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Invokana Warnings and Precautions

There are some cases where Invokana may not be safe or appropriate to use, such as in people who have severe kidney impairment or those on kidney dialysis. Other warnings for safely using Invokana include precautions for people who have certain allergies, those taking certain medications, and women who are pregnant or nursing.


What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to taking Invokana® (canagliflozin) if you have:
  • Kidney disease, such as kidney failure (renal failure)
  • Low blood pressure (hypotension)
  • High blood potassium levels (hyperkalemia)
  • Problems with yeast infections
  • Any allergies, including to foods, dyes, or preservatives.
Also, let your healthcare provider know if you are:
  • Pregnant or thinking of becoming pregnant
  • An uncircumcised male
  • Breastfeeding.
You should also tell your healthcare provider about all other medications you are taking, including prescription and nonprescription medicines, vitamins, and herbal supplements.

Specific Precautions and Warnings for Invokana

Some warnings and precautions to be aware of with this drug include the following:
  • Invokana has a diuretic effect. This can be a problem, leading to dehydration and dangerously low blood pressure in some individuals, especially those with kidney problems, people who already have low blood pressure, or people already taking diuretics or blood pressure medications. Watch for signs of dehydration or low blood pressure, such as lightheadedness, dizziness, or fainting.
  • Invokana decreases kidney function. This can be a serious problem, as people with type 2 diabetes already have kidney problems. If you have mild-to-moderate kidney problems, your healthcare provider will carefully monitor your kidney function (using blood tests). If you have severe kidney impairment, this drug is not for you.
  • Invokana increases the level of potassium in the blood. Potassium levels may rise to dangerous levels if Invokana is combined with other medications that increase potassium levels, especially in people with kidney problems (see Invokana Drug Interactions).
  • The risk of low blood sugar (hypoglycemia) is low for Invokana. However, combining Invokana with insulin medications or sulfonylureas increases the risk of low blood sugar. Your healthcare provider may need to lower the dosage of your sulfonylurea. Sulfonylureas include:
  • Because of the way it works (because Invokana increases sugar levels in the urine), the drug increases the risk for genital fungal infections, such as vaginal yeast infections in women and fungal penile infections in uncircumcised men.
  • Invokana is a pregnancy Category C medication. This means that it may not be safe for use in pregnant women, although the full risks are currently unknown. Talk to your healthcare provider before taking Invokana during pregnancy (see Invokana and Pregnancy).
  • It is unknown if Invokana passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to taking the drug (see Invokana and Breastfeeding).
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