| Diabetes Mellitus, Non-Insulin-Dependent
Invokamet vs Rybelsus
Side-by-side clinical, coverage, and cost comparison for diabetes mellitus, non-insulin-dependent.Deep comparison between: Invokamet vs Ozempic 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 signalsOzempic has a higher rate of injection site reactions vs Invokamet based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Ozempic but not Invokamet, including UnitedHealthcare
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Category
Invokamet
Ozempic
At A Glance
Oral
Once or twice daily
SGLT2 inhibitor + biguanide
Oral
Daily
GLP-1 receptor agonist
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 Starting dose 1.5 mg orally once daily for 30 days (not effective for glycemic control); escalate to 4 mg once daily days 31-60; maintain at 4 mg or increase to 9 mg once daily if additional glycemic control is needed. Take on an empty stomach in the morning with up to 4 oz water; wait at least 30 minutes before eating, drinking, or taking other oral medications.
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
- Personal or family history of medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
- Prior serious hypersensitivity reaction to semaglutide or any excipient in OZEMPIC tablets
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%) nausea, abdominal pain, diarrhea, decreased appetite, vomiting, constipation
Serious risk of thyroid C-cell tumors, acute pancreatitis, diabetic retinopathy complications, hypoglycemia with concomitant insulin secretagogues or insulin, acute kidney injury due to volume depletion, severe gastrointestinal reactions, hypersensitivity reactions, acute gallbladder disease, pulmonary aspiration during general anesthesia or deep sedation
Postmarketing acute and necrotizing pancreatitis, ileus, intestinal obstruction, anaphylaxis, angioedema, rash, urticaria, cholecystitis, cholelithiasis requiring cholecystectomy, dizziness, dysesthesia, dysgeusia, headache, pulmonary aspiration, acute kidney injury, alopecia
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.
Semaglutide is a GLP-1 receptor agonist (GLP-1 analogue with 94% sequence homology to human GLP-1) that selectively binds to and activates the GLP-1 receptor, stimulating glucose-dependent insulin secretion and inhibiting glucagon secretion to lower blood glucose, with a minor delay in early postprandial gastric emptying; its long half-life results from albumin binding and stabilization against DPP-4 degradation.
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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)
Ozempic
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (10/12) · Qty limit (11/12)
UnitedHealthcare
Invokamet
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (1/8)
Ozempic
- Covered on 4 commercial plans
- PA (8/8) · Step Therapy (0/8) · Qty limit (8/8)
Humana
Invokamet
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (1/3) · Qty limit (3/3)
Ozempic
- 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 Invokamet.
No savings programs available for Ozempic.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.