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Invokana (canagliflozin) is an orally administered anti-diabetic medication used therapeutically in the treatment of Type II diabetes. A gliflozin inhibitor, it works by reducing the reabsorption of blood glucose by the kidneys, allowing it to pass out of the body in urine instead.

Gliflozin inhibitors such as Invokana are novel in that they remove blood glucose not only from the blood but from the whole body, thus improving both blood glucose levels and control. Since blood glucose is the primary problem in Type II diabetes, removing it from the blood stream not only lowers blood glucose levels but also helps alleviate the symptoms and progression of symptoms higher levels can cause.

Advantages & Administration

Invokana has been demonstrated to promote the excretion of up to 119 grams---over four ounces---of blood glucose into the urine stream. Invokana is a good addition to diet and exercise as well as most existing Type II diabetes medications.

The medication offers a number of advantages over some other anti-diabetic medications:

• Administered via tablet; no injections required
• Tablets are easy to carry and take discreetly
• Tablets are taken just once per day
• Removes excess blood glucose from the body completely
• May be used in conjunction with diet and exercise to further improve overall control
• May be used in conjunction with other Type II diabetes medications to further enhance results
• Associated with a much lower risk of low blood glucose than insulin or sulfonylurea based medications

Otherwise healthy adults are typically started on 100 mg per day, taken in a single dose prior to consuming breakfast. If 100 mg proves insufficient after several days or weeks of treatment, dosage may be increased up to 300 mg per day, again taken in a single dose prior to breakfast.

Treatment may continue for as along as it provides benefit. In many cases if lifestyle changes are made the need for medication can be eliminated altogether, though unfortunately this is not always the case even when those changes are made and adhered to.

Because Type II diabetes is associated with kidney damage it is prudent for diabetic patients to have a physician evaluate kidney function prior to starting treatment with this or any medication. Likewise periodic checkups throughout treatment are highly advisable; kidney damage is unlikely to be detected until severe otherwise.

Warnings & Potential Complications

While Invokana is a highly effective and convenient medication, it is not entirely without risk. Patients should be alert for warning signs and consult a doctor with any concerns; diabetes is a serious condition and delaying treatment can have serious, permanent consequences.

Some things to keep in mind to ensure treatment is hassle-free:

• Ensure adequate hydration. Invokana itself can cause increased urine output, and is often used along with diuretics which also increase urine output.
• Invokana is intended for the treatment of Type II diabetes. It should not be used for the treatment of Type I diabetes.
• A long term therapy, it should not be used for acute blood glucose levels such as occur accompanying diabetic ketoacidosis. Diabetic ketoacidosis is a medical emergency requiring treatment by a physician.
• Invokana should not be used by anyone with advanced kidney failure and/or on dialysis.
• Many drugs, including Invokana, are removed from the body by the kidneys. Regular evaluations of kidney function are highly recommended throughout treatment.

Most patients experience only a few, mild side effects, and these will often stop occurring as the body adjusts to treatment. Most common are:

• Increased urination
• Increased thirst
• Increased risk of urinary tract infections

As is always true with Type II diabetes, patients taking Invokana should maintain a regimen of regular foot inspection and report ulcers, cracks, numbness, circulation problems, redness, or other symptoms to a physician. Anyone with Type II diabetes should have their feet examined directly by a physician on a routine basis as well.

The effects of Invokana on unborn or nursing babies aren't fully understood. In general the medication should be avoided if pregnant or breastfeeding.