| Diabetes Mellitus, Non-Insulin-Dependent
Invokamet vs Steglujan
Side-by-side clinical, coverage, and cost comparison for diabetes mellitus, non-insulin-dependent.Deep comparison between: Invokamet vs Steglujan 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 signalsSteglujan has a higher rate of injection site reactions vs Invokamet based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Steglujan but not Invokamet, including UnitedHealthcare
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Category
Invokamet
Steglujan
At A Glance
Oral
Once or twice daily
SGLT2 inhibitor + biguanide
Oral
Once daily
SGLT2 inhibitor + DPP-4 inhibitor
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 5 mg ertugliflozin/100 mg sitagliptin orally once daily in the morning, with or without food; may increase to 15 mg/100 mg once daily for additional glycemic control; not recommended if eGFR less than 45 mL/min/1.73 m2; withhold at least 4 days before surgery or procedures associated with prolonged fasting.
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 less than 30 mL/min/1.73 m2), end-stage renal disease (ESRD), or on dialysis
- Hypersensitivity to sitagliptin, ertugliflozin, or any excipient in STEGLUJAN
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
Serious Diabetic ketoacidosis, pancreatitis, lower limb amputation, acute renal failure, volume depletion, urosepsis and pyelonephritis, heart failure, hypoglycemia (with insulin or insulin secretagogues), necrotizing fasciitis of the perineum (Fournier's Gangrene), hypersensitivity reactions, severe and disabling arthralgia, bullous pemphigoid
Postmarketing Necrotizing fasciitis of the perineum, angioedema, rash, anaphylaxis, urticaria, cutaneous vasculitis, Stevens-Johnson syndrome, pruritus, hepatic enzyme elevations, acute pancreatitis, worsening renal function, severe and disabling arthralgia, myalgia, rhabdomyolysis
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.
STEGLUJAN combines ertugliflozin, an SGLT2 inhibitor that reduces renal reabsorption of filtered glucose and increases urinary glucose excretion, and sitagliptin, a DPP-4 inhibitor that slows inactivation of incretin hormones (GLP-1 and GIP), thereby increasing insulin release and decreasing glucagon secretion in a glucose-dependent manner.
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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)
Steglujan
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (7/12) · Qty limit (9/12)
UnitedHealthcare
Invokamet
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (1/8)
Steglujan
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Invokamet
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (1/3) · Qty limit (3/3)
Steglujan
- 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 Steglujan.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.