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Medical Disclaimer: This information is for educational purposes only and is not a substitute for professional medical advice.
Different strengths and dosage forms
| Strength | Form | Route | NDC |
|---|---|---|---|
| 300 mg/1 | TABLET, FILM COATED | ORAL | 55154-1426 |
| 300 mg/1 | TABLET, FILM COATED | ORAL | 50090-5029 |
| 100 mg/1 | TABLET, FILM COATED | ORAL |
References used for this content
This page is for informational purposes only and does not replace medical advice. Before using any prescription or over-the-counter medication for Invokana, you must consult a qualified healthcare professional.
| 100 mg/1 | TABLET, FILM COATED | ORAL | 50090-5034 |
| 100 mg/1 | TABLET, FILM COATED | ORAL | 50458-140 |
| 300 mg/1 | TABLET, FILM COATED | ORAL | 50458-141 |
| 300 mg/1 | TABLET, FILM COATED | ORAL | 50090-4364 |
Detailed information about Invokana
Canagliflozin is a potent SGLT2 inhibitor used to manage blood glucose in type 2 diabetes and reduce the risk of major cardiovascular events and end-stage kidney disease in high-risk patients.
The standard starting dose of Canagliflozin for most adults is 100 mg taken once daily. This dose is effective for both glycemic control and providing cardio-renal protection. For patients who require additional blood sugar lowering and who tolerate the 100 mg dose well, healthcare providers may increase the dosage to 300 mg once daily, provided the patient's kidney function (estimated Glomerular Filtration Rate or eGFR) is sufficient.
In patients with established cardiovascular disease or diabetic nephropathy, the 100 mg dose is often the target dose for its protective benefits, even if blood sugar is already well-controlled. Your doctor will tailor the dose based on your specific health goals and laboratory results.
As of 2026, the safety and effectiveness of Canagliflozin in pediatric patients (under the age of 18) have not been fully established. Therefore, it is currently not approved for use in children. Clinical trials are ongoing to determine if SGLT2 inhibitors are safe for adolescent type 2 diabetes management.
Because Canagliflozin's efficacy and safety are closely tied to kidney function, dosage adjustments are mandatory based on eGFR (mL/min/1.73 m²):
Patients aged 65 and older are at a higher risk for volume depletion (dehydration) and low blood pressure. While no specific starting dose adjustment is required solely for age, healthcare providers often start at 100 mg and monitor kidney function and hydration status closely.
If you miss a dose, take it as soon as you remember. However, if it is almost time for your next scheduled dose, skip the missed dose and return to your regular schedule. Do not take two doses at the same time to make up for a missed one, as this increases the risk of side effects like dehydration or low blood pressure.
In the event of an overdose, contact your local Poison Control Center or seek emergency medical attention immediately. While there is no specific antidote for Canagliflozin, treatment usually involves supportive care, including monitoring of electrolytes and hydration. Because the drug is highly protein-bound, it is unlikely to be removed by hemodialysis.
> Important: Follow your healthcare provider's dosing instructions exactly. Do not adjust your dose or stop the medication without medical guidance, as this could lead to a significant rise in blood sugar levels.
The most frequently reported side effects of Canagliflozin are related to its mechanism of increasing glucose in the urine.
Canagliflozin is a powerful medication that requires careful monitoring. Patients must be aware that while it offers significant benefits for the heart and kidneys, it alters the body's fluid and electrolyte balance. Maintaining adequate hydration is the most critical daily precaution. Furthermore, patients should be educated on the symptoms of ketoacidosis, as this can occur even if blood sugar levels appear 'normal' on a home monitor.
No FDA black box warnings currently exist for Canagliflozin. The previous boxed warning regarding lower limb amputation was removed by the FDA in 2020. However, the risk remains a significant precaution, and patients should maintain diligent foot care.
There are no absolute 'never-use' drug-drug contraindications for Canagliflozin, but certain combinations require extreme caution or are effectively avoided due to risk. For example, using Canagliflozin while on dialysis is contraindicated because the drug requires functional kidneys to work.
Canagliflozin must NEVER be used in the following circumstances:
These conditions require a careful risk-benefit analysis by a specialist:
Based on animal data showing adverse renal effects in developing fetuses, Canagliflozin is not recommended during the second and third trimesters of pregnancy.
It is not known if Canagliflozin passes into human breast milk. However, because the drug could potentially affect the kidney development of a nursing infant, the current recommendation is to
Canagliflozin is an inhibitor of the sodium-glucose co-transporter 2 (SGLT2). SGLT2 is the primary transporter responsible for the reabsorption of glucose from the glomerular filtrate back into the systemic circulation. By inhibiting SGLT2, Canagliflozin reduces the renal threshold for glucose (RTG) and increases urinary glucose excretion (UGE). This results in a direct reduction of plasma glucose levels. Additionally, by inhibiting sodium reabsorption, it promotes natriuresis, which reduces preload and afterload on the heart and lowers intraglomerular pressure, providing cardiovascular and renal benefits.
Following a single oral dose, the increase in urinary glucose excretion is dose-dependent and persists for 24 hours. In healthy subjects, a 300 mg dose can result in the excretion of approximately 70 to 100 grams of glucose per day. This caloric loss contributes to the weight reduction observed in clinical trials. The onset of effect is rapid, with increased glucose excretion occurring within the first few hours of the first dose.
| Parameter | Value |
Common questions about Invokana
Canagliflozin is primarily used to manage blood sugar levels in adults with type 2 diabetes alongside diet and exercise. Beyond glucose control, it is FDA-approved to reduce the risk of major cardiovascular events like heart attacks and strokes in patients with established heart disease. It is also a vital treatment for reducing the risk of end-stage kidney disease and heart failure hospitalizations in patients with diabetic kidney disease. By helping the kidneys remove excess sugar through urine, it provides a multi-faceted approach to managing diabetes complications. It is not intended for use in type 1 diabetes.
The most common side effects are genital yeast infections in both women and men, as well as urinary tract infections. Because the drug works by increasing the amount of sugar in your urine, it creates an environment where yeast and bacteria can grow more easily. Other frequent side effects include increased urination, thirst, and mild constipation. Some patients may also experience dizziness or lightheadedness due to the drug's mild diuretic (water-losing) effect. Most of these side effects are manageable, but you should report persistent symptoms to your doctor.
It is generally advised to limit alcohol consumption while taking Canagliflozin. Alcohol can increase your risk of developing diabetic ketoacidosis, a life-threatening condition that can occur even if your blood sugar is not very high. Additionally, alcohol contributes to dehydration, which can worsen the volume-depletion effects of the medication. Heavy drinking can also interfere with your ability to recognize symptoms of low blood sugar. Always discuss your alcohol habits with your healthcare provider to ensure your safety while on this medication.
Canagliflozin is generally not recommended during pregnancy, especially during the second and third trimesters. Animal studies have shown that the drug may interfere with the normal development of the fetal kidneys. If you are pregnant or planning to become pregnant, it is crucial to talk to your doctor about alternative ways to manage your blood sugar. Maintaining tight glucose control is essential for a healthy pregnancy, but SGLT2 inhibitors are usually replaced with insulin during this time. Breastfeeding is also discouraged while taking this medication.
Canagliflozin begins to work very quickly, with increased glucose excretion in the urine occurring within hours of the first dose. However, it may take several days to weeks of consistent use to see a significant and stable reduction in your daily blood sugar readings. The full impact on your HbA1c (3-month average) is typically evaluated after 3 to 6 months of therapy. For heart and kidney protection, the benefits build up over months and years of continuous use. Do not stop taking the medication if you don't see immediate results.
You should not stop taking Canagliflozin suddenly without first consulting your healthcare provider. Stopping the medication can cause your blood sugar levels to rise significantly, increasing the risk of long-term diabetes complications. If you need to stop the drug for a scheduled surgery or because of a serious side effect, your doctor will provide a specific plan. In the case of surgery, it is usually stopped 3 days in advance to prevent ketoacidosis. Always have a plan for managing your blood sugar if you must discontinue the drug.
If you miss a dose of Canagliflozin, take it as soon as you remember that same day. However, if it is almost time for your next dose, skip the missed dose and resume your regular schedule the following morning. Do not take two tablets at once to make up for a missed dose, as this can increase the risk of dehydration and low blood pressure. Consistency is key to managing blood sugar, so try to take your medication at the same time every morning before breakfast. Setting a daily alarm can help.
No, Canagliflozin is actually associated with modest weight loss rather than weight gain. Because the drug causes the body to excrete glucose (sugar) in the urine, you are effectively losing calories that would otherwise be stored as fat. Most patients in clinical trials lost between 2% and 3% of their initial body weight over the first six months of treatment. This weight loss is generally considered a beneficial side effect for patients with type 2 diabetes. However, this should not replace a healthy diet and regular exercise program.
Canagliflozin is frequently prescribed alongside other medications like Metformin, but it requires careful monitoring when combined with certain drugs. If you take insulin or sulfonylureas, the combination can increase the risk of low blood sugar, requiring a dose adjustment. It can also interact with diuretics (water pills), increasing the risk of dehydration. Some medications like rifampin can make Canagliflozin less effective. Always provide your doctor with a complete list of all prescriptions, over-the-counter drugs, and herbal supplements you are taking to avoid dangerous interactions.
As of 2026, generic versions of Canagliflozin have become available in many markets following the expiration of certain patent protections for the brand name Invokana. Generic medications contain the same active ingredient and meet the same FDA standards for safety and effectiveness as the brand-name drug. Choosing a generic can often reduce your out-of-pocket costs significantly. Check with your pharmacist or insurance provider to see if a generic version is covered under your plan. Regardless of whether you take the brand or generic, the clinical effects remain the same.
Other drugs with the same active ingredient (Canagliflozin)
> Warning: Stop taking Canagliflozin and call your doctor immediately if you experience any of these serious conditions:
Previously, Canagliflozin carried a Black Box Warning regarding an increased risk of lower limb amputations (primarily toes and midfoot), based on findings from the CANVAS trial. However, after reviewing additional data from the CREDENCE trial and post-marketing surveillance, the FDA removed this Black Box Warning in 2020. Despite the removal, the risk is still listed as a Precaution. Patients with a history of prior amputation, peripheral vascular disease, or neuropathy should be monitored closely for foot ulcers or infections.
Report any unusual symptoms to your healthcare provider immediately. Regular foot exams and monitoring of skin integrity are essential for all patients taking this medication.
To ensure safety, your healthcare provider will order regular laboratory tests:
Canagliflozin itself does not typically cause drowsiness. However, if you experience low blood pressure (dizziness) or low blood sugar (if used with insulin), your ability to drive or operate machinery may be impaired. Ensure you know how you react to the medication before engaging in these activities.
Alcohol consumption should be limited. Alcohol can increase the risk of ketoacidosis and dehydration while taking Canagliflozin. It can also mask the symptoms of low blood sugar.
If you are scheduled for surgery, your doctor will likely advise you to stop taking Canagliflozin at least 3 days prior to the procedure to reduce the risk of perioperative ketoacidosis. Do not stop the medication for any other reason without consulting your doctor, as your blood sugar levels may rise rapidly.
> Important: Discuss all your medical conditions, especially any history of kidney disease, heart problems, or circulation issues, with your healthcare provider before starting Canagliflozin.
For each interaction, the primary management strategy involves vigilant monitoring of clinical symptoms (like dizziness or thirst) and regular laboratory checks of kidney function and electrolytes.
> Important: Tell your doctor about ALL medications, supplements, and herbal products you are taking, including over-the-counter pain relievers like NSAIDs (e.g., Ibuprofen), which can further stress the kidneys.
There is no documented cross-sensitivity between Canagliflozin and other classes of antidiabetic drugs (like Metformin or Sulfonylureas). However, if a patient has had a hypersensitivity reaction to another SGLT2 inhibitor (like Empagliflozin or Dapagliflozin), healthcare providers should exercise extreme caution, as the chemical structures are related.
> Important: Your healthcare provider will evaluate your complete medical history, including your kidney function and surgical history, before prescribing Canagliflozin to ensure it is safe for you.
Canagliflozin is not approved for use in patients under 18 years of age. The safety profile and long-term effects on growth and bone development in children have not been established.
Patients aged 65 and older are at increased risk for:
While the drug is effective in the elderly, healthcare providers usually start with the 100 mg dose and monitor hydration status very closely.
The efficacy of Canagliflozin for glucose lowering is dependent on kidney function. As eGFR declines, the glucose-lowering effect diminishes. However, the kidney-protective effects (reducing the risk of dialysis) persist even in patients with lower eGFR.
> Important: Special populations require individualized medical assessment. Always inform your doctor if you are pregnant, planning to become pregnant, or have any history of kidney or liver disease.
| Bioavailability | ~65% |
| Protein Binding | 99% (primarily albumin) |
| Half-life | 10.6 - 13.1 hours |
| Tmax | 1 - 2 hours |
| Metabolism | UGT1A9 and UGT2B4 (O-glucuronidation) |
| Excretion | Fecal 51.7%, Renal 33% (mostly as metabolites) |
Canagliflozin is a member of the SGLT2 Inhibitor class. Related medications include Empagliflozin (Jardiance), Dapagliflozin (Farxiga), and Ertugliflozin (Steglatro). These drugs are distinct from other antidiabetics because they do not rely on insulin to lower blood sugar.