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

Key takeaways

Invokamet (canagliflozin / metformin) and saxagliptin are both medications used to treat Type 2 diabetes. However, they belong to different medication classes. Invokamet is a combination of a sodium-glucose cotransporter 2 (SGLT2) inhibitor and a biguanide, while saxagliptin is a dipeptidyl peptidase-4 (DPP-4) inhibitor. Invokamet is available as immediate-release tablets taken twice daily or extended-release tablets taken once daily, whereas saxagliptin is taken once daily. Invokamet is only available as a brand-name medication, while saxagliptin is available in a generic form and used to be available as brand-name Onglyza. Invokamet can cause side effects like urinary tract infections, yeast infections, and frequent urination, while saxagliptin may lead to upper respiratory infections and headaches. Both medications can interact with other diabetes medications, potentially causing low blood sugar.

Invokamet

(canagliflozin / metformin)

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Saxagliptin

(Onglyza)

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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

Summary for Onglyza

Prescription only

Saxagliptin (Onglyza) is an add-on medication to exercise and a balanced, nutritious diet to improve blood sugar control in adults with Type 2 diabetes. It belongs to the drug class called dipeptidyl peptidase-4 (DPP-4) inhibitors. The saxagliptin (Onglyza) dosage is taken by mouth once daily. Possible side effects include certain infections and headaches. The brand name, Onglyza, is no longer available. But the lower-cost generic version is still available.

Indications for Onglyza

Type 2 diabetes in adults

Pros and Cons for Onglyza

Pros

Taken once daily (with or without food)
Less likely to cause weight gain (compared to some other diabetes medications)
Very low risk of causing hypoglycemia (low blood sugar) when it's taken by itself