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Drug · FAERS side-effect profile with label screen

Canagliflozin side effects: what 29,747 FDA adverse event reports show

Canagliflozin · Invokana · 1,109 reaction terms · 80,286 drug–reaction co-reports · data 2026-09-14
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Drug class

Sodium-glucose co-transporter 2 (sglt2) inhibitor

FDA label, Indications wording

Brand names

Invokana

openFDA label

Who reports

29,747 reports · 65% serious · 685 with death outcome · 49% female

openFDA FAERS counts, all years, deduplication not applied

Used for

INVOKANA (canagliflozin) is indicated: • as an adjunct to diet and exercise to improve glycemic control in adults and pediatric patients aged 10 years and older with type 2 diabetes mellitus. • to reduce the risk of major adverse cardiovascular events (cardiovascular death, nonfatal myocardial infarction and nonfatal stroke) in adults with type 2 diabetes mellitus and established cardiovascular disease (CVD).

FDA label, Indications and Usage

What it is

INVOKANA ® (canagliflozin) contains canagliflozin, an inhibitor of SGLT2, the transporter responsible for reabsorbing the majority of glucose filtered by the kidney. Canagliflozin, the active .

FDA label, Description section

Boxed warning

None in the current label

How to read this page. FAERS is a spontaneous-reporting system: counts are not incidence rates and a signal is not proof of causation. Each reaction below is run through an automated screen — is the term in the FDA label (known), in the indications (the disease being treated), an administrative/coding term, or none of these (unlabeled)? That screen is mechanical text matching, not a causality assessment. The 30 hand-written Bradford Hill assessments are on the causality assessment page. Not medical advice.

Causality screen of the 40 strongest signals

Labeled adverse reaction 11Labeled (related wording) 12Likely indication confounding 1Lab value / disease marker 1Not in label — unassessed 15
What the badges mean

Strongest disproportionality signals

Flagged terms (PRR ≥ 2, χ² ≥ 4, n ≥ 10), ranked by PRR; infinite PRRs (no comparator reports) excluded. The EBGM column is a second, shrinkage-based estimate (MGPS) with its 5th percentile EB05 and the BCPNN IC025; a pair flagged by PRR alone is marked PRR-only and should be read as fragile. The strata column recomputes the PRR on serious reports only and flags pairs whose reports are unusually skewed by sex or come mostly from consumers rather than clinicians. 1,069 further terms are in the interactive explorer. Reaction links open the term's cross-drug page.

Show:
ReactionReportsPRR 95% CI · ROR · χ²/pEBGM EB05 · IC025Label screenSerious-only & strataTrial cross-check
Metatarsal excision1021,864.5
1,284.9–2,705.6ROR 1,870.9 · χ² 51,060 / p <1e-300
462.6 EB05 392.1 · IC025 +6.9
3/3 methods agree
Not in label — unassessedserious n=102 · ♀ 27% (drug 49%) · 100% consumernot reported in cached trials
Limb amputation2691,448.5
1,174.6–1,786.2ROR 1,461.7 · χ² 125,649 / p <1e-300
454.9 EB05 411.0 · IC025 +7.8
3/3 methods agree
Labeled adverse reaction
exact term
serious n=269 · ♀ 23% (drug 49%) · 84% consumernot reported in cached trials
Malignant mediastinal neoplasm56762.7
522.0–1,114.4ROR 764.2 · χ² 19,943 / p <1e-300
323.8 EB05 258.6 · IC025 +6.0
3/3 methods agree
Not in label — unassessedserious n=56 · ♀ 100% (drug 49%)not reported in cached trials
Diabetic neuropathic ulcer11545.8
247.8–1,202.1ROR 546.0 · χ² 3,051 / p <1e-300
200.2 EB05 119.3 · IC025 +3.4
3/3 methods agree
Likely indication confounding
shares a disease stem with the indications wording
serious n=11not reported in cached trials
Genital infection fungal281364.8
315.9–421.3ROR 368.3 · χ² 66,612 / p <1e-300
235.7 EB05 213.5 · IC025 +7.2
3/3 methods agree
Labeled adverse reaction
exact term
serious n=64NCT01989754: 1/2,904 (0.0%) on Canagliflozin (serious AE)
Amputation325247.8
218.4–281.1ROR 250.5 · χ² 58,704 / p <1e-300
181.0 EB05 165.1 · IC025 +7.0
3/3 methods agree
Labeled adverse reaction
exact term
serious n=325 · ♀ 22% (drug 49%) · 71% consumerNCT02065791: 1/2,197 (0.0%) control (serious AE)
Diabetic foot788244.7
225.8–265.2ROR 251.3 · χ² 141,263 / p <1e-300
180.4 EB05 170.1 · IC025 +7.2
3/3 methods agree
Labeled adverse reaction
exact term
serious n=787 · ♀ 22% (drug 49%) · 91% consumerNCT01989754: 3/2,904 (0.1%) on Canagliflozin; 4/2,903 (0.1%) control (serious AE)
Ischaemic skin ulcer19194.1
116.7–322.7ROR 194.2 · χ² 2,704 / p <1e-300
132.1 EB05 89.4 · IC025 +4.2
3/3 methods agree
Not in label — unassessedserious n=19not reported in cached trials
Gangrene1,086153.9
144.2–164.2ROR 159.7 · χ² 134,954 / p <1e-300
125.9 EB05 119.7 · IC025 +6.8
3/3 methods agree
Labeled adverse reaction
exact term
serious n=1,086 · ♀ 28% (drug 49%) · 88% consumerNCT01989754: 2/2,903 (0.1%) control (serious AE)
Neuropathic arthropathy114152.0
124.1–186.1ROR 152.6 · χ² 13,906 / p <1e-300
122.4 EB05 104.6 · IC025 +6.0
3/3 methods agree
Not in label — unassessedserious n=114 · ♀ 23% (drug 49%) · 89% consumerNCT02065791: 3/2,197 (0.1%) control (serious AE)
Cellulitis of male external genital organ16118.2
69.6–200.9ROR 118.3 · χ² 1,491 / p <1e-300
90.6 EB05 59.1 · IC025 +3.8
3/3 methods agree
Not in label — unassessedserious n=16not reported in cached trials
Diabetic ketoacidosis3,435118.0
114.0–122.1ROR 133.3 · χ² 340,938 / p <1e-300
101.0 EB05 98.2 · IC025 +6.6
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 90.0NCT01989754: 5/2,904 (0.2%) on Canagliflozin; 2/2,903 (0.1%) control (serious AE)
Osteomyelitis2,16595.8
91.8–100.1ROR 103.3 · χ² 178,615 / p <1e-300
84.3 EB05 81.3 · IC025 +6.3
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 76.2 · ♀ 26% (drug 49%) · 91% consumerNCT01989754: 6/2,904 (0.2%) on Canagliflozin; 5/2,903 (0.2%) control (serious AE)
Balanoposthitis9291.3
73.5–113.4ROR 91.6 · χ² 7,182 / p <1e-300
79.5 EB05 66.8 · IC025 +5.5
3/3 methods agree
Labeled adverse reaction
exact term
serious n=33 · ♀ 0% (drug 49%) · 91% clinicianNCT01989754: 1/2,904 (0.0%) on Canagliflozin (serious AE)
Urine output increased23970.6
61.8–80.6ROR 71.1 · χ² 14,816 / p <1e-300
63.8 EB05 57.3 · IC025 +5.6
3/3 methods agree
Labeled adverse reaction
exact term
serious n=52not reported in cached trials
Cellulitis gangrenous1870.2
43.3–114.0ROR 70.3 · χ² 1,054 / p 2e-231
60.0 EB05 40.2 · IC025 +3.8
3/3 methods agree
Not in label — unassessedserious n=18not reported in cached trials
Ketoacidosis64366.3
61.2–71.8ROR 67.8 · χ² 37,714 / p <1e-300
60.5 EB05 56.7 · IC025 +5.7
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 54.3NCT01989754: 5/2,904 (0.2%) on Canagliflozin; 2/2,903 (0.1%) control (serious AE)
Genital infection2865.7
44.6–96.8ROR 65.8 · χ² 1,571 / p <1e-300
57.9 EB05 42.0 · IC025 +4.3
3/3 methods agree
Labeled adverse reaction
exact term
serious n=17 · 100% clinicianNCT01989754: 1/2,904 (0.0%) on Canagliflozin (serious AE)
Staphylococcal osteomyelitis1352.2
29.7–91.7ROR 52.2 · χ² 560 / p 3e-124
45.6 EB05 28.4 · IC025 +3.2
3/3 methods agree
Not in label — unassessedserious n=13not reported in cached trials
Vascular stenosis2043.6
27.7–68.4ROR 43.6 · χ² 743 / p 7e-164
39.6 EB05 27.1 · IC025 +3.6
3/3 methods agree
Not in label — unassessedserious n=20NCT01989754: 1/2,903 (0.0%) control (serious AE)
Joint ankylosis3343.0
30.3–61.1ROR 43.1 · χ² 1,236 / p 5e-271
39.7 EB05 29.6 · IC025 +4.1
3/3 methods agree
Not in label — unassessedserious n=33 · ♀ 0% (drug 49%) · 100% cliniciannot reported in cached trials
Extremity necrosis9540.3
32.8–49.5ROR 40.4 · χ² 3,403 / p <1e-300
37.9 EB05 31.9 · IC025 +4.7
3/3 methods agree
Not in label — unassessedserious n=95 · 81% consumerNCT01989754: 3/2,904 (0.1%) on Canagliflozin; 5/2,903 (0.2%) control (serious AE)
Ketonuria4137.5
27.4–51.3ROR 37.5 · χ² 1,347 / p 4e-295
35.1 EB05 27.0 · IC025 +4.1
3/3 methods agree
Not in label — unassessedserious n=36 · ♀ 26% (drug 49%)NCT01989754: 1/2,904 (0.0%) on Canagliflozin (serious AE)
Blood ketone body1736.2
22.2–59.0ROR 36.2 · χ² 520 / p 2e-115
33.3 EB05 22.0 · IC025 +3.3
3/3 methods agree
Not in label — unassessedserious n=11not reported in cached trials
Urine ketone body present7736.1
28.7–45.3ROR 36.2 · χ² 2,463 / p <1e-300
34.1 EB05 28.2 · IC025 +4.4
3/3 methods agree
Lab value / disease markerserious n=55not reported in cached trials
Acetonaemia1235.8
20.0–63.9ROR 35.8 · χ² 353 / p 4e-79
32.5 EB05 19.8 · IC025 +2.9
3/3 methods agree
Not in label — unassessedserious n=12not reported in cached trials
Necrotising soft tissue infection1135.5
19.4–65.1ROR 35.6 · χ² 319 / p 1e-71
32.1 EB05 19.1 · IC025 +2.8
3/3 methods agree
Not in label — unassessedserious n=11not reported in cached trials
Penile erythema1733.3
20.4–54.1ROR 33.3 · χ² 477 / p 4e-106
30.8 EB05 20.4 · IC025 +3.3
3/3 methods agree
Not in label — unassessedserious n=7not reported in cached trials

Trial evidence (ClinicalTrials.gov)

✓ Trial adverse-event data found on ClinicalTrials.gov

Largest completed trials with posted results that list Canagliflozin as a study intervention. The right-hand column of the signal table shows whether each FAERS term was also recorded in these trials, with a real denominator (23 of 40 signal terms matched).

Caveats: trial populations, doses and follow-up differ from the reporting population; AE terms are sponsor-coded and matched here by wording; absence from a trial list means the term was not reported above the sponsor's frequency threshold, not that it cannot occur.

Most frequently reported reactions

By raw co-report count, regardless of disproportionality. Common terms here are often the illness itself or generic outcomes.

ReactionReportsPRR 95% CI · ROR · χ²/pEBGM EB05 · IC025Label screenSerious-only & strataTrial cross-check
Diabetic ketoacidosis3,435118.0
114.0–122.1ROR 133.3 · χ² 340,938 / p <1e-300
101.0 EB05 98.2 · IC025 +6.6
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 90.0NCT01989754: 5/2,904 (0.2%) on Canagliflozin; 2/2,903 (0.1%) control (serious AE)
Osteomyelitis2,16595.8
91.8–100.1ROR 103.3 · χ² 178,615 / p <1e-300
84.3 EB05 81.3 · IC025 +6.3
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 76.2 · ♀ 26% (drug 49%) · 91% consumerNCT01989754: 6/2,904 (0.2%) on Canagliflozin; 5/2,903 (0.2%) control (serious AE)
Acute kidney injury (sudden kidney damage)1,9989.4
9.0–9.8ROR 10.0 · χ² 14,817 / p <1e-300
9.2 EB05 8.9 · IC025 +3.1
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 8.2 · 79% consumerNCT01989754: 7/2,904 (0.2%) on Canagliflozin; 15/2,903 (0.5%) control (serious AE)
Blood glucose increased1,2344.6
4.4–4.9ROR 4.8 · χ² 3,508 / p <1e-300
4.6 EB05 4.4 · IC025 +2.1
3/3 methods agree
Likely indication confounding
term in indications; also in warnings
serious PRR 4.0 · 73% consumerNCT01989754: 3/2,903 (0.1%) control (serious AE)
Gangrene1,086153.9
144.2–164.2ROR 159.7 · χ² 134,954 / p <1e-300
125.9 EB05 119.7 · IC025 +6.8
3/3 methods agree
Labeled adverse reaction
exact term
serious n=1,086 · ♀ 28% (drug 49%) · 88% consumerNCT01989754: 2/2,903 (0.1%) control (serious AE)
Cellulitis (skin infection)1,03514.7
13.9–15.7ROR 15.2 · χ² 13,006 / p <1e-300
14.5 EB05 13.7 · IC025 +3.7
3/3 methods agree
Not in label — unassessedserious PRR 14.0 · ♀ 28% (drug 49%) · 89% consumerNCT01989754: 9/2,904 (0.3%) on Canagliflozin; 11/2,903 (0.4%) control (serious AE)
Urinary tract infection (bladder infection)1,0184.2
4.0–4.5ROR 4.4 · χ² 2,521 / p <1e-300
4.2 EB05 4.0 · IC025 +2.0
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 3.7 · ♀ 71% (drug 49%)NCT01989754: 2/2,904 (0.1%) on Canagliflozin; 1/2,903 (0.0%) control (serious AE)
Off label use (used outside approved label)1,0160.8
0.8–0.9ROR 0.8 · χ² 39 / p 2e-10
0.8 EB05 0.8 · IC025 -0.4
PRR-only: not supported by EBGM or IC
Reporting / coding artifactserious PRR 0.9not reported in cached trials
Nausea1,0150.9
0.9–1.0ROR 0.9 · χ² 10 / p 8e-4
0.9 EB05 0.9 · IC025 -0.2
PRR-only: not supported by EBGM or IC
Labeled adverse reaction
exact term
serious PRR 0.8NCT02065791: 54/2,200 (2.5%) on Canagliflozin; 52/2,197 (2.4%) control
Drug ineffective (drug did not work)1,0120.5
0.5–0.6ROR 0.5 · χ² 418 / p 3e-93
0.5 EB05 0.5 · IC025 -1.0
PRR-only: not supported by EBGM or IC
Reporting / coding artifactserious PRR 0.6not reported in cached trials
Dizziness8431.2
1.1–1.3ROR 1.2 · χ² 27 / p 1e-7
1.2 EB05 1.1 · IC025 +0.1Labeled adverse reaction
exact term
serious PRR 0.8NCT01989754: 2/2,904 (0.1%) on Canagliflozin; 2/2,903 (0.1%) control (serious AE)

Unlabeled candidate signals

These flagged terms were not found in the FDA label text and do not match an artifact pattern. They are the pairs that would merit a structured assessment (temporality, dose-response, biological plausibility, consistency across databases, trial or cohort evidence). The screen has not done that; string-matching misses label wording, and a strong PRR can still be stimulated reporting, co-medication, or the disease itself.

✓ A hand-written Bradford Hill causality assessment exists for this drug: Canagliflozin ↔ Amputation.

Want to assess one of these properly? The runbook describes the Bradford Hill / trial-evidence workflow used on the assessment page, and handoff_top1000_signals.csv lists the strongest unassessed pairs across all drugs.

Common questions

What are the most reported side effects of Canagliflozin?

In FDA FAERS, the most frequently co-reported reaction terms for Canagliflozin are diabetic ketoacidosis, toe amputation, osteomyelitis, acute kidney injury, fungal infection, weight decreased. These are report counts, not rates: FAERS has no denominator, reporting is voluntary and uneven, and a term can be reported because of the illness being treated rather than the drug.

Does Canagliflozin have an FDA boxed warning?

No. The FDA label retrieved for Canagliflozin has no boxed warning; see the label's Warnings and Precautions for the recognised risks.

Do FAERS signals prove that Canagliflozin causes these side effects?

No. A disproportionality signal (PRR, ROR) means a reaction is reported more often with this drug than with others in the database. That can reflect a real effect, but also the disease being treated, stimulated reporting after news or litigation, co-medications, or how reports are coded. Causality needs temporality, dose-response, biological plausibility, consistency across data sources and, ideally, trial or cohort evidence. This page screens each term against the FDA label and ClinicalTrials.gov results; it does not establish causation.

Sources & methods

Page generated 2026-10-08. Label and PubChem text are retrieved automatically and may lag the current label; always check the current prescribing information. OpenPV is a beta research tool of the Open Source Medicine Foundation.