Invokana works in the kidneys to change the way glucose is processed in the body. Your kidneys act as a filtering and cleaning system for your body, filtering glucose, water, salt and other small substances. Some of these substances are reabsorbed back into the bloodstream, and any waste products are taken out of the bloodstream and leave your body when you urinate. The aim of this is to maintain healthy levels of these substances in the blood, which can help prevent heart disease.

Invokana works by increasing the amount of glucose removed from your body in your urine. This reduces the amount of glucose in your blood. ¹

Always take this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure.

Dose
Treatment of type 2 diabetes without diabetic kidney disease.
The starting dose for Invokana is one 100 mg tablet, once a day. Sometimes the dose may be increased, for example if you get on well with Invokana but need a little more help controlling your blood glucose. Your doctor can increase your dose to one 300 mg tablet per day, if you agree.

Treatment of diabetic kidney disease.
If you have diabetic kidney disease, the dose is 100 mg tablet, once a day. If you need more help controlling your blood glucose, your doctor may prescribe you an additional medicine.

How to take your tablets

• Swallow the tablet whole.
• You can take your tablet with or without food, ideally before your first meal of the day.
• Try to take it at the same time each day. This will help you remember to take it.

What if I forget to take my tablet?
If you miss your daily tablet it should be taken as soon as you can.

Do not take two tablets in the same day.

You may find it helpful to consider some other options to help you to remember to take your tablet every day. For example, some people find it helpful to leave their medication next to their toothbrush so that when they brush their teeth in the morning they are reminded to take it.

What if I take more Invokana than I should?
If you take more of this medicine than you should, seek medical advice or go to your nearest hospital immediately.

How long will I need to take my tablets for?
Many people will need to keep taking their tablets or medication for type 2 diabetes throughout their lives in order to stay well, but everyone is different.

Make sure you take your medicine as prescribed by your nurse, doctor or pharmacist. If you are unsure then you should check with them.

Tell your doctor or pharmacist if you are taking any other medicines, including those you have recently taken or might take in the future. Invokana can affect the way some other medicines work, and vice versa.

It is particularly important to tell your doctor if you are taking:

• other medicines used to treat diabetes, including insulin or a sulphonylurea (e.g. glimepiride or glipizide). Your doctor may reduce your dose to avoid your blood glucose level getting too low (hypoglycaemia);
• medicines used to lower your blood pressure (anti-hypertensives), including diuretics (medicines used to remove levels of excess water in the body, also known as water tablets). Invokana may add to the blood pressure-lowering effects of these medicines;
• St. John’s wort – a herbal medicine to treat depression;
• carbamazepine, phenytoin, or phenobarbital – medicines used to control seizures;
• efavirenz or ritonavir – medicines used to treat HIV infection;
• rifampicin – an antibiotic used to treat infections including tuberculosis;
• cholestyramine – a medicine used to reduce cholesterol levels in the blood. Invokana should be taken least 1 hour before this type of medicine, or 4 – 6 hours afterwards. Your doctor will discuss with you the best way to take your medicines;
• digoxin or digitoxin – medicines used for certain heart problems. The level of digoxin or digitoxin in your blood may need to be checked if you are taking either of these medicines as well as Invokana;
• dabigatran – a blood thinning medicine that lowers the risk of blood clot formation.