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Actos vs Invokana
Introduction
For patients with type 2 diabetes, certain drugs that influence the way your body uses insulin or produces and eliminates sugar can aid in managing blood glucose levels. Actos and Invokana are two such medications prescribed for this purpose. Each of these drugs impacts different processes in your body but both aim to control high blood sugar levels in those with type 2 diabetes.
Actos, known as a thiazolidinedione, works by making tissues more sensitive to insulin thus allowing them to use glucose more effectively. On the other hand, Invokana is an SGLT2 inhibitor which hinders reabsorption of glucose into the bloodstream from kidneys; it primarily increases the amount of sugar expelled through urination.
What is Actos?
Pioglitazone (the generic name for Actos) was a major development in the thiazolidinedione class of anti-diabetic medications. It was first approved by the FDA in 1999. Actos works by increasing the sensitivity of fat, liver, and muscle cells to insulin allowing them to remove glucose from the blood more efficiently. It is prescribed for type 2 diabetes management. On the other hand, Canagliflozin (Invokana) belongs to a newer class of drugs known as SGLT2 inhibitors introduced in 2013 that work by inhibiting reabsorption of glucose in kidneys thus promoting its excretion via urine. Both drugs have different side effect profiles: while Actos may cause weight gain and carry a slight risk of bladder cancer over long-term use; Invokana can lead to dehydration due to increased urination and carries risk of genital yeast infections.
What conditions is Actos approved to treat?
Actos is approved for the management of specific health conditions, including:
- Type 2 diabetes Mellitus (either alone or in combination with other diabetes medications like metformin and insulin)
- Prediabetes, to delay the onset of type 2 diabetes
- Polycystic ovary syndrome (off-label use)
On the other hand, Invokana is also used in the treatment of:
- Type 2 Diabetes Mellitus
- Lowering risk of major cardiovascular events such as heart attack or stroke in patients with type 2 diabetes and known heart disease.
How does Actos help with these illnesses?
Actos helps to manage type 2 diabetes by increasing the sensitivity of body tissues to insulin. It accomplishes this by binding and activating the peroxisome proliferator-activated receptor gamma (PPARγ), a receptor that plays an essential role in regulating carbohydrate and fat metabolism, thereby improving how your body uses insulin. Insulin is a hormone produced by the pancreas that allows cells to take in glucose from our blood for energy use or storage. In people with type 2 diabetes, their bodies don't effectively use insulin as they should leading to high levels of sugar in their blood. Therefore, by enhancing insulin sensitivity, Actos can lower these elevated blood sugar levels and help patients better manage their condition.
What is Invokana?
Invokana, also known as canagliflozin, is a medication used to treat type 2 diabetes. It functions as a sodium-glucose co-transporter 2 (SGLT2) inhibitor, which means it works by blocking the reabsorption of glucose in the kidneys and promoting its excretion through urine. Invokana was first approved by the FDA in 2013. Unlike Actos (pioglitazone), which aids in regulating blood sugar levels by increasing your body's sensitivity to insulin, Invokana operates independently from insulin action. This unique mechanism of action allows Invokana to potentially lower blood sugar without causing weight gain or significantly increasing the risk of hypoglycemia - common side effects associated with medications like Actos that act on insulin sensitivity. The ability for canagliflozin to reduce blood glucose levels independent of insulin makes it an effective treatment option especially for patients who have not achieved adequate glycemic control with traditional diabetic treatments such as pioglitazone.
What conditions is Invokana approved to treat?
Invokana is a powerful medication that has been approved for the treatment of:
- Type 2 diabetes, as it works by encouraging your kidneys to get rid of glucose from your bloodstream.
- Reducing the risk of significant cardiovascular events such as stroke and heart attack in patients with type 2 diabetes who have already established cardiovascular disease.
How does Invokana help with these illnesses?
Invokana, similar to Actos, is a medication used in the management of type 2 diabetes. It works by inhibiting sodium-glucose transport proteins which are responsible for reabsorbing glucose into the bloodstream from the kidneys. By blocking these proteins, Invokana allows more glucose to be excreted through urination, thereby reducing blood sugar levels in diabetic patients. This mechanism is different from that of Actos and might offer benefits such as weight loss due to caloric loss via urine. However, it may also lead to increased risk of urinary tract infections and other side effects not typically associated with drugs like Actos. Therefore, Invokana may be prescribed when a patient does not respond well or cannot tolerate other typical antidiabetic medications like Actos.
How effective are both Actos and Invokana?
Both pioglitazone (Actos) and canagliflozin (Invokana) have been approved by the FDA for managing type 2 diabetes, with Actos being approved in 1999 and Invokana receiving approval in 2013. Since they act on different aspects of glucose metabolism, their use may vary based on specific patient circumstances. In a clinical trial conducted in 2014 that directly compared the two drugs, both medications displayed comparable efficacy in lowering HbA1c levels – an indicator of long-term blood sugar control.
An extensive review conducted in 2007 demonstrated that Actos effectively lowers blood sugar beginning from the first few weeks of treatment and has a side effect profile that is considered favourable compared to other thiazolidinediones. The same study highlights that it remains one of the most widely prescribed antidiabetic drugs globally due to its ability to improve insulin sensitivity. However, some patients reported weight gain as a side effect.
In contrast, Invokana works differently by inhibiting renal glucose reabsorption which leads to increased urinary glucose excretion thereby reducing plasma glucose levels and contributing towards weight loss—a potential advantage over many other antidiabetic treatments. A meta-analysis completed in 2017 indicated that Invokana was more effective than placebo at improving glycaemic control and led to significant reductions in body weight and systolic blood pressure but had slightly higher risk for genitourinary infections.
Therefore, while both options are viable for managing type 2 diabetes under proper medical supervision; individual tolerance profiles, co-existing conditions like heart disease or recurrent infections should be taken into account when choosing between these two medicines.
At what dose is Actos typically prescribed?
Oral dosages of Actos for treating type 2 diabetes typically start at 15-30 mg/day, although a dosage of 45 mg/day may be used if necessary. In contrast, Invokana is usually initiated with a dose of 100 mg once daily, taken before the first meal of the day. If more glycemic control is needed and patients can tolerate it, this may be increased to a maximum dose of 300 mg per day. As always, medication adjustments should only be made under the guidance and supervision of your healthcare provider.
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At what dose is Invokana typically prescribed?
Invokana treatment is usually initiated at a dosage of 100 mg once daily, taken before the first meal of the day. The dose can then be increased to 300 mg/day if needed and as tolerated by the patient. It's important that kidney function is evaluated prior to starting Invokana and regularly thereafter, as this medication should not be used in patients with severe renal impairment or who are on dialysis. Additionally, it's crucial to monitor for signs of urinary tract infection and yeast infections since these can occur while taking Invokana. If there isn't an adequate response to treatment at 100-300 mg/day after several weeks, further assessment may be necessary.
What are the most common side effects for Actos?
Some of the most common side effects associated with Actos include:
- Swelling (edema) in the legs, ankles and feet
- Weight gain
- Sinusitis (inflammation of the sinus cavities in the head)
- Muscular pain
- Headache and fatigue
On the other hand, Invokana may cause:
- Increased urination
- Thirst
- Yeast infections in women and men
- Urinary tract infections
- Changes in urination including urgent need to go, pain during urination or a lot more urine being passed than usual.
Both these medications target type 2 diabetes but their side effects can be quite different. It's crucial to discuss all potential side effects with your healthcare provider before starting any new medication regimen.
Are there any potential serious side effects for Actos?
Invokana and Actos are two different diabetes medications with distinct side effects. Here's what you need to know about their potential adverse reactions:
- Increased risk of amputation: Invokana, in rare cases, can lead to lower limb amputations primarily of the toe and middle of the foot.
- Signs of allergic reaction: Both could cause an allergic reaction, characterized by hives; difficulty breathing; swelling on face, lips, tongue or throat.
- Dehydration symptoms: Invokana may cause dehydration symptoms like dizziness or lightheadedness due to its diuretic effect.
- Heart failure risks: With Actos there might be a significant increase in weight gain leading to heart failure.
- Vision changes/blurred vision: This is more common with Actos due to macular edema (fluid build-up in the eye).
- Bone fractures: Long-term usage of Actos often leads to higher occurrences of bone fractures especially in women. In case any signs such as unusual pain and discomfort in extremities (for Invokana) or rapid weight gain, shortness of breath (especially when lying down), unusually slow/fast/irregular heartbeat(due to congestive heart failure for Actos) occur seek immediate medical help.
What are the most common side effects for Invokana?
When it comes to Invokana, some individuals may experience a range of side effects:
- Frequent urination
- Thirst and dry mouth due to increased fluid loss
- Yeast infections in women or men due to the sugar present in urine
- Nausea or stomach discomfort
- Fatigue and sleep problems
- Dizziness upon standing up (orthostatic hypotension)
- Weight loss as your body expels more glucose through urine
- Increased risk for low blood pressure, leading to feelings of lightheadedness
- Rash or skin sensitivity -Muscle pain or joint stiffness.
It is essential to monitor these symptoms and consult with your healthcare provider if any become severe.
Are there any potential serious side effects for Invokana?
Invokana, like any other medication, can have side effects. Some people may experience severe symptoms that require immediate medical attention. These include:
- Signs of an allergic reaction such as hives; difficulty breathing; swelling of your face, lips, tongue or throat
- Symptoms indicative of ketoacidosis - a serious condition sometimes caused by Invokana which might include nausea, vomiting, stomach pain, confusion and unusual fatigue or sleepiness
- A urinary tract infection with symptoms such as burning sensation while urination, frequent urges to urinate and lower abdominal pain
- Kidney problems characterized by little or no urinating; painful or difficult urination; swelling in your feet or ankles
- Severe dehydration symptoms including feeling very thirsty or hot, being unable to urinate and heavy sweating If you notice any of these signs after starting on Invokana treatment it's crucial to contact a healthcare provider immediately for guidance.
Contraindications for Actos and Invokana?
Both Actos and Invokana, like most other diabetes medications, may cause some side effects. If you notice an increase in urinary tract infections or yeast infections while taking these drugs, please consult with your doctor immediately.
Neither Actos nor Invokana can be taken if you have severe kidney disease or are on dialysis. Always inform your healthcare provider regarding the medicines that you are taking; certain medications will require a period of time to clear from the system to prevent dangerous interactions with both Actos and Invokana.
Moreover, there's risk for serious conditions such as heart failure with Actos and lower limb amputations (especially toes) with Invokana. Therefore, it is crucial to discuss all potential risks and benefits associated with these medications before starting therapy.
How much do Actos and Invokana cost?
Looking at brand name versions of Actos and Invokana:
- The price of 30 tablets of Actos (45mg) averages around $700, which works out to about $23/day.
- The price for a similar quantity of Invokana (300 mg) typically is about $475, working out to approximately $16/day.
Thus, if you are on the higher dosage range for Actos (i.e., 45 mg/day), then brand-name Invokana is less expensive on a per-day treatment basis. Please note that cost should not be your primary consideration when determining which drug is right for you.
In terms of generic versions available:
- Pioglitazone, the generic form of Actos, can significantly lower costs with prices ranging from about $0.60 to $2.25 per day depending upon the dose.
- Canagliflozin isn’t currently sold as a generic version in U.S so costs will remain closer to those associated with its name-brand counterpart until such time as it becomes available.
Popularity of Actos and Invokana
Pioglitazone, in generic form as well as brand names such as Actos, was estimated to have been prescribed to about 1.5 million people in the US in 2020. Pioglitazone accounted for roughly 10% of thiazolidinediones prescriptions (a class of medication used for diabetes) in the US. However, it appears to be a less-common choice compared to newer classes of antidiabetic drugs due its association with increased risk of bladder cancer.
Canagliflozin, including brand versions such as Invokana, was prescribed to approximately 2.3 million people in the USA in 2020. In the US, canagliflozin accounts for just over 30% of SGLT2 inhibitors prescriptions (another class used for diabetes), and is one of the more popular choices within this group due its effectiveness at lowering blood sugar levels and potential cardiovascular benefits. The prevalence of canagliflozin has been increasing since its approval by FDA back in March 2013.
Conclusion
Both Actos (pioglitazone) and Invokana (canagliflozin) are frequently used medications for the treatment of type 2 diabetes, with numerous clinical studies indicating their effectiveness in managing blood sugar levels. Both drugs can be employed as standalone treatments or combined with other antidiabetic medications depending on individual patient needs, but they should not be used together without careful consideration by a healthcare provider due to potential interactions.
Actos and Invokana operate through different mechanisms: Actos enhances the body's sensitivity to insulin while Invokana inhibits renal glucose reabsorption leading to increased urinary glucose excretion. This means that they might be prescribed under different circumstances; for instance, Actos is often preferred if insulin resistance is a primary concern whereas Invokana may be more beneficial when reducing the risk of cardiovascular events is paramount.
Both drugs are available in generic form which represents significant cost savings especially for patients who must pay out-of-pocket. The effects of these medications do not happen immediately - it usually takes some time before noticeable changes occur.
The side effect profiles for both these drugs differ somewhat: while both have common side effects such as weight gain (more common with Actos) and genital yeast infections (more common with Invokana), each has unique risks including bladder cancer risk association with long-term use of Actos and an increased risk of lower limb amputation linked to use of Invokana. For both drugs, patients must closely monitor their blood sugar levels regularly and seek immediate medical help if they experience symptoms like excessive thirst or urination, sudden vision changes or unexplained nausea.