Invokana vs Invokamet

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Introduction

For patients with type 2 diabetes, certain drugs that influence the regulation of blood sugar can help in managing symptoms and preventing complications. Invokana and Invokamet are two such drugs prescribed for this purpose. They each impact different aspects of glucose control but both have beneficial effects in patients with type 2 diabetes.

Invokana is a sodium-glucose co-transporter 2 (SGLT2) inhibitor. It works by inhibiting SGLT2, which reduces reabsorption of glucose in the kidney, leading to excretion of excess glucose through urine.

On the other hand, Invokamet is a combination drug containing Canagliflozin (the same active ingredient as in Invokana) and Metformin - an oral antihyperglycemic medication used to control high blood sugar levels. Thus it combines mechanisms of action from both categories: SGLT2 inhibition from Canagliflozin and decreased hepatic glucose production from Metformin.

What is Invokana?

Canagliflozin (the generic name for Invokana) was the first drug of the SGLT2 inhibitors class, which marked a significant advancement in treating type 2 diabetes. Canagliflozin was initially approved by the FDA in 2013. Invokana works by blocking a protein called sodium-glucose cotransporter 2 (SGLT2), effectively keeping glucose from being reabsorbed into the kidneys and instead is excreted in urine. This helps maintain blood sugar levels within normal limits.

On the other hand, we have Invokamet, which not only contains canagliflozin but also metformin hydrochloride—a well-established medication used to improve glycemic control in adults with type 2 diabetes. Metformin works differently than canagliflozin—it decreases hepatic glucose production and intestinal absorption of glucose while improving insulin sensitivity.

Thus, having two active ingredients targeting different mechanisms results in better management of blood sugar levels compared to using either component alone—making it an appealing choice for patients whose condition isn't adequately controlled with just one medication or diet/exercise regimen alone.

What conditions is Invokana approved to treat?

Invokana is approved for the treatment of different types of diabetes:

  • Type 2 diabetes, as an adjunct to diet and exercise to improve glycemic control
  • To reduce the risk of major cardiovascular events such as heart attack or stroke in people with type 2 diabetes who have known cardiovascular disease

On the other hand, Invokamet is a combination drug used for:

  • Type 2 Diabetes management along with diet and exercise. It combines two drugs – Canagliflozin (the active ingredient in Invokana) and Metformin.
  • Initially improving blood sugar levels in adults when one medication does not control their condition.

How does Invokana help with these illnesses?

Invokana helps to manage type 2 diabetes by increasing the amount of glucose that is expelled from the body in urine. It does this by inhibiting a protein called sodium-glucose co-transporter 2 (SGLT2) in the kidneys, thus preventing glucose from being reabsorbed into the blood and instead ensuring it's excreted through urine. Glucose is a simple sugar that provides energy for cells throughout your body but can be problematic when levels are too high, as they tend to be in individuals with diabetes. Therefore, by promoting its expulsion via urine, Invokana can limit the negative effects of high blood sugar levels and help patients manage their condition.

On the other hand, Invokamet combines two drugs: Canagliflozin (Invokana) and Metformin. While Canagliflozin works as described above, Metformin reduces glucose production in the liver and improves insulin sensitivity thereby assisting in lowering blood glucose levels more effectively than taking either medication alone.

What is Invokamet?

Invokamet is a combination medication that contains Canagliflozin and Metformin. While Canagliflozin, sold under the brand name Invokana among others, inhibits SGLT2 (sodium-glucose cotransporter-2) in the proximal renal tubules to reduce reabsorption of glucose from the tubular lumen and lower blood sugar levels, Metformin works by decreasing glucose production in the liver and increasing insulin sensitivity in muscle cells.

The FDA first approved Invokamet for use in 2014. Unlike Invokana which only contains Canagliflozin, its dual-action approach can provide additional benefits for patients with type 2 diabetes who require more than one drug to control their blood sugars. Its side-effect profile may also differ slightly due to the addition of metformin; gastrointestinal issues such as diarrhea or nausea could potentially be more common but weight gain is less likely compared to some other diabetic medications.

What conditions is Invokamet approved to treat?

Invokamet is a medication approved for the management of:

  • Type 2 diabetes mellitus (T2DM) This drug is specifically designed to be utilized in combination with an appropriate diet and exercise routine to control high blood sugar. It combines two active ingredients, canagliflozin and metformin, which work together to help your body regulate blood glucose levels. Please note that Invokamet should not be used in patients with Type 1 diabetes or diabetic ketoacidosis.

How does Invokamet help with these illnesses?

Invokamet is a medication that combines two active ingredients, canagliflozin and metformin, to manage blood sugar levels in adults with type 2 diabetes. Much like the "fight or flight" response mentioned above, maintaining balanced blood sugar levels is crucial for the body's overall functioning. Canagliflozin, similar to Invokana, works by helping the kidneys remove glucose from the bloodstream through urine. On top of this mechanism of action, Invokamet also includes metformin which decreases hepatic glucose production and improves insulin sensitivity by increasing peripheral glucose uptake and utilization. This dual-action approach helps control high blood sugar more effectively than using either drug alone. Consequently, Invokamet may be prescribed when a patient does not respond well to other diabetic treatments or may be combined with them.

How effective are both Invokana and Invokamet?

Both canagliflozin (Invokana) and a combination of canagliflozin/metformin (Invokamet) have proven to be effective in managing type 2 diabetes, with their initial FDA approval only a year apart. They function by inhibiting the sodium-glucose cotransporter-2 (SGLT2), which reduces reabsorption of glucose by the kidneys and promotes excretion of excess glucose through urine. The primary difference between these two medications is that Invokamet also includes metformin, an oral antidiabetic medication that decreases hepatic glucose production.

A direct comparison between monotherapy with canagliflozin and combination therapy with canagliflozin/metformin was conducted in a double-blind clinical trial in 2013; both treatments demonstrated efficacy in lowering HbA1c levels, though the reduction was more pronounced with the combination treatment. No significant differences were observed regarding safety profiles or incidences of adverse events.

Numerous studies have confirmed that canagliflozin effectively lowers blood sugar levels from early stages of treatment itself, has favourable side effect profiles over many other antidiabetics, and is well-tolerated even among elderly populations. Canagliflozin not only aids in controlling blood sugar but also contributes to weight loss and reduction in systolic blood pressure.

In terms of Invokamet, its dual mechanism action offers greater control over high blood sugar compared to using either drug alone. Although typically considered as second-line treatment options after metformin monotherapies due to potential gastrointestinal side-effects associated with metformin's use, they are prescribed when patients fail to achieve adequate glycemic control on other drugs or cannot tolerate them due to various reasons.

abstract image of a researcher studying a bottle of drug.

At what dose is Invokana typically prescribed?

Oral dosages of Invokana typically start at 100 mg once daily, taken before the first meal of the day. If necessary and well-tolerated, your doctor may increase this to a maximum dosage of 300 mg daily. On the other hand, Invokamet is a combination drug that also includes metformin. The starting dose for Invokamet varies depending on each patient's current regimen but usually starts with one tablet containing 50mg of canagliflozin (the active ingredient in Invokana) and 500mg of metformin twice daily. Adjustments to both medications should be made based on effectiveness and tolerability while not exceeding the maximum recommended daily doses.

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At what dose is Invokamet typically prescribed?

Invokamet is typically initiated with a dosage of 50–1000 mg/day, taken in combination with metformin. The dose can then be increased to 150 mg/day combined with up to 2000mg of metformin, divided into two doses spaced 12 hours apart. An increase to the maximum daily dose of Invokamet, which is comprised of 300 mg canagliflozin (the active ingredient in Invokana) and 2000mg metformin, may be considered if there's no response to treatment at the lower dose after several weeks. This should be split into two equal doses taken morning and evening for optimal effect. As always, any changes in medication or dosage should only be made under the supervision of your healthcare provider.

What are the most common side effects for Invokana?

Common side effects of both Invokana and Invokamet include:

  • Frequent urination
  • Increased thirst
  • Yeast infections in women and men
  • Urinary tract infections
  • Changes in urination, including urgent need to go, increased frequency, or color changes
  • Nausea, constipation or upset stomach
  • Dry mouth and dehydration symptoms such as dizziness or lightheadedness
  • Tiredness (fatigue)

It's worth noting that because Invokamet also contains metformin, some patients may experience additional side effects like diarrhea, indigestion (dyspepsia), abdominal discomfort and a metallic taste in the mouth.

Please consult with your healthcare provider for any concerns about these medications' side effects.

abstract image of a patient experiencing side effect

Are there any potential serious side effects for Invokana?

While both Invokana and Invokamet are used to manage type 2 diabetes, there can be some varying side effects between the two medications. In rare cases, these can include:

  • Signs of an allergic reaction such as hives; difficulty breathing; swelling in your face or throat.
  • Symptoms of a severe skin reaction like fever, sore throat, burning eyes, skin pain followed by a red or purple skin rash that spreads (especially on the face or upper body) causing blistering and peeling.
  • Vision changes including blurred vision or other visual disturbances.
  • Cardiovascular symptoms such as fast heartbeats that feel like pounding in your chest; fluttering sensations in your chest; shortness of breath accompanied with dizziness which may lead to fainting spells.
  • Low potassium levels - signs include leg cramps, constipation, irregular heartbeats, fluttering in your chest, increased thirst or urination.
  • Severe kidney problems - little or no urinating; painful or difficult urination; swelling in your feet and ankles; shortness of breath.

If you experience any combination of these symptoms while taking either medication it is important to seek immediate medical attention.

What are the most common side effects for Invokamet?

Invokamet, a combination of metformin and canagliflozin, carries the potential for certain side effects:

  • Possible dehydration leading to dizziness, lightheadedness or fainting
  • Increased urination
  • Nausea, vomiting or upset stomach
  • Changes in appetite resulting in weight loss
  • Sleep issues such as insomnia
  • Mild rash could occur
  • Unusual tiredness or weakness due to low blood sugar levels (hypoglycemia)
  • Fast heartbeat -Muscle pain and joint discomfort may be experienced. It's crucial that patients communicate any adverse reactions they experience while on Invokamet with their healthcare provider.

Are there any potential serious side effects for Invokamet?

Invokamet, a medication combining canagliflozin and metformin, is generally considered safe but may cause some serious side effects in rare situations. If you experience any of the following symptoms while using Invokamet:

  • Signs of allergic reaction: hives, itching; difficulty breathing or swallowing; swelling in your face or throat
  • Symptoms related to lactic acidosis (a build-up of lactic acid in the body), such as unusual fatigue or weakness, slow heart rate, cold feeling, muscle pain, shortness of breath and stomach discomfort.
  • Dehydration symptoms - extreme thirstiness; dry mouth; darkened urine; reduced frequency of urination
  • Genital yeast infections causing itching or discomfort around genital area
  • Kidney problems – back pain just below ribs coupled with bloody urine
  • Ketoacidosis (high levels of certain acids called ketones) - nausea/vomiting, trouble breathing.

If any such signs present themselves while taking Invokamet therapy it's vital that medical attention be sought promptly.

Contraindications for Invokana and Invokamet?

Both Invokana and Invokamet, along with most other diabetes medications, may worsen symptoms of kidney issues in some people. If you notice your urine becoming cloudy or foamy, or if you experience swelling in the hands and feet, it could indicate a problem with your kidneys—please seek immediate medical attention.

Neither Invokana nor Invokamet can be taken if you are taking medications that strongly affect renal function such as diuretics or certain blood pressure medicines. Always inform your doctor about all the medication you’re currently taking; certain drugs will require a period of clearance from the system to prevent dangerous interactions with Invokana and Invokamet.

How much do Invokana and Invokamet cost?

For the brand name versions of these drugs:

  • The price for 30 tablets of Invokana (100 mg) is about $500, which works out to approximately $16.67 per day.
  • The cost for 60 tablets of Invokamet (50/500 mg) averages around $1,000, working out to roughly $33.33 per day.

Thus, if you are taking a lower dosage or single tablet daily, then brand-name Invokana could be less expensive on a per-day treatment basis compared to Invokamet. However, it's important that cost should not be the main factor in determining which drug is suitable for you as efficacy and side effects play crucial roles too.

As for generic versions of these medications, both are still under patent protection and thus there are no approved generic options available yet. When generics do become available in the future they will likely provide a more affordable option than their respective branded counterparts.

Popularity of Invokana and Invokamet

Canagliflozin, under the brand name Invokana, has been a crucial drug for treating type 2 diabetes since its FDA approval in 2013. In 2020 alone, it was prescribed to around 1.6 million people in the US and accounted for nearly 13% of SGLT2 inhibitor prescriptions.

Invokamet is a combination medication that includes canagliflozin (as found in Invokana) and metformin, another widely used diabetes medication. This duo aims to control blood sugar levels more effectively than either medicine on its own could do. The use of combination therapy like Invokamet has been increasing rapidly over recent years as doctors aim to manage their patients' glucose levels more aggressively with multiple medications simultaneously. Despite this trend though, standalone canagliflozin continues to be prescribed more frequently than combined therapies involving this agent due largely to individual patient needs and tolerability profiles.

Conclusion

Invokana (canagliflozin) and Invokamet (a combination of canagliflozin and metformin) are both commonly prescribed for the management of type 2 diabetes. Numerous clinical studies show they are effective in reducing blood glucose levels compared to placebo treatments. In some situations, these medications may be used together or added to other diabetes medication regimens, but this should only be done under a physician's guidance.

The fundamental difference between the two is that while Invokana contains just one active ingredient - canagliflozin, which works by causing the kidneys to get rid of more glucose from your body into your urine; Invokamet combines this with metformin, an older drug that reduces liver production of glucose and improves insulin sensitivity.

Both drugs are available as generics which makes them relatively affordable even for patients who must pay out-of-pocket expenses. It's worth noting though that the effects of these medications aren't usually felt immediately as it takes time for blood sugar levels to balance out.

In terms of side effect profiles, both medicines have similar risks including urinary tract infections due to increased urination and genital fungal infections. However, Invokamet because it contains metformin has an additional risk – gastrointestinal issues such as diarrhea or upset stomach. Patients need regular monitoring for kidney function while using either medication since they work by altering kidney handling of sugars. Immediate medical attention should be sought if users experience symptoms such as dehydration or ketoacidosis.