If you are taking Invokana and have type 2 diabetes, you should read this. We’re not here to frighten you , but we do want you to be aware of the harmful adverse effects that are affecting countless patients who have taken this particular medication. It can be confusing to know where to start in your journey for answers, so we’ve compiled important facts for you to consider concerning Invokana, Invokamet (canagliflozin) and SGLT2 inhibitors.

Canagliflozin is an SGLT2 inhibitor with strong links to amputations.
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What is an SGLT2 Inhibitor?

Generally speaking, SGLT2 stands for sodium-glucose co-transporter-2 and inhibitors reduce the amount of glucose in your body. Typically, your blood is filtered through your kidneys and the glucose is reabsorbed and redistributed throughout the body. With an SGLT2 inhibitor, the proteins that promote the glucose to be reabsorbed are blocked and the excess glucose leaves the body through the urine.

SGLT2 Amputations

It is unclear how this type of medication increases the risk in amputations, but studies have shown that there is a very strong link between SGLT2 inhibitors and amputations. In May 2017, the FDA mandated that the strongest warning, a black box warning, be added to canagliflozin drug labels so that patients will be notified of this dangerous risk.

In a recent report published in the Lancet Diabetes & Endocrinology, doctors analyzed 66 reports of SGLT2-inhibitor–associated amputations and discovered that 57 (86%) of the patients involved reported taking canagliflozin. Additionally, two-thirds of these patients weren’t considered to be at risk for amputations before taking this medication. The most common type of amputation was the removal of a toe, but 13 patients suffered from above-ankle leg or limb amputations, two patients endured multiple amputations and one patient had to have his hand amputated. Three of these patients who had amputations ended up dying.

Another report called A Study of the Effects of Canagliflozin on Renal Endpoints (CANVAS-R) determined that patients who took canagliflozin were twice as likely to have toe and foot amputations than those patients in the study who were given a placebo.

It is important to note that there are several types of SGLT2 inhibitors on the market which were  included in these studies. Forxiga (dapagliflozin) and Jardiance (empagliflozin) are also in this drug category, but only Invokana and Invokamet (canagliflozin) pose this additional adverse effect.

What Should I Do If I’m Taking Invokana?

If you are taking Invokana and are worried about the terrifying possibility of having an amputation, make an appointment with your doctor to discuss your concerns. There are many other safer options that can help to manage your type 2 diabetes. You may want to consider medications that don’t have this dangerous potential or you might want to try a more holistic approach involving diet and exercise. However, you should never stop your medication without first consulting your doctor. Doing so could result in dangerous glucose levels and other possible complications that could be extremely harmful.

“SGLT2 Inhibitors (Gliflozins)”. Diabetes.co.uk. Accessed November 27, 2017. https://www.diabetes.co.uk/diabetes-medication/sglt2-inhibitors.html
“FDA confirms increased risk of leg and foot amputations with the diabetes medicine canagliflozin (Invokana, Invokamet, Invokamet XR)”. FDA. Accessed November 27, 2017. https://www.fda.gov/downloads/Drugs/DrugSafety/UCM558427.pdf
“FDA Reports Further Support for Canagliflozin-Amputation Link”. Medscape. Accessed November 27, 2017. https://www.medscape.com/viewarticle/883782