Invokana, which contains the drug ingredient canagliflozin, was approved by the Food and Drug Administration (FDA) in March 2012. It is classified as an SGLT2 inhibitor, which works by reducing blood sugar levels by helping the patient’s kidney’s remove excess sugar through their urine. Other drugs in this class include the brand names Invokamet, Farxiga, Xigduo XR, Jardiance, and Glyxambi.
In May 2015, the FDA issued a warning that SGLT2 inhibitors had been linked to ketoacidosis, a serious buildup of acids, called ketones, in the blood that can be life threatening if left untreated. The condition is caused by an insulin deficiency that forces cells to burn fat for energy instead of glucose, which produces ketones. In diabetic patients, it is also known as diabetic ketoacidosis, or DKA. At that time, the FDA reported 20 cases of ketoacidosis in patients who had used SGLT2 inhibitors.