or cranberries don’t treat a current UTI.

Many cranberry juices have added sugar, which may raise your blood sugar level. So your doctor may suggest drinking unsweetened juice or taking cranberry supplements.

You should talk with your doctor before using cranberry juice or supplements as part of your daily routine. They can help determine if it’s right for you and how much you should use. Your doctor can also suggest other ways to help prevent a UTI during your Invokana treatment.

Dana Kim, PharmDAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.

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 other 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.