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

Key takeaways

Invokana (canagliflozin) and Invokamet (canagliflozin/metformin) are both used to treat Type 2 diabetes, but they have some key differences. Invokana contains only canagliflozin, which works by helping your kidneys remove excess sugar through urine and can also improve heart and kidney health. On the other hand, Invokamet combines canagliflozin with metformin, a biguanide, and is available in both immediate-release (taken twice daily) and extended-release (taken once daily) forms, combining two medications into one pill, potentially simplifying your treatment regimen. Metformin helps lower the amount of sugar your liver makes and improves your body's response to insulin. While both medications can cause side effects like urinary tract infections and genital infections, Invokamet also carries a risk of low vitamin B12 levels and lactic acidosis due to the metformin component. Both are only available as brand-name medications.

Invokana

(canagliflozin)

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Invokamet

(canagliflozin / metformin)

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Summary for Invokana

Prescription only

Invokana (canagliflozin) is a medication that's used together with a healthy diet and exercise to lower blood sugar levels in adults with Type 2 diabetes. It can also lessen the chance of worsening heart and kidney problems in some people with Type 2 diabetes. This medication is taken by mouth once a day.

Indications for Invokana

Type 2 diabetes
Lowering the risk of major heart events (e.g., heart attack, stroke) in adults with Type 2 diabetes and heart disease
Lowering 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 Invokana

Pros

Only taken once a day
Can use alone or together with other diabetes medications
Dose can be adjusted based on how well the medication is working for you

Cons

Only available as brand only
Might raise the risk of genital infections or bone fracture
Not recommended in second and third trimesters of pregnancy
Unknown if safe or works well in people on dialysis

Common Side Effects for Invokana

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

Warnings for Invokana

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

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