Invokana™ (canagliflozin): Risk of diabetic ketoacidosis

Janssen would like to inform healthcare professionals of the risk of diabetic ketoacidosis (DKA) during treatment with sodium glucose co-transporter 2 (SGLT2) inhibitors, including Invokana™. Serious and sometimes life-threatening cases of DKA in patients treated with SGLT2 inhibitors have been reported, with the majority of them requiring hospitalization. The presentation of DKA in a number of cases was atypical in that glucose levels were only mildly elevated at less than 11 mmol/L (or 200 mg/dL), while DKA typically occurs at glucose levels greater than 14 mmol/L (or 250 mg/dL). Healthcare professionals are advised to assess the patients, who are taking SGLT2 inhibitors, for ketoacidosis when they present with signs or symptoms of metabolic acidosis in order to prevent delayed diagnosis and patient management.

Only abstracts of the Dear Healthcare Professional Letters (DHCPL) are provided on this website. Details of these letters can be found in the MOH Alert System, which is accessible via the Health Professionals Portal (HPP), a one-stop portal for all healthcare professionals in Singapore. Dentists, medical doctors and pharmacists may access HPP at https://hpp.moh.gov.sg and follow the procedures below to access the MOH Alert system.

Step 1: Select your profession under ‘For Healthcare Professionals’.

Step 2: Click on ‘Useful links’.

Step 3: Click on ‘MOH Alert’ and log in via Singpass.

Step 4: Click on ‘Drug Alerts’ or ‘Med Device Alerts’ to view the DHCPLs.