Canagliflozin Amputation Risk: What You Need to Know

When you take canagliflozin, a type of SGLT2 inhibitor used to lower blood sugar in type 2 diabetes. Also known as Invokana, it helps your kidneys remove excess glucose through urine—but it also comes with a serious, documented risk: amputation risk, the increased chance of losing a toe, foot, or part of a leg. This isn’t theoretical. The FDA issued a warning after clinical trials showed more amputations in people taking canagliflozin compared to placebo. It’s not common, but when it happens, it’s often preventable.

Who’s most at risk? People with a history of foot ulcers, peripheral artery disease, or nerve damage from diabetes. If you’ve had a prior amputation, you’re at even higher risk. The mechanism isn’t fully understood, but researchers believe it’s tied to reduced blood flow, dehydration from increased urination, and possibly changes in how the body heals. SGLT2 inhibitors, a class of diabetes drugs that includes canagliflozin, dapagliflozin, and empagliflozin, all carry some level of this warning, though canagliflozin has the strongest data behind it. It’s not that these drugs are dangerous for everyone—many people take them safely and benefit from better blood sugar control and heart protection—but you need to know your personal risk factors before starting.

What should you do? Talk to your doctor if you’re on canagliflozin. Don’t stop taking it without medical advice, but ask: Do I have foot problems? Am I on other meds that affect circulation? Have I noticed sores, swelling, or numbness? Check your feet daily. Keep them clean and dry. Wear proper shoes. If you see a blister or cut that won’t heal, get it checked immediately. This isn’t about fear—it’s about awareness. Many amputations happen because small issues go unnoticed. The same attention you give to your blood sugar numbers should go to your feet.

Below, you’ll find real-world guidance on how other patients and doctors handle this risk. From spotting early warning signs to comparing safer alternatives, the posts here cut through the noise. You’ll learn what the data says, how to talk to your provider, and what steps actually make a difference in protecting your health.