A medication for treating Type 2 diabetes, Invokana appeared on the market in 2013. Johnson & Johnson’s marketing efforts pushed its popularity in a short period of time, but that year, health organizations began pointing out its life-threatening side effects.

Gaining visibility, the drug’s association with developing ketoacidosis prompted the FDA to issue a warning. Multiple lawsuits have followed in response.


On its own or combined with metformin, generic drug canagliflozin is a sodium-glucose cotransporter-2 (SGLT2) inhibitor prescribed strictly for managing Type 2 diabetes in conjunction with diet and exercise. This drug class signals to the kidneys to release blood glucose through the urine. Normally, the kidneys store glucose and release it naturally, but in Type 2 cases, this organ holds onto too much.

While Invokana’s 2 million prescriptions make it the widest-used, other manufacturers now have their own variations:

  • AstraZeneca – Farxiga
  • Eli Lilly and Boehringer Ingelheim – Jardiance and Glyxambi

Symptoms & Warning

Diabetes ketoacidosis (DKA) develops when insulin levels drop too low. The body, in response, starts overproducing blood acids, or ketones, as waste.

Untreated or ignored symptoms progress to a severe condition resulting in a coma or death. Patients also have experienced cardiovascular injuries or kidney failure as a result.

20 cases from May 2013 to June 2014 in the FDA’s database triggered a warning. The organization, currently investigating the drug’s safety, reported patients have required emergency attention and hospitalization to treat DKA. Out of this group, patients noticed they took the drug for at least two weeks before noticing symptoms:

  • Difficulty breathing
  • Nausea and vomiting
  • Abdominal pain
  • Confusion
  • Fatigue

Even after this cutoff, patients continue to report instances of Invokana-related DKA.

While researchers haven’t discovered a clear cause, patients appear to develop DKA following a major illness, from reduced food and fluid intake, and a lower insulin dosage.

The FDA isn’t the first organization to express concern about Invokana usage. In 2013, Public Citizen objected to the SGLT2 inhibitor, stating the public wasn’t supplied with sufficient safety information.

In May 2015, the Institute for Safe Medication released a report about the drug’s other adverse reactions, citing 450 instances of:

  • Renal toxicity
  • Kidney failure or impairment
  • Dehydration or fluid imbalance
  • Kidney stones
  • Urinary tract infections
  • Sudden and sharp weight loss


Patients have only recently started coming forward to talk about their experiences using Invokana. In response, those developing DKA or a severe kidney condition have started filing lawsuits on a local level. Multi-district litigation (MDL) is expected to develop.

Trantolo & Trantolo’s Connecticut-based team of lawyers handles such dangerous drug and product liability lawsuits. If you think you, after experiencing these frightening side effects, have a case, contact any of our law offices to speak with an experienced attorney.