The Dangers of Invokana and Diabetic Ketoacidosis


Diabetic ketoacidosis is a serious complication of diabetes that occurs when your body produces high levels of blood acids called ketones.

Diabetic ketoacidosis develops when your body is unable to produce enough insulin. Insulin normally plays a key role in helping sugar (glucose) — a major source of energy for your muscles and other tissues — enter your cells. Without enough insulin, your body begins to break down fat as an alternate fuel. This process produces a buildup of toxic acids in the bloodstream called ketones, eventually leading to diabetic ketoacidosis if untreated.

Source: Mayo Clinic

FDA Warning: SGLT2 inhibitors’ Link to Ketoacidosis

SGLT2 inhibitors work by blocking the reabsorption of glucose by the kidney, increasing glucose excretion, and lowering blood glucose levels in diabetics who have elevated blood glucose levels.

Invokana, an SGLT2 inhibitor manufactured by Janssen Pharmaceuticals, was approved in 2013 to treat type 2 diabetes.

In May 2015, the FDA issued a warning that SGLT2 inhibitors, such as Janssen Pharmaceutical’s Invokana, may lead to or cause ketoacidosis. The FDA recommends that anyone taking SGLT2 inhibitors know the symptoms for ketoacidosis.

What are the signs and symptoms of diabetic ketoacidosis?

  • Frequent urination
  • Excessive thirst
  • Abdominal pain
  • Vomiting and nausea
  • Weakness or fatigue
  • Shortness of breath
  • Confusion
  • Fruity-scented breath

Two more-specific signs of diabetic ketoacidosis can be detected through home blood and urine testing kits:

  • High blood sugar level (hyperglycemia)
  • High ketone levels in your urine

What are the side effects of Invokana?

Common side effects include increased urination, genital yeast infections and urinary tract infections.

Common side effects of the SGLT2 inhibitors include the genital yeast infections, dehydration and urinary tract infections and may increase levels of bad cholesterol (LDL).

SGLT2 inhibitor medications on the market.

  • Canagliflozin, marketed as Invokana, manufactured by Johnson & Johnson’s Janssen Pharmaceuticals
  • Canagliflozin and Metformin, marketed as Invokamet, also manufactured by J&J’s Janssen Pharmaceuticals
  • Dapagliflozin, marketed as Farxiga, manufactured by AstraZeneca
  • Dapagliflozin and Metformin extended-release, marketed as Xigduo XR, also manufactured by AstraZeneca
  • Empagliflozin, marketed as Jardiance, manufactured by Lilly and Boehringer-Ingelheim
  • Empagliflozin and Linagliptin, marketed as Glyxambi, manufactured by Lilly and Boehringer-Ingelheim

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If your health has been adversely affected after taking an SGLT2 inhibitor drug, such as Invokana, let’s talk. The attorneys at Nash & Franciskato will review your situation and see if you have a case against one of the drug manufacturers.

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