Invokana (canagliflozin) is a relatively new drug marketed to treat Type 2 diabetes. The drug is the first in a new class of medications known as sodium-glucose cotransporter 2 (SGLT2) inhibitors. This class of drugs also includes Farxiga, Glyxambi, Jardiance, and Xigduo XR. How does this new class of drugs work? The drugs work by altering kidney function to stop reabsorption of glucose into the bloodstream. Instead, sugar is excreted through the urine.

In March 2013, the Food and Drug Administration (FDA) approved Invokana. Since approval, Invokana sales have grown rapidly. Johnson & Johnson may realize $1 Billion in annual sales from its new blockbuster medication.

Is Invokana safe? Since its introduction just over two years ago, Invokana has been linked to hundreds of adverse event reports. These include reports of kidney damage, kidney failure, urinary tract infections, and ketoacidosis. In May 2015, the FDA issued a drug safety communication warning patients about the risk of ketoacidosis from Invokana and the other drugs in its class. Diabetic ketoacidosis is a build-up of acid in the blood. It is a serious condition that can lead to diabetic coma or even death. What are some symptoms of ketoacidosis? Symptoms include:

  • Confusion
  • Abdominal Pain
  • Difficulty Breathing
  • Unusual Fatigue or Sleepiness
  • Vomiting or Nausea

In just the first year the drug was marketed, QuarterWatch Report (published by the Institute for Safe Medication Practices) identified 457 serious adverse event reports. This is likely a small percentage of all problems truly associated with the medication. Most problems are not fully reported. The QuarterWatch Report then summarizes the issue:

The unanswered question about canagliflozin – shared in part by other diabetes medications – is whether it has clinical benefits, and whether those benefits outweigh the risks.

Diabetes is a serious health condition in the United States. And, drug companies have made billions of dollars rushing new drugs to market. Too often, drug companies have wrongly valued profits over people. Drug companies have marketed other classes of diabetes drugs that have also resulted in patient injury and death. I’ve written about some of these past dangerous and defective medications as well as our efforts to assist clients injured by those drugs. We are continuing to investigate Invokana and other SGLT2 inhibitors closely.