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

Key takeaways

Repaglinide and canagliflozin (Invokana) are both medications used to treat Type 2 diabetes. However, they belong to different medication classes and have some important differences. Repaglinide is a meglitinide that stimulates the pancreas to release more insulin, helping to lower blood sugar levels. The typical dosage is a 0.5 mg to 4 mg oral tablet before each meal. In contrast, canagliflozin is an SGLT2 inhibitor that works by preventing sugar reabsorption in the kidneys, causing excess sugar to be eliminated through urine. It is taken once daily before the first meal of the day, with a starting dose of 100 mg. Repaglinide is available as a generic, while canagliflozin is only available as a brand-name medication. Common side effects of repaglinide include low blood sugar, headache, and diarrhea, whereas canagliflozin may cause yeast infections, urinary tract infections, and increased urination. Additionally, canagliflozin is FDA-approved to reduce the risk of major heart events and worsening kidney problems in some people with Type 2 diabetes.

Repaglinide

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Invokana

(canagliflozin)

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Summary for Prandin

Prescription only

Repaglinide is an oral tablet taken in addition to diet and exercise to control blood sugar in adults with Type 2 diabetes. It belongs to the drug class called meglitinide, and works similar to sulfonylureas. The usual dosing is to take 0.5 mg to 4 mg by mouth before each meal. Potential warnings and side effects include low blood sugar, headache, and diarrhea. The brand name Prandin has been discontinued, but this medication is still available as a generic.

Indications for Prandin

Type 2 diabetes

Pros and Cons for Prandin

Pros

Can quickly lower blood sugar during meal times
Comes as an oral tablet taken by mouth
Available as a lower-cost generic

Cons

Has a risk of low blood sugar
Can cause some weight gain
Can interact with many medications

Common Side Effects for Prandin

Low blood sugar (31%)
Upper respiratory infection (16%)
Headache (11%)
Sinus infection (6%)
Joint pain (6%)
Nausea (5%)
Diarrhea (5%)
Back pain (5%)

Warnings for Prandin

Low blood sugar
Possible risk of serious heart problems

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