| Diabetes Mellitus, Non-Insulin-Dependent
Invokana vs Janumet
Side-by-side clinical, coverage, and cost comparison for diabetes mellitus, non-insulin-dependent.Deep comparison between: Invokana 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 Invokana based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Janumet but not Invokana, including UnitedHealthcare
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Category
Invokana
Janumet
At A Glance
Oral
Once daily
SGLT2 inhibitor
Oral
Twice daily
DPP-4 inhibitor / biguanide combination
Indications
- Diabetes Mellitus, Non-Insulin-Dependent
- Diabetes Mellitus, Non-Insulin-Dependent
Dosing
Diabetes Mellitus, Non-Insulin-Dependent (glycemic control) 100 mg orally once daily before the first meal of the day; may increase to 300 mg once daily in patients tolerating 100 mg with eGFR >= 60 mL/min/1.73 m2 who require additional glycemic control.
Cardiovascular risk reduction, Diabetic nephropathy 100 mg orally once daily.
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
- Serious hypersensitivity reaction to canagliflozin or any excipient, 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 Diabetic ketoacidosis, lower limb amputation, volume depletion, urosepsis and pyelonephritis, hypoglycemia with concomitant 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)
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
SGLT2 inhibitor; canagliflozin inhibits SGLT2 in the proximal renal tubules, reducing glucose reabsorption and lowering the renal threshold for glucose, thereby increasing urinary glucose excretion; also blocks SGLT2-dependent sodium reabsorption, believed to increase tubuloglomerular feedback and reduce intraglomerular pressure.
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
Invokana
- Covered on 5 commercial plans
- PA (9/12) · 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
Invokana
- 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
Invokana
- 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
Cost estimate not availableAccessia Health Heart Failure Patient Program
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
No savings programs available for Janumet.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.