| Diabetes Mellitus, Non-Insulin-Dependent
Invokana vs Synjardy
Side-by-side clinical, coverage, and cost comparison for diabetes mellitus, non-insulin-dependent.Deep comparison between: Invokana vs Synjardy 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 signalsSynjardy has a higher rate of injection site reactions vs Invokana based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Synjardy but not Invokana, including UnitedHealthcare
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Category
Invokana
Synjardy
At A Glance
Oral
Once daily
SGLT2 inhibitor
Oral
Once or twice daily
SGLT2 inhibitor / biguanide
Indications
- Diabetes Mellitus, Non-Insulin-Dependent
- Diabetes Mellitus, Non-Insulin-Dependent
- Cardiovascular Diseases
- Congestive heart failure
- Chronic Kidney Diseases
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 SYNJARDY: empagliflozin 10 mg/day (may increase to 25 mg/day) plus metformin HCl up to 2,000 mg/day, taken orally twice daily with meals; SYNJARDY XR: once daily with morning meal; not recommended if eGFR <45 mL/min/1.73 m2.
Cardiovascular Diseases, Congestive heart failure, Chronic Kidney Diseases Empagliflozin 10 mg/day component as part of SYNJARDY or SYNJARDY XR, taken orally; not recommended if eGFR <45 mL/min/1.73 m2.
Contraindications
- Serious hypersensitivity reaction to canagliflozin or any excipient, such as anaphylaxis or angioedema
- Severe renal impairment (eGFR <30 mL/min/1.73 m2)
- Acute or chronic metabolic acidosis, including diabetic ketoacidosis
- Hypersensitivity to empagliflozin, metformin HCl, or any excipient in SYNJARDY or SYNJARDY XR
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%) Hypoglycemia (with sulfonylurea), urinary tract infection, nasopharyngitis, diarrhea, nausea/vomiting, flatulence, abdominal discomfort, indigestion, asthenia, headache
Serious Lactic acidosis, diabetic ketoacidosis, volume depletion, urosepsis, pyelonephritis, necrotizing fasciitis of the perineum (Fournier's gangrene), hypersensitivity reactions, vitamin B12 deficiency, lower limb amputation
Postmarketing Constipation, necrotizing fasciitis of the perineum, urosepsis, pyelonephritis, ketoacidosis, acute kidney injury, angioedema, rash, urticaria, cholestatic/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.
Empagliflozin is an SGLT2 inhibitor that reduces renal reabsorption of filtered glucose, lowers the renal threshold for glucose, and increases urinary glucose excretion; metformin HCl is a biguanide antihyperglycemic agent that decreases hepatic glucose production, reduces intestinal absorption of glucose, and improves insulin sensitivity by increasing peripheral 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)
Synjardy
- Covered on 5 commercial plans
- PA (0/12) · 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)
Synjardy
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (7/8)
Humana
Invokana
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (1/3) · Qty limit (3/3)
Synjardy
- 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 Synjardy.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.