SGLT2 Side Effects
Invokana’s side effects range from yeast infections to more serious issues like diabetic ketoacidosis. In May 2015 the FDA issued a drug safety communication that warned patients and doctors that studies linked Invokana and Invokamet — and other SGLT2 inhibitors — to diabetic ketoacidosis (DKA).
Unlike other SGLT2’s, the FDA also found a link between Invokana and increased toe and foot amputations. The agency released a Drug Safety Communication in May 2016 and said it was investigating. Additionally, Invokana was not tested in pregnant women, but animal studies showed irreversible kidney problems in fetuses.
In 2016, the FDA also began investigating reports of acute pancreatitis linked to SGLT2 inhibitors. Acute pancreatitis occurs when the pancreas, the organ responsible for producing insulin, becomes swollen and inflamed. It can cause serious health issues if not treated and may even be fatal. Currently, the agency is "evaluating the need for regulatory action."
Invokana is available in 100 mg and 300 mg tablets. People with moderate renal problems should not take more than 100 mg daily, and doctors do not recommend Invokana for people with poor kidney function. Some side effects were more severe with higher doses.