Invokana® and SGLT2 Inhibitors

Invokana (canagliflozin) is a sodium-glucose co-transporter-2 (SGLT2) inhibitor used to control blood sugar in patients with Type 2 Diabetes. SGLT2 inhibitors lower blood glucose levels by reducing the amount of glucose that is absorbed by the kidneys. These drugs inhibit the kidneys from passing glucose back through the blood stream, and instead cause the kidneys to eliminate excess glucose through urination. Some of the most widely prescribed SGLT2 Inhibitors are:

  • Invokana
  • Invokamet
  • Farxiga
  • Xigduo XR
  • Jardiance
  • Glyxambi

In May of 2015 the US Food and Drug Administration issued a Drug Safety Communication, warning citizens that SGLT2 Inhibitors may lead to a serious medical condition called diabetic ketoacidosis which can result in diabetic coma or even death. Diabetic ketoacidosis is a condition rarely seen in patients with Type 2 diabetes. The condition has historically been associated with Type 1 diabetes. Cells in the human body use glucose in the blood to create energy. When a person’s cells don’t receive sufficient levels of glucose to create energy, the body starts to burn fat to create energy. The process of burning fat produces acidic waste chemicals called ketones. As ketones accumulate in the bloodstream, the blood becomes more acidic. If this process is not controlled, the blood becomes too acidic, resulting in diabetic ketoacidosis.

Because ketoacidosis had rarely been seen in patients with Type 2 diabetes and suddenly was being seen in Type 2 diabetes patients, in 2015 the FDA initiated a safety review that resulted in the addition of diabetic ketoacidosis warnings to the labels of SGLT2 Inhibitors on June 14, 2016. Symptoms of ketoacidosis include:

  • Difficulty breathing
  • Nausea
  • Vomiting
  • Abdominal Pain
  • Confusion
  • Fatigue
  • Sleepiness

Ketoacidosis is a serious condition, and if you or a loved one has been diagnosed with ketoacidosis and believe that it may have been caused by ingestion of a SGLT2, please call the experienced drug and device attorneys at Franklin D. Azar and Associates for a free consultation.