| Diabetes Mellitus, Non-Insulin-Dependent
Cycloset vs Invokamet
Side-by-side clinical, coverage, and cost comparison for diabetes mellitus, non-insulin-dependent.Deep comparison between: Cycloset vs Invokamet with Prescriber.AI
AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.Safety signalsInvokamet has a higher rate of injection site reactions vs Cycloset based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Invokamet but not Cycloset, including UnitedHealthcare
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Category
Cycloset
Invokamet
At A Glance
Oral
Daily
Dopamine D2 receptor agonist
Oral
Once or twice daily
SGLT2 inhibitor + biguanide
Indications
- Diabetes Mellitus, Non-Insulin-Dependent
- Diabetes Mellitus, Non-Insulin-Dependent
- Diabetic Nephropathy
Dosing
Diabetes Mellitus, Non-Insulin-Dependent 1.6 mg to 4.8 mg once daily within 2 hours after waking in the morning with food; initiate at 0.8 mg, increase by one tablet per week to maximal tolerated dose; limit to 1.6 mg daily with moderate CYP3A4 inhibitors; avoid with strong CYP3A4 inhibitors.
Diabetes Mellitus, Non-Insulin-Dependent INVOKAMET: One tablet orally twice daily with meals, starting at canagliflozin 100 mg and metformin HCl 1,000 mg total daily dose. INVOKAMET XR: Two tablets orally once daily with morning meal, swallow whole. Maximum: canagliflozin 300 mg and metformin HCl 2,000 mg total daily. Not recommended if eGFR <45 mL/min/1.73 m2. Dose adjust for renal impairment: eGFR 45-60, max canagliflozin 100 mg daily; eGFR 30-45, assess benefit/risk, max canagliflozin 100 mg daily.
Diabetic Nephropathy Canagliflozin 100 mg orally once daily as a component of INVOKAMET or INVOKAMET XR. Dose adjust based on eGFR. Contraindicated if eGFR <30 mL/min/1.73 m2.
Contraindications
- Known hypersensitivity to bromocriptine, ergot-related drugs, or any excipient in CYCLOSET
- Syncopal migraine
- Postpartum patients
- Lactating patients
- Severe renal impairment (eGFR less than 30 mL/min/1.73 m2)
- Acute or chronic metabolic acidosis, including diabetic ketoacidosis
- Serious hypersensitivity reaction to canagliflozin or metformin HCl, such as anaphylaxis or angioedema
Adverse Reactions
Most common (>=5%) Nausea, fatigue, vomiting, headache, dizziness, rhinitis, constipation, sinusitis, diarrhea, asthenia, somnolence, dyspepsia, amblyopia, anorexia
Serious Hypotension, psychotic disorders, somnolence, syncope, fibrotic-related complications, cardiovascular events (myocardial infarction, stroke)
Postmarketing Hallucinations, retroperitoneal fibrosis, pulmonary fibrosis, pleural effusion, pericarditis, pericardial effusions, cardiac valvulopathy, psychotic and psychiatric disorders, impulse control/compulsive behaviors, neuroleptic-like malignant syndrome
Most common (>=2%) Urinary tract infections, increased urination, thirst, constipation, nausea, female genital mycotic infections, vulvovaginal pruritus, male genital mycotic infections
Serious Lactic acidosis, diabetic ketoacidosis, lower limb amputation, volume depletion, urosepsis, pyelonephritis, hypoglycemia with insulin or insulin secretagogues, necrotizing fasciitis of the perineum (Fournier's gangrene), hypersensitivity reactions, bone fracture
Postmarketing Ketoacidosis, acute kidney injury, anaphylaxis, angioedema, urosepsis and pyelonephritis, necrotizing fasciitis of the perineum (Fournier's gangrene), cholestatic hepatocellular and mixed hepatocellular liver injury
Pharmacology
CYCLOSET (bromocriptine mesylate) is a sympatholytic dopamine D2 receptor agonist; timed morning administration in type 2 diabetes is associated with increased insulin sensitivity and glucose disposal and reduced fasting and postprandial hyperglycemia without raising plasma insulin levels.
Canagliflozin is an SGLT2 inhibitor that reduces renal glucose reabsorption, lowers the renal threshold for glucose, and increases urinary glucose excretion, thereby lowering plasma glucose. Metformin is a biguanide that decreases hepatic glucose production, decreases intestinal glucose absorption, and improves insulin sensitivity by increasing peripheral glucose uptake and utilization.
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Most Common Insurance
Anthem BCBS
Cycloset
- Covered on 5 commercial plans
- PA (4/12) · Step Therapy (2/12) · Qty limit (6/12)
Invokamet
- Covered on 5 commercial plans
- PA (5/12) · Step Therapy (9/12) · Qty limit (11/12)
UnitedHealthcare
Cycloset
- Covered on 4 commercial plans
- PA (1/8) · Step Therapy (0/8) · Qty limit (0/8)
Invokamet
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (1/8)
Humana
Cycloset
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (2/3) · Qty limit (2/3)
Invokamet
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (1/3) · Qty limit (3/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Cycloset.
No savings programs available for Invokamet.
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CyclosetView full Cycloset profile
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.