Invokana, also known as canagliflozin, is an oral antidiabetic medication. It has a few indications, including that it:
Improves glycemic control in adults with type 2 diabetes mellitus (T2DM) in addition to diet and exercise
Decreases the risk of serious cardiovascular events (e.g. death, myocardial infarction, stroke) in adults with T2DM and cardiovascular disease (CVD)
Decreases the risk of developing end-stage kidney disease (ESKD), serum creatinine doubling, death from cardiovascular causes, and hospitalization for heart failure in adults with T2DM and diabetic nephropathy with albuminuria over 300 mg/day
Controlling hyperglycemia prevents downstream complications such as kidney damage, loss of limbs, blindness, heart attack, stroke, or nerve problems. Cardiovascular and renal events in diabetes can also be detrimental. It is important that diabetes and related events remain controlled to lessen the chance of related complications. Invokana is not indicated for the treatment of type I diabetes.
HOW DOES INVOKANA WORK?
Invokana is a sodium-glucose co-transporter 2 (SGLT2) inhibitor. SGLT2 is a transporter that reabsorbs filtered glucose in the proximal renal tubules. Invokana inhibits SGLT2, decreasing renal reabsorption of glucose and lessening the renal glucose threshold, which elevates the amount of glucose excreted into the urine. By preventing SGLT2-dependent reabsorption of glucose and sodium, Invokana also increases the amount of sodium getting to the distal tubule. This elevates tubuloglomerular feedback and decreases intraglomerular pressure.
Common side effects include:
Urination changes (e.g. increased urgency, increased frequency)
Urinary tract infection
Low blood sugar
Increased serum potassium