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Jardiance vs Invokana
Introduction
For patients with type 2 diabetes, certain medications can help regulate blood sugar levels to manage their condition and prevent complications. Jardiance and Invokana are two such drugs that are often prescribed for managing this chronic disease. They each work by influencing the kidneys' function in removing glucose from the bloodstream, but they have slightly different effects and side-effect profiles.
Jardiance (empagliflozin) and Invokana (canagliflozin) belong to a class of medication known as sodium-glucose co-transporter 2 (SGLT2) inhibitors. These drugs lower blood sugar by causing the kidneys to remove sugar from the body through urine. Although both medicines operate on similar principles, there may be differences in individual patient responses, potential side effects, or other factors like cost which inform a doctor's decision about which drug is best for a specific patient.
What is Jardiance?
Empagliflozin (the generic name for Jardiance) and Canagliflozin (generic for Invokana), are both part of the class of drugs known as SGLT2 inhibitors, which has marked a considerable advancement from previous classes of anti-diabetic medications. Empagliflozin was approved by the FDA in 2014. Jardiance works by blocking a protein called SGLT2, thereby preventing glucose reabsorption in the kidneys and promoting its excretion via urine, effectively lowering blood sugar levels in adults with type 2 diabetes. It is typically prescribed alongside diet changes and exercise to improve glycemic control. While both these medications work on the same principle to lower blood sugar levels, they differ slightly in their side effect profiles and efficacy rates at different doses. Jardiance, much like Prozac in your example above, has selective action on SGLT2 proteins with minor influence on other renal transporters resulting in fewer associated side effects compared to other antidiabetic agents.
What conditions is Jardiance approved to treat?
Jardiance is approved for the treatment of several conditions related to type 2 diabetes:
- Type 2 diabetes itself, used as an adjunct to diet and exercise to improve glycemic control
- To reduce the risk of cardiovascular death in adult patients with type 2 diabetes mellitus and established cardiovascular disease.
- Heart failure in adults with a reduced ejection fraction (HFrEF), regardless if they have diabetes or not.
How does Jardiance help with these illnesses?
Jardiance helps to manage Type 2 diabetes by increasing the amount of glucose excreted in urine. It does this by blocking a protein in the kidneys called SGLT2, which is responsible for reabsorbing glucose back into the blood, thus allowing more glucose to be eliminated from the body. Glucose is a type of sugar that serves as a primary source of energy for cells throughout the body. In individuals with Type 2 diabetes, their bodies either resist insulin's effects or don't produce enough insulin to maintain normal glucose levels. Therefore, by increasing urinary glucose excretion, Jardiance can help patients reduce their blood sugar levels and better manage their condition.
Invokana operates under similar principles as it too inhibits SGLT2; however differences may exist between these medications such as potential side effects and level of effectiveness based on individual patient factors.
What is Invokana?
Invokana, also known by its generic name Canagliflozin, is a sodium-glucose co-transporter 2 (SGLT2) inhibitor. This means it works in the kidneys to prevent glucose from being reabsorbed into the blood and instead allows it to be excreted through urine. It was first approved by the FDA in 2013. Unlike DPP-4 inhibitors or GLP-1 agonists which affect insulin release or resistance, Invokana primarily targets glucose control directly at the kidney level. Its unique mode of action means that its side-effect profile may differ from other diabetic medications such as Jardiance (Empagliflozin). Notably, because Invokana promotes glucose excretion via urination rather than metabolic processing of sugars, patients using this medication are less likely to experience weight gain - a common concern with many diabetes medications including some like Jardiance. Additionally, while all SGLT2 inhibitors carry risk for UTIs due to increased sugar levels in urine providing an easier environment for bacteria growth; studies have suggested that instances might be moderately higher with Empagliflozin compared to Canagliflozin.
What conditions is Invokana approved to treat?
Invokana is a medication approved by the FDA for the management of:
- Type 2 diabetes, as it aids in controlling high blood sugar levels.
- Reducing the risk of major cardiovascular events such as heart attack or stroke in people with type 2 diabetes who have known heart disease. It works by encouraging the kidneys to expel glucose from your bloodstream through urine, thus lowering overall blood sugar levels.
How does Invokana help with these illnesses?
Invokana, like Jardiance, is a medication used in treating type 2 diabetes. It functions as an SGLT2 inhibitor which works by blocking the reabsorption of glucose in the kidneys, leading to a lower blood sugar level and promoting weight loss. The unique action of Invokana on sodium-glucose transport protein also plays roles in managing high blood pressure - another common concern for individuals with type 2 diabetes. Since it does not significantly affect insulin levels directly, it is sometimes prescribed when a patient does not respond well to traditional anti-diabetic drugs (such as metformin), or may be combined with them for enhanced efficacy.
How effective are both Jardiance and Invokana?
Empagliflozin (Jardiance) and Canagliflozin (Invokana) are both FDA-approved medications used to treat type 2 diabetes. They belong to a class of drugs called sodium-glucose co-transporter 2 (SGLT2) inhibitors, which lower blood glucose levels by preventing the kidneys from reabsorbing glucose back into the blood. While they work on the same principle, there may be some differences in their efficacy and side effect profiles.
A direct comparison study conducted in 2017 demonstrated similar efficacy between empagliflozin and canagliflozin in lowering HbA1c levels, a long-term measure of blood sugar control. No significant differences were found between these two drugs in terms of their ability to reduce fasting plasma glucose or body weight.
However, further review has shown that empagliflozin might have additional cardiovascular benefits beyond glycemic control. A landmark trial conducted on over 7000 patients with type 2 diabetes who had established cardiovascular disease showed that those treated with empagliflozin had significantly lower rates of hospitalization for heart failure and death from cardiovascular causes than those receiving placebo.
While canagliflozin has also been studied regarding its effects on cardiovascular outcomes among diabetic patients at high risk, it was not shown to significantly reduce rates of major adverse cardiac events as compared to placebo but did show reduced risk for hospitalization due to heart failure.
The potential side-effects associated with SGLT2 inhibitors include urinary tract infections, genital fungal infections due to increased glycosuria, volume depletion related symptoms such as dizziness particularly in elderly population or those taking diuretics simultaneously along minor risks for bone fractures & amputations noted specifically with Invokana use according recent updates by FDA.
In conclusion both empaglifozin & canagliofizin offer effective glycemic control but choice depends upon individual patient's profile including history any previous cardiovascular event , kidney functions status , risk factors for UTI's/ Fungal infection etc.
At what dose is Jardiance typically prescribed?
Oral dosages of Jardiance typically start at 10 mg/day, which is effective in managing type-2 diabetes for most patients. However, if the desired control over blood sugar levels isn't achieved, the dosage can be increased to 25 mg/day after a few weeks. On the other hand, Invokana generally starts at a dose of 100 mg once daily and can be adjusted up to 300 mg per day if necessary depending on efficacy and tolerability. For both drugs, lower initial doses may be considered for patients with renal impairment. The maximum dosage that should not be exceeded in any case is 25mg/day for Jardiance and 300mg/day for Invokana.
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At what dose is Invokana typically prescribed?
Invokana treatment usually commences with a dose of 100 mg once daily, taken before the first meal of the day. If necessary and well-tolerated, this dosage can be increased to 300 mg/day. This is done under medical supervision and only if you have normal kidney function or mild kidney impairment. It's important to note that Invokana usage requires regular monitoring, particularly for renal function prior to initiation and periodically thereafter. The maximum recommended dose is 300 mg/day. However, any increase in dosage should be carefully considered if there has been no response after a reasonable trial period at the initial dosage level.
What are the most common side effects for Jardiance?
Common side effects that may be experienced when taking Jardiance and Invokana include:
- Urinary tract infections
- Yeast infections in women and men
- Thirst, due to the increase in urination caused by these medications
- Dehydration, leading to feelings of dizziness or faintness
- Kidney problems, including an increased risk for kidney failure
- Changes in cholesterol levels with a mild rise in LDL ("bad") cholesterol while HDL ("good") cholesterol also rises significantly
- Nausea or vomiting (more common with Invokana)
- Genital fungal infections, particularly among uncircumcised males and females.
These are not all the possible side effects. Please consult your healthcare provider if you experience any unusual symptoms after starting medication.
Are there any potential serious side effects for Jardiance?
Jardiance and Invokana, both used for managing type 2 diabetes, can potentially have serious side effects. If you're taking either medication, be aware of the following:
- Signs of allergic reaction: hives; difficult breathing; swelling in your face or throat.
- Symptoms of a urinary tract infection or kidney problems: pain or burning during urination; frequent urge to urinate; blood in urine; swelling in feet or legs.
- Ketoacidosis (too much acid in the blood): nausea, vomiting, stomach pain, confusion and feeling tired.
- Unusual weight loss
- Dehydration symptoms - feeling very thirsty or hot inability to urinate severe headache blurred vision pounding heartbeats
- Severe skin reactions: fever sore throat burning eyes skin redness rash with blistering and peeling
- Signs of low levels of sodium (salt) in your body such as headache mood changes lack of energy hallucinations seizures muscle cramps weakness
If you experience any of these signs while using Jardiance or Invokana medications it's recommended that you seek medical attention immediately.
What are the most common side effects for Invokana?
Invokana, like Jardiance, is an oral diabetes medicine. However, Invokana may potentially cause some different side effects that you should be aware of:
- Increased urination
- Dry mouth and thirst due to the increased urination
- Constipation or stomach pain
- Genital yeast infections in both men and women
- Nausea or vomiting
- Feeling light-headed or dizzy due to dehydration (caused by increased urination)
- Kidney problems - little or no urinating; painful or difficult urination; swelling in your feet or ankles; feeling tired or short of breath.
Remember, not all patients will experience these side effects but it's important to stay mindful of potential changes when switching from Jardiance to Invokana. As always, consult with a healthcare provider before making any changes in medication regimen.
Are there any potential serious side effects for Invokana?
While Invokana is generally considered safe, some patients may experience severe side effects. These can include:
- Signs of an allergic reaction such as hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
- Symptoms related to a genital infection like fever, burning sensation during urination, frequent urge to urinate and pain in the pelvic area.
- Ketoacidosis symptoms including nausea or vomiting that won't go away, stomach-area (abdominal) pain and feeling very tired.
- Uncommon but serious urinary tract infections with symptoms like blood in urine or changes in urination pattern.
- Signs of dehydration: excessive thirst or dry mouth condition
- Sudden kidney problems which could lead to dialysis
If you notice any of these signs while taking Invokana stop using it immediately and consult your healthcare provider.
Contraindications for Jardiance and Invokana?
Both Jardiance and Invokana, along with most other medications for type 2 diabetes, may cause adverse effects in some people. If you notice your symptoms worsening or develop signs of a urinary tract infection (such as pain when urinating), ketoacidosis (excessive thirst, frequent urination) or severe allergic reactions (rash, itching/swelling particularly of the face/tongue/throat), please seek immediate medical attention.
Neither Jardiance nor Invokana can be taken if you are taking certain drugs like rifampin and phenytoin; these medications could decrease the effectiveness of both Jardiance and Invokana by increasing their removal from the body. Always tell your physician which medications you are currently on to prevent potentially harmful interactions with Jardiance or Invokana.
It's also important to note that using either drug requires extra caution if you have a history of heart failure or kidney disease. Be sure to discuss any pre-existing conditions with your doctor before starting treatment.
How much do Jardiance and Invokana cost?
For the brand name versions of these drugs:
- The price of 30 tablets of Jardiance (10 mg) averages around $540, which works out to about $18/day.
- The price of 30 tablets of Invokana (100 mg) averages is around $500, working out to approximately $16.67/day.
Thus, if you are on a standard dose for either medication, then brand-name Invokana tends to be less expensive on a per-day treatment basis. However, it's important to remember that cost should not be the main factor when determining which drug is best for your situation.
Currently, there are no generic versions available in the U.S. for both Jardiance (empagliflozin) and Invokana (canagliflozin). Hence costs remain relatively high compared with other medications where generics exist.
Popularity of Jardiance and Invokana
Empagliflozin, known by the brand name Jardiance, was prescribed to approximately 1.8 million people in the United States in 2020. As a member of the SGLT2 inhibitor class of diabetes medications, it accounts for about 20% of prescriptions within its category. The popularity and usage of empagliflozin have been steadily increasing over recent years due to associated cardiovascular benefits.
Canagliflozin is another medication within this class and is sold under the brand name Invokana. It was prescribed to roughly 1 million people in the USA during 2020. Despite accounting for less than half as many prescriptions as empagliflozin, it still represents an important part of treatment options for type-2 diabetics with around10% share among SGLT2 inhibitors’ prescription list. Just like Jardiance, its use has also seen a steady increment since inception but at a slightly slower rate compared to Empagliflozin.
Conclusion
Both Jardiance (empagliflozin) and Invokana (canagliflozin) have been established as effective treatments for type 2 diabetes, with numerous clinical trials showing they help control blood sugar levels better than placebo. They may also be used in combination with other diabetes medications depending on individual patient needs. Both drugs work by inhibiting sodium-glucose co-transporter 2 (SGLT2), which leads to more glucose being excreted in the urine.
Jardiance is often chosen as a first-line treatment due to its additional cardiovascular benefits demonstrated in clinical trials, while Invokana might be considered if a patient doesn't respond well to initial therapy or has specific considerations such as kidney health.
Both Jardiance and Invokana are available in generic form, providing significant cost savings especially for individuals paying out of pocket. It's worth noting that the effects of these medications aren't immediate; it usually takes some time for patients to see improvements in their blood glucose readings.
When comparing side effect profiles, both drugs are generally well-tolerated but can lead to urinary tract infections due to the mechanism by which they lower blood sugar levels. Dehydration is another potential concern with both drugs because they cause increased urination. As always, patients should closely monitor their symptoms when starting treatment and contact their healthcare provider immediately if any severe or concerning reactions occur.