Canagliflozin (Invokana▼): Increased risk of lower limb amputation

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Canagliflozin (Invokana▼), a sodium-glucose co-transporter 2 (SGLT2) inhibitor is indicated for the treatment of T2DM as monotherapy in metformin intolerant or contraindicated patients or as add-on therapy to achieve glycemic control.

Patients on canagliflozin are at increased risk of lower-limb amputation (mainly toes). Preventive measures like routine foot care and adequate hydration recommended.Treatment should be discontinued if complications like infection, skin ulcer, osteomyletis or gangrene reported. An increased risk for amputation has not yet been observed with dapagliflozin and empagliflozin