Glyxambi vs. Invokamet for Diabetes Type 2: Important Differences and Potential Risks.

Key takeaways

Glyxambi (empagliflozin/linagliptin) and Invokamet (canagliflozin/metformin) are both combination medications used to treat Type 2 diabetes, but they have some key differences. Glyxambi combines an SGLT2 inhibitor (empagliflozin) and a DPP-4 inhibitor (linagliptin), while Invokamet combines an SGLT2 inhibitor (canagliflozin) and a biguanide (metformin). Glyxambi is taken once daily, whereas Invokamet is available in both immediate-release (taken twice daily) and extended-release (taken once daily) forms. Glyxambi can lower the risk of death from heart disease in people with Type 2 diabetes and heart disease, which Invokamet is also approved for. Invokamet can also lower the risk of major heart events and hospitalization for heart failure and worsening kidney problems in adults with type 2 diabetes and kidney disease. Both medications can cause urinary tract infections and genital infections, but Invokamet also raises the risk of bone fractures and low vitamin B12 levels. Additionally, Invokamet is only available as a brand-name medication, while Glyxambi does not have a generic form either.

Glyxambi

(empagliflozin / linagliptin)

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Invokamet

(canagliflozin / metformin)

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Summary for Glyxambi

Prescription only

Glyxambi (empagliflozin / linagliptin) is used to manage blood sugar levels in adults with Type 2 diabetes. It's a combination of 2 medications: empagliflozin (a sodium-glucose co-transporter 2 (SGLT2) inhibitor) and linagliptin (a dipeptidyl peptidase-4 (DPP-4) inhibitor). It lowers blood sugar by getting rid of extra sugar through your urine and helping your body make more insulin. Glyxambi (empagliflozin / linagliptin) is taken by mouth once daily. Some common side effects include urinary tract infections and upper respiratory tract infections.

Indications for Glyxambi

Type 2 diabetes in adults (when taken along with nutritious diet and regular exercise)
Lowers risk of death from heart problems in adults with Type 2 diabetes and heart disease

Pros and Cons for Glyxambi

Pros

Combines two medications into one pill for convenience
Can lower the risk of death from heart attack or stroke in people with Type 2 diabetes and heart disease
Only taken once a day in the morning with or without food
Not likely to cause weight gain

Cons

Not safe for use in people on dialysis
Not approved for people with Type 1 diabetes
Might cause you to urinate more often
Might cause urinary tract infections or genital yeast infections

Common Side Effects for Glyxambi

Urinary tract infection (11-13%)
Upper respiratory tract infection (7%)

Warnings for Glyxambi

Pancreas problems
Ketoacidosis (too much acid in the blood)
Low fluids in the body (leading to low blood pressure or dehydration, or kidney problems)
Low blood sugar with other diabetes medications
Genital and urinary tract infections
Serious allergic or skin reactions
Joint pain
Leg and foot amputations
Heart failure

Summary for Invokamet

Prescription only

Invokamet (canagliflozin / metformin) is a combination medication used along with diet and exercise to lower blood sugar levels in adults with Type 2 diabetes. It's available as immediate-release tablets that are taken twice daily, as well as extended-release tablets that are taken once daily. This medication raises the risk of urinary tract infections (UTIs) and genital infections.

Indications for Invokamet

Type 2 diabetes
To lower the risk of major heart events (e.g., heart attack, stroke) in adults with Type 2 diabetes and heart disease
To lower the risk of hospitalization for heart failure, death due to heart problems, and worsening of kidney problems in certain adults with Type 2 diabetes and diabetic kidney disease

Pros and Cons for Invokamet

Pros

Combines two medications into one pill
Available as an extended-release tablet that lasts throughout the day (Invokamet XR)
Can lower A1C (a blood test that measures your average sugar level over time) by up to 1.8% in people who aren't already taking either Invokana (canagliflozin) or metformin
Dose can be adjusted based on how well the medication is working for you

Cons

Might cause more urination
Can lower vitamin B12 levels
Raises the risk of urinary tract infections (UTIs), genital infections, and bone fractures
Only available as brand

Common Side Effects for Invokamet

Vaginal yeast infection in females (11-12%)
Urinary tract infections (UTIs; 4-6%)
More urination (5%)
Male genital yeast or fungal infections (4%)
Diarrhea (4%)

Warnings for Invokamet

Lactic acidosis
Leg and foot amputations
Ketoacidosis
Low fluids in the body (leading to low blood pressure or dehydration)
Genital and urinary tract infections
Low blood sugar (hypoglycemia) when used with certain other diabetes medications
Severe allergic reactions
Bone fractures
Low vitamin B12 levels