| Diabetes Mellitus, Non-Insulin-Dependent
Invokamet vs Janumet
Side-by-side clinical, coverage, and cost comparison for diabetes mellitus, non-insulin-dependent.Deep comparison between: Invokamet vs Janumet 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 signalsJanumet has a higher rate of injection site reactions vs Invokamet based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Janumet but not Invokamet, including UnitedHealthcare
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Category
Invokamet
Janumet
At A Glance
Oral
Once or twice daily
SGLT2 inhibitor + biguanide
Oral
Twice daily
DPP-4 inhibitor / biguanide combination
Indications
- Diabetes Mellitus, Non-Insulin-Dependent
- Diabetic Nephropathy
- Diabetes Mellitus, Non-Insulin-Dependent
Dosing
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.
Diabetes Mellitus, Non-Insulin-Dependent 50 mg sitagliptin/500 mg metformin HCl twice daily with meals as starting dose for patients not on metformin; for patients on metformin HCl 850 mg twice daily, start at 50 mg sitagliptin/1000 mg metformin HCl twice daily; max 100 mg sitagliptin/2000 mg metformin HCl daily; do not split or divide tablets.
Contraindications
- 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
- Severe renal impairment (eGFR below 30 mL/min/1.73 m2)
- Acute or chronic metabolic acidosis, including diabetic ketoacidosis
- History of a serious hypersensitivity reaction to JANUMET, sitagliptin, or metformin, such as anaphylaxis or angioedema
Adverse Reactions
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
Most common (>=5%) Diarrhea, upper respiratory tract infection, headache, nasopharyngitis, nausea/vomiting, flatulence, abdominal discomfort, indigestion, asthenia
Serious Lactic acidosis, pancreatitis, heart failure, acute renal failure, hypoglycemia (with sulfonylurea or insulin), hypersensitivity reactions, severe and disabling arthralgia, bullous pemphigoid
Postmarketing Anaphylaxis, angioedema, rash, urticaria, cutaneous vasculitis, Stevens-Johnson syndrome, hepatic enzyme elevations, fatal and non-fatal hemorrhagic and necrotizing pancreatitis, worsening renal function, acute renal failure, tubulointerstitial nephritis, rhabdomyolysis, constipation, myalgia, back pain, pruritus, mouth ulceration, cholestatic and hepatocellular liver injury
Pharmacology
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.
Sitagliptin is a DPP-4 inhibitor that slows inactivation of incretin hormones GLP-1 and GIP, increasing insulin release and decreasing glucagon in a glucose-dependent manner; metformin is a biguanide that decreases hepatic glucose production, reduces intestinal glucose absorption, and improves peripheral insulin sensitivity by increasing glucose uptake and utilization.
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Most Common Insurance
Anthem BCBS
Invokamet
- Covered on 5 commercial plans
- PA (5/12) · Step Therapy (9/12) · Qty limit (11/12)
Janumet
- Covered on 5 commercial plans
- PA (1/12) · Step Therapy (9/12) · Qty limit (11/12)
UnitedHealthcare
Invokamet
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (1/8)
Janumet
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (2/8)
Humana
Invokamet
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (1/3) · Qty limit (3/3)
Janumet
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (1/3) · Qty limit (3/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Invokamet.
No savings programs available for Janumet.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.