Invokana (canagliflozin) Logo - After first line, take a firm line
Invokana (canagliflozin) Logo - After first line, take a firm line
Potential side effects

Like all medicines, Invokana may cause side effects, although not everybody gets them.
Please refer to the Patient Information Leaflet for all potential side effects.

Invokana Potential Side effects Icon
What potential side-effects should I be aware of?

Most of the side-effects you could get with Invokana are the result of losing glucose in the urine. While most side-effects are mild, some people could experience a more serious side-effect, and some of the side-effects may need treatment. Tell your nurse, doctor or pharmacist if you notice any of the following side-effects, as you may need medical treatment.

Common side effects 1

Hypoglycaemia (see below)

Genital infections
Including vaginal thrush, and rash or redness of the penis or foreskin.

Constipation

Feeling thirsty

Nausea

Urinary tract infections

Changes in urination
Including urinating more frequently or in larger amounts, urgent need to urinate, need to urinate at night.

Blood tests
may show changes in blood fat (cholesterol) levels and increased numbers of red blood cells in your blood (haematocrit).

For more detailed information on these side effects, please see the patient information leaflet in the box
with your tablets.

Hypoglycaemia

This is very common (may affect more than 1 in 10 people) if you are taking Invokana as well as insulin or sulphonylurea (other diabetes medicines). Hypoglycaemia, ‘hypos’ or ‘lows’ happen when you don’t have enough glucose in your blood to allow your body to function properly.

Possible signs of hypoglycaemia include:

  • Blurred vision
  • Tingling of lips
  • Trembling
  • Sweating
  • Looking pale
  • Change in mood
  • Anxiety
  • Confusion

Tell your doctor as soon as possible if you think you could have hypoglycaemia. Your doctor will tell you how to treat low blood glucose levels and what to do if you have any of these symptoms.

Reporting side effects

Talk to your doctor, pharmacist or nurse if you get any side-effects, including any not listed in the package leaflet. You can also report side effects directly via the Yellow Card Scheme at www.mhra.gov.uk/yellowcard, or search for MHRA Yellow Card in the Google Play or Apple App Store. By reporting side effects you can help provide more information on the safety of this medicine.

Other side-effects

Weight loss
The way Invokana works may result in you losing some weight (2 – 4 kg or 4 – 9 lbs) when you start taking this medicine. This is not usually anything to be concerned about, but talk to your nurse, doctor or pharmacist if you have any questions. They will also be able to advise you about the amount of weight loss that would be normal for you.

It is important to keep following advice about healthy eating and increased activity given by your nurse or doctor and continue any other medicines given to you. If you are following a diabetic weight control diet, continue to follow it while you are taking this medicine.

Talk to your nurse, doctor or pharmacist about this if you need any more information.

Blood pressure
Because of the way Invokana works, it can also lower blood pressure. It is possible you may get symptoms as a result of lower blood pressure, including feeling dizzy or faint after standing quickly. Make sure you drink enough fluid through the day, as keeping hydrated can help to reduce these effects.

Please see your doctor if you have any of these symptoms.

Serious side-effects

Stop taking Invokana and talk to a doctor or go to the nearest hospital immediately if you have any of the following serious side-effects.

Severe allergic reaction

This is a rare side-effect that could affect up to 1 in 1,000 people. Signs you could be experiencing a severe allergic reaction include swelling of your face, lips, mouth, tongue or throat, which could lead to difficulty breathing or swallowing.

Dehydration

One of the side-effects of Invokana is urinating more often, or in larger amounts. Some people taking Invokana may lose too much fluid from their body and become dehydrated. Dehydration is uncommon, affecting up to 1 in 100 people. It is more likely to affect you if you are aged 75 or over, have kidney problems or are taking diuretic medicines (also called water tablets).

Possible signs of dehydration include:

  • Feeling light-headed or dizzy
  • Fainting or feeling dizzy or faint when you stand up
  • Having a very dry or sticky mouth
  • Feeling very thirsty
  • Feeling very weak or tired
  • Passing little or no urine
  • Fast heart rate
Diabetic Ketoacidosis

DKA is a rare but serious, sometimes life-threatening, complication of diabetes, which may affect up to 1 in 1,000 people. It occurs when there is not enough insulin available in the body, so blood glucose can’t be used for energy. Instead, fat is used as an alternative source of fuel. This causes a build-up of potentially harmful by-products called ‘ketone bodies’, which can be detected in blood and urine tests.

You may be more likely to develop DKA if you don’t eat for a long time, drink excessive alcohol, are dehydrated, suddenly reduce your insulin dose or need more insulin because of surgery or serious illness.

Symptoms of diabetic ketoacidosis include:

  • Increased levels of “ketone bodies” in your urine or blood
  • Rapid weight loss
  • Feeling or being sick
  • Stomach pain
  • Excessive thirst
  • Fast and deep breathing
  • Confusion
  • Unusual sleepiness or tiredness
  • A sweet smell to your breath
  • A sweet or metallic taste in your mouth
  • A different odour to your urine or sweat

You should contact your healthcare professional or nearest hospital immediately if you have any of these symptoms, irrespective of your blood glucose levels. Your doctor may decide to temporarily or permanently stop your treatment with Invokana.

Fournier’s gangrene

Talk to your doctor immediately if you develop pain, tenderness, redness or swelling of the genitals, or the area between the genitals and the anus, combined with fever or feeling generally unwell. These symptoms could be a sign of necrotising fasciitis of the perineum (Fournier’s gangrene). This is a rare but serious, even life-threatening, infection that destroys the tissue under the skin and has to be treated immediately.

For more detailed information on these side effects, please see the patient information leaflet in the box
with your tablets.

Amputation

Some studies indicate that taking Invokana may have contributed to the risk of lower limb amputation, mainly of the toes or the middle part of the foot.

It is important to check your feet regularly and contact your doctor immediately if you notice any changes.
(Click here for more information about foot care)

For more detailed information on these side effects, please see the patient information leaflet in the box with your tablets.

References

  1. Reference 1
  2. Reference 2
This information is intended only for patients who have been prescribed Invokana by a UK healthcare professional.

Reporting side effects
If you get any side effects, talk to your doctor, nurse or pharmacist. This includes any possible side effects not listed in the package leaflet.
You can also report side effects directly via the Yellow Card scheme at
www.mhra.gov.uk/yellowcard
By reporting side effects you can help provide more information on the safety of this medicine.

Date of preparation: September 2020 | Job code: INV-18087(4)

What is type 2 diabetes?
– Diabetes complications

What is Invokana?
– How does Invokana work?
– How should I take Invokana?
– Is it OK to take Invokana if I’m taking other medicines?



What potential side-effects should I be aware of?
– Common side-effects
– Reporting side-effects
– Other side effects
– Serious side-effects



Self care
– Keeping healthy
– Sick day rules
– Foot care
– What can I do to help reduce my risk of side-effects?

Useful contacts & support