| Diabetes Mellitus, Non-Insulin-Dependent
Invokamet vs Segluromet
Side-by-side clinical, coverage, and cost comparison for diabetes mellitus, non-insulin-dependent.Deep comparison between: Invokamet vs Segluromet 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 signalsSegluromet has a higher rate of injection site reactions vs Invokamet based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Segluromet but not Invokamet, including UnitedHealthcare
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Category
Invokamet
Segluromet
At A Glance
Oral
Once or twice daily
SGLT2 inhibitor + biguanide
Oral
Twice daily
SGLT2 inhibitor/biguanide
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 Individualize starting dosage; take orally twice daily with meals; maximum recommended dosage is 7.5 mg ertugliflozin/1,000 mg metformin HCl per dose (15 mg/2,000 mg daily); not recommended if eGFR <45 mL/min/1.73 m2; contraindicated if eGFR <30 mL/min/1.73 m2, ESRD, or dialysis.
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
- Hypersensitivity to ertugliflozin, metformin, or any excipient in SEGLUROMET
- Severe renal impairment (eGFR less than 30 mL/min/1.73 m2), end stage-renal disease (ESRD), or dialysis
- Acute or chronic metabolic acidosis, including diabetic ketoacidosis, with or without coma
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 (>=2%) Female genital mycotic infections, male genital mycotic infections, urinary tract infections, headache, vaginal pruritus, increased urination, nasopharyngitis, back pain, weight decreased, thirst
Most common (>=5%, metformin) Diarrhea, nausea, vomiting, flatulence, abdominal discomfort, indigestion, asthenia, headache
Serious Lactic acidosis, diabetic ketoacidosis, lower limb amputation, volume depletion, urosepsis and pyelonephritis, hypoglycemia, Fournier's Gangrene, vitamin B12 deficiency
Postmarketing Necrotizing fasciitis of the perineum (Fournier's Gangrene), angioedema, rash (ertugliflozin); cholestatic, hepatocellular, and mixed hepatocellular liver injury (metformin)
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.
Ertugliflozin is an SGLT2 inhibitor that reduces renal glucose reabsorption and lowers the renal threshold for glucose, increasing urinary glucose excretion; metformin HCl is a biguanide that decreases hepatic glucose production, reduces intestinal glucose absorption, and improves peripheral insulin sensitivity.
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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)
Segluromet
- Covered on 5 commercial plans
- PA (6/12) · Step Therapy (10/12) · Qty limit (9/12)
UnitedHealthcare
Invokamet
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (1/8)
Segluromet
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (2/8) · Qty limit (1/8)
Humana
Invokamet
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (1/3) · Qty limit (3/3)
Segluromet
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (3/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Invokamet.
No savings programs available for Segluromet.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.