Xigduo XR

Drug Class

SGLT2 inhibitor

Indication for Use

Treatment of Type II Diabetes


Diabetic ketoacidosis
Renal failure


Invokana and other drugs in the Glifozin class came on the market in 2013 for the treatment of Type II Diabetes.

In a person without diabetes, sugars within the blood are metabolized by insulin processes, with normal blood sugars entering the kidney and going through a reabsorption to be reutilized within the body. By contrast, a diabetic often has too much sugar in the blood stream to be reabsorbed, therefore an emergency mechanism kicks in to filter the excess sugar through the kidneys and into the urine. This is a short term solution to a metabolic problem, however, and the kidneys are not designed to sustain this type of overload.

Invokana works to block the reabsorption process and capitalize on this biological emergency mechanism, putting strain on the kidneys, which can lead to renal failure, and leaving high levels of acid in the blood resulting in ketoacidosis. High levels of acid in the blood pose a significant risk of cardiovascular events.

Litigations against the manufacturer of these drugs, including Johnson & Johnson, are pending in a variety of state and federal venues across the country.