The U.S. Food and Drug Administration has released a warning that two diabetes medications, Invokana and Ivokament, may lead to an increased risk in developing bone fractures.

This caution comes just four months after the federal agency warned that these drugs and other SGLT2 inhibitors may also increase the risk of kidney failure and ketoacidosis in patients.

SGLT2 Inhibitor Diabetes Medications

Several oral medications for type-2 diabetes are in the class of drugs known as SGLT2 inhibitors, also known as glifozins. SGLT2 stands for sodium glucose-linked transporter 2 (or sodium-glucose co-transporter-2) and it is a glucose transporter found in the proximal convoluted tubule in the duct system of kidney. These glucose transporters contribute to the reabsorption of glucose into the kidney.

There are currently three classes of SGLT2 inhibitors: dapagliflozin (Farxiga, Xiduo XR), canagliflozin (Invokana, Invokamet) and empagliflozin (Jardincace, Glyxambi, Synhardy). These medications lead to a reduction in blood glucose levels and also assist in reducing body weight and blood pressure. Essentially, the inhibition of SGLT2 allows the kidneys to remove glucose from the blood and excrete it in the urine.

Invokana is a single ingredient medication that includes canagliflozin and Invokamet is a combination drug that includes canagliflozin and metformin. These particular drugs have been called into question with respect to bone health.

Canagliflozin and Bone Health

In a healthy individual, there is adequate bone mineral density that leads to strong bones. In some patients taking Invokana and Invokamet, bone mineral density has been compromised and can lead to physical complications.

According to the FDA, bone fractures have been observed in patients who are taking the canagliflozin-based drugs Invokana and Invokamet.

These fractures have occurred as early as twelve weeks after starting the diabetes medications and the risk of fractures increases over time. In addition to bone fractures, a reduction in bone density in the hip and lower spine has also been reported.

Some individuals have an increased predisposition to developing bone fractures and this should be discussed with the physician who is prescribing Invokana or Invokamet.

Risk factors for the general development of bone fractures include: Previous history of fractures, family history of hip fracture, smoking, alcohol consumption, oral glucocorticoid use, rheumatoid arthritis and a diagnosis of secondary osteoporosis

The FDA is currently investigating the other drugs in the SGLT2 class of oral medications (Farxiga, Xigduo XR, Jardinace, Glyxambi and Synjardy) for the possible link to bone fractures as well to determine if there is an increased risk.

A couple of explanations have been proposed as to why this class of medications seems to affect bone density and predispose individuals to bone fractures. An article published in Lancet earlier this year suggested that SGLT2 inhibitors increase the amount of phosphate in the serum which has the possibility of affecting bone composition.

Additionally, they reported that SGLT2 inhibitors increase the amount of parathyroid hormone which enhances bone resorption, a process where bone is broken down. This in turn can cause the bone to be more susceptible to fractures.

Diabetes Medication Lawsuits

If you or a loved one has suffered a bone fracture or loss of bone mineral density as a result of taking Invokana, Invokament, or other SGLT2 inhibitors, you may have a legal claim.

Diabetes Medication Attorneys are investigating the possibility of a class action lawsuit to represent individuals who have taken these drugs and who have suffered severe side effects. Consultations with a lawyer to discuss your case are free and confidential.