Invokana: The New Kid on the Block for Diabetes

Roni Shye
Roni Shye, PharmD BCGP BCACP, is a licensed pharmacist in the states of Florida, Ohio, and Pennsylvania.
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Invokana (canaglifozin) is now readily available at most pharmacies after receiving approval for the treatment of type 2 diabetes earlier this year. Here’s what you need to know.

What is Invokana?

Type 2 diabetes leads to elevated levels of glucose in the blood, because of the inability of your body either to make enough insulin or because your cells cannot use it properly. Invokana is a novel drug that works by blocking glucose from being reabsorbed by the kidney. This leads to more glucose being excreted from the body through urine, leading to lower blood glucose levels.

Invokana is the first of a class of medicines known as the SGLT2 (sodium glucose co-transporter 2) inhibitors.

Where does Invokana fit in your diabetes therapy?
Invokana is indicated, along with diet and exercise, to improve glycemic control if you have type 2 diabetes. It should not be used if you have type 1 diabetes or if you have severe kidney disease.

Initial studies showed that Invokana 100mg alone allowed people to achieve goal A1c levels (indicating average blood glucose levels) in 45% of patients versus 21% on placebo. With the higher dose, Invokana 300mg, this was seen in 62% of patients.

Invokana helps through an effect on weight loss as well. Obesity is a major contributing factor to insulin resistance, and weight loss of 5-8 pounds has been observed during studies.

Further studies showed improved glycemic control when adding Invokana to metformin, a first-line oral type 2 diabetes medication. Studies also showed Invokana lowered A1c levels more versus other oral diabetes medications, including Januvia (Invokana 300mg) and glimepiride (both Invokana 100mg and 300mg).

What should you know about your Invokana therapy?

In studies, the most common adverse effect observed was an increase in yeast infections, urinary tract infections and increased urination. The increase in yeast infections was seen more commonly in females and uncircumcised males.

Invokana can cause a lowering of blood pressure, which can lead to feeling faint. Your provider should also monitor blood potassium levels.

If you are taking any other medications, check for any possible interactions with either your provider or pharmacist.

Till next week,

The GoodRx Pharmacist

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