Manufacturer: Johnson & Johnson
Mechanism of Action: These drugs inhibit a form of proteins, which help to reabsorb glucose into the blood, called sodium-glucose transport proteins (SGLT2). By blocking these proteins, less glucose is reabsorbed into the blood and the excess glucose is passed out in urine.
Indications: Canagliflozin are TGA approved as an adjunct to diet and exercise for glycaemic control in adults with type 2 diabetes mellitus
Limitation of use: Not recommended in patients with type 1 diabetes or for the treatment of diabetic ketoacidosis
History of serious hypersensitivity reaction to Invokana
Severe renal impairment, ESRD or on dialysis
Serious Side Effects: The organization said the FDA has received over 457 adverse events for Invokana in its first 12 months on the market, mostly falling into six categories:
- Kidney failure or impairment
- Kidney stones
- Fluid/electrolyte problems
- Urinary tract infections
- The most serious potential side effects, problems and risks caused through the use Invokana (Invokamet) are myocardial infarction (heart attack), kidney damage and ketoacidosis.
- Kidney failure occurs when your kidneys stop functioning without the use of dialysis or a kidney transplant
- Myocardial infarction (commonly known as a heart attack) is the irreversible death of cells within the heart caused by restriction of blood.
- Ketoacidosis (Diabetic ketoacidosis, Ketosis) is a very serious, potentially fatal condition where the acid level in the blood rises dangerously high
Symptoms of ketoacidosis include:
- Difficulty breathing
- Abdominal pain
- Unusual fatigue or sleepiness
Common side effects of Invokana may include:
- Genital yeast infections (in both male and female)
- Urinary tract infection
- Sun intolerance
- Rash or itching
- Laboratory abnormalities including cholesterol changes
CASE REVIEW FOCUS AREAS:
- Whether the patient was prescribed Invokana?
- Reason for Prescription?
- Dosage and Intake details (To be included under pharmacy log)
- Did the patient have any pre-existing conditions, allergies or contraindications for Invokana?
- What was the injury due to Invokana (Ketoacidosis/Kidney failure/MI)?
- When and where was the injury diagnosed? Whether hospitalized? Dates of hospitalization?
- Treatment/management. Any complications
- Follow-up visits for treatment/management of injury.
- Outcome/prognosis. Resolution of injury?
Identify and report cases with the following scenarios:
No Injuries: Patient took Invokana but did not develop any injuries
No Invokana intake: Patient was given a different drug and not Invokana – Hold case and communicate to client
Invokana contraindicated in patient but still prescribed
Any medical/surgical history, social history that could have had an effect on the injury