| Diabetes Mellitus, Non-Insulin-Dependent

Invokana vs Rybelsus

Side-by-side clinical, coverage, and cost comparison for diabetes mellitus, non-insulin-dependent.
Deep comparison between: Invokana vs Ozempic with Prescriber.AI
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Safety signalsOzempic has a higher rate of injection site reactions vs Invokana based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Ozempic but not Invokana, including UnitedHealthcare
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Invokana
Ozempic
At A Glance
Oral
Once daily
SGLT2 inhibitor
Oral
Daily
GLP-1 receptor agonist
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 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
  • Serious hypersensitivity reaction to canagliflozin or any excipient, 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 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%) 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
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.
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
Invokana
  • Covered on 5 commercial plans
  • PA (9/12) · Step Therapy (9/12) · Qty limit (11/12)
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Ozempic
  • Covered on 5 commercial plans
  • PA (12/12) · Step Therapy (10/12) · Qty limit (11/12)
View full coverage details ›
UnitedHealthcare
Invokana
  • Covered on 4 commercial plans
  • PA (0/8) · Step Therapy (0/8) · Qty limit (1/8)
View full coverage details ›
Ozempic
  • Covered on 4 commercial plans
  • PA (8/8) · Step Therapy (0/8) · Qty limit (8/8)
View full coverage details ›
Humana
Invokana
  • Covered on 0 commercial plans
  • PA (3/3) · Step Therapy (1/3) · Qty limit (3/3)
View full coverage details ›
Ozempic
  • Covered on 0 commercial plans
  • PA (3/3) · Step Therapy (1/3) · Qty limit (3/3)
View full coverage details ›
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 Ozempic.
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InvokanaView full Invokana profile
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.