If you have type 2 diabetes, your doctor might prescribe canagliflozin (Invokana) to help control your blood sugar levels. Like any drug, canagliflozin might cause some unwanted effects. Some may be mild and go away after some time. But in rare cases, side effects may be serious enough to require treatments. The medication will affect different people differently. Not all side effects need medical attention. It’s best to watch for any after-effects, especially when you first start taking canagliflozin. The most common potential issues are urinary tract infections, yeast infections, low blood sugar (hypoglycemia), and dehydration. Yeast infection. This can happen in your vagina or penis. You’re more likely to get it if you have a history of genital yeast infections. The most common symptoms include vaginal discharge, odor, and itching. Yeast infections are more likely to happen with uncircumcised penises than with circumcised penises. Symptoms like discharge, odor, pain, and swelling around the skin can make it harder to pull back the foreskin. Yeast infections can be uncomfortable, but they’re treatable with timely care. let your doctor know as soon as you notice symptoms. Your doctor likely will prescribe an antifungal medication. They’re available as a tablet you take by mouth, a suppository that you insert inside your vagina, or a cream you apply to the affected area for relief. It should help clear up the infection in 7 to 14 days. To prevent or lower your risk for a yeast infection, it’s best to: It’s best to wait to have sex until after your infection clears up. if you have sex during treatment, it could lower the effectiveness of certain contraceptives, like condoms and diaphragms. Urinary tract infection (UTI). Tell your doctor if you notice symptoms like bladder pain, bloody or cloudy pee, a hard time peeing, a burning sensation when you pee, a strong urge to pee, or lower back or side pain. In some cases, a UTI could lead to a kidney infection (pyelonephritis). Your doctor might prescribe a course of antibiotics to clear the infection. To feel better, you should: To prevent a UTI, you should: Hypoglycemia (low blood sugar). This can happen when you take canagliflozin along with other diabetes medications like insulin, glipizide, or glyburide. Symptoms can include feeling dizzy, shaky, jittery, or weak. If your blood sugar dips too much, you may pass out. If you think you have signs of hypoglycemia, check your blood sugar and call your doctor right away. They may suggest changes to your diet. Or they may change or stop the medication to prevent future episodes. In severe cases, you might need to call 911 or head to the nearest hospital. If you’re hypoglycemic, you should: Wear an identification bracelet that says you have diabetes in case you have a blood sugar dip in the future. This will help medical professionals in an emergency setting. Let your family and friends know about your whereabouts in case of emergency. Dehydration. Canagliflozin is designed to flush out excess sugar in your body through pee. But the downside is you might lose too much. This can leave you feeling very thirsty, dizzy, lightheaded, and weak. You may have a higher risk for dehydration if you’re taking medications for low blood pressure or if you’re following a low-salt diet. Talk to your doctor about any lifestyle changes you can make to avoid dehydration in the future. Be careful in hot weather or when you exercise, as you may lose water through sweat. To prevent dehydration, drink lots of fluids to stop fluid loss. You can also add electrolytes to give you a much-needed boost. For severe dehydration, call 911 or get medication attention right away at a hospital. Other common, mostly mild side effects can include: If these side effects bother you or don’t go away, tell your doctor about them. If necessary, they’ll adjust your dosage. In some cases, canagliflozin might cause serious issues. These issues are relatively rare, and may include: Heart problems. The drug can cause shortness of breath, a fast or irregular heartbeat, or make you pass out. Serious allergic reaction (anaphylaxis or angioedema) that causes intense itching or large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or genitals Broken bones or serious fractures. Canagliflozin can raise your risk for both. Fournier’s gangrene (necrotizing fasciitis). It’s a rare bacterial infection you can get around the genitals. The infection can damage the tissue under the skin around your anus and genitals. It can spread quickly and can sometimes be deadly. If you notice any signs like tenderness, pain, or swelling in the area, get medical help as soon as possible. Other serious side effects can include: Other rare side effects can include: In some cases, the serious side effects might need medical attention right away. Tell your doctor or call 911 for medical attention.