| Diabetes Mellitus, Non-Insulin-Dependent
Invokamet vs Xultophy
Side-by-side clinical, coverage, and cost comparison for diabetes mellitus, non-insulin-dependent.Deep comparison between: Invokamet vs Xultophy 100/3.6 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 signalsXultophy 100/3.6 has a higher rate of injection site reactions vs Invokamet based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Xultophy 100/3.6 but not Invokamet, including UnitedHealthcare
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Category
Invokamet
Xultophy 100/3.6
At A Glance
Oral
Once or twice daily
SGLT2 inhibitor + biguanide
SC injection
Once daily
Basal insulin/GLP-1 receptor agonist 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 Patients naive to basal insulin or GLP-1 receptor agonist: start 10 units SC once-daily; patients currently on basal insulin or GLP-1 receptor agonist: start 16 units SC once-daily (discontinue prior therapy first); titrate by 2 units once or twice weekly based on fasting plasma glucose; maximum 50 units/day.
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)
- Episodes of hypoglycemia
- Hypersensitivity to insulin degludec, liraglutide, or any excipient in Xultophy 100/3.6
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%) Nasopharyngitis, headache, nausea, diarrhea, increased lipase, upper respiratory tract infection, hypoglycemia
Serious Thyroid C-cell tumors, acute pancreatitis, hypoglycemia, acute kidney injury, severe gastrointestinal reactions, hypersensitivity reactions including anaphylaxis, acute gallbladder disease, hypokalemia, pulmonary aspiration
Postmarketing Localized cutaneous amyloidosis, acute and necrotizing pancreatitis, hepatitis, cholecystitis, angioedema, anaphylactic reactions, medullary thyroid carcinoma, acute renal failure, 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.
Xultophy 100/3.6 combines insulin degludec, a long-acting basal insulin analog that lowers blood glucose by stimulating peripheral glucose uptake and inhibiting hepatic glucose production, with liraglutide, a GLP-1 receptor agonist that increases glucose-dependent insulin release, decreases glucagon secretion, and slows gastric emptying.
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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)
Xultophy 100/3.6
- Covered on 5 commercial plans
- PA (5/12) · 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)
Xultophy 100/3.6
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (1/8)
Humana
Invokamet
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (1/3) · Qty limit (3/3)
Xultophy 100/3.6
- 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 Xultophy 100/3.6.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.