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

Key takeaways

Januvia (sitagliptin) and Invokana (canagliflozin) are both oral medications used to treat Type 2 diabetes, but they work in different ways and belong to different drug classes. Januvia is a dipeptidyl peptidase 4 (DPP-4) inhibitor that helps increase insulin levels and decrease sugar production in your body, while Invokana is a sodium-glucose co-transporter 2 (SGLT2) inhibitor that helps your kidneys remove excess sugar through urine. Januvia is typically taken once daily and does not affect body weight, whereas Invokana can cause weight loss and is also taken once daily, preferably before the first meal. Invokana has additional benefits of lowering the risk of major heart events and worsening kidney problems, which Januvia does not specifically address. However, Invokana carries a risk of genital infections and possible amputations, while Januvia may cause severe joint pain and has a rare risk of pancreatitis. Both Invokana and Januvia are only available as brand-name medications.

Januvia

(sitagliptin)

Get free coupons

Invokana

(canagliflozin)

Get free coupons

Summary for Januvia

Prescription only

Januvia (sitagliptin) is a prescription medication that helps lower blood sugar in adults with Type 2 diabetes. It works best when you also follow a balanced diet and exercise regularly. It belongs to the drug class called dipeptidyl peptidase-4 (DPP-4) inhibitors, or gliptins. Januvia (sitagliptin) comes as a tablet you take by mouth once a day. Side effects include stuffy or runny nose and headache. Januvia (sitagliptin) is a brand-name medication only; the generic version isn't available yet.

Indications for Januvia

Type 2 diabetes in adults

Pros and Cons for Januvia

Pros

Taken once a day
Not likely to affect your body weight

Cons

Not for people with Type 1 diabetes
Possible risk of severe joint pain

Common Side Effects for Januvia

Runny or stuffy nose and other symptoms of the common cold (5%)

Warnings for Januvia

Inflammation of the pancreas (pancreatitis)
Risk of heart failure
Sudden kidney problems
Low blood sugar when taken with other diabetes medications
Serious allergic reactions
Joint pain
Severe skin reactions

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