P-Glycoprotein Inhibitors

Sodium-Glucose Transporter 2 Inhibitors

<section class="Section" data-sectioncode="34089-3"><a name="s41"></a><a name="section-10"></a><p></p><h1>11 DESCRIPTION</h1><p class="First">INPEFA tablets for oral administration contain sotagliflozin, a sodium-glucose cotransporter 2 (SGLT2) inhibitor.</p><p>The chemical name of sotagliflozin is (2S,3R,4R,5S,6R)-2-(4-chloro-3-(4-ethoxybenzyl)phenyl)-6-(methylthio)tetrahydro-2H-pyran-3,4,5-triol.</p><p>Its molecular formula is C<span class="Sub">21</span>H<span class="Sub">25</span>ClO<span class="Sub">5</span>S and the molecular weight is 424.94. The structural formula is:</p><p><a name="f01"></a><img alt="Structural Formula
" src="sot00-0005-01.jpg"/></p><p>Sotagliflozin is a white to off-white solid. It is practically insoluble in water.</p><p>Each film-coated tablet of INPEFA contains 200 mg or 400 mg of sotagliflozin and the following inactive ingredients. The core of the tablet contains colloidal silicon dioxide, croscarmellose sodium, magnesium stearate, microcrystalline cellulose, and talc. The film coating for the 200 mg tablet contains: indigo carmine aluminum lake, polyethylene glycol, polyvinyl alcohol (partly hydrolyzed), talc, and titanium dioxide. The film coating for the 400 mg tablet contains: hypromellose, lactose monohydrate, titanium dioxide, triacetin, and yellow iron oxide. The black printing ink contains ammonium hydroxide, black iron oxide, isopropyl alcohol, N-butyl alcohol, propylene glycol, and shellac.</p></section>

INPEFA

Inpefa

sotagliflozin

sotagliflozin 200 MG Oral Tablet

sotagliflozin 200 MG Oral Tablet [Inpefa]

sotagliflozin 400 MG Oral Tablet

sotagliflozin 400 MG Oral Tablet [Inpefa]

Biguanide

Type 2 Diabetes Mellitus

<section class="Section" data-sectioncode="34089-3"><a name="S11"></a><a name="section-10"></a><p></p><h1>11 DESCRIPTION</h1><p class="First">INVOKAMET <span class="Bold"><span class="Sup">®</span></span> (canagliflozin and metformin HCl) and INVOKAMET <span class="Bold"><span class="Sup">®</span></span> XR (canagliflozin and metformin hydrochloride extended-release tablets) contain canagliflozin and metformin HCl. </p><div class="Section" data-sectioncode="42229-5"><a name="section-10.1"></a><p></p><p class="First"><span class="Underline">Canagliflozin</span></p><p>Canagliflozin is an inhibitor of sodium-glucose co-transporter 2 (SGLT2), the transporter responsible for reabsorbing the majority of glucose filtered by the kidney. Canagliflozin is chemically known as (1 <span class="Italics">S</span>)-1,5-anhydro-1-[3-[[5-(4-fluorophenyl)-2-thienyl]methyl]-4-methylphenyl]-D-glucitol hemihydrate and its molecular formula and weight are C <span class="Sub">24</span>H <span class="Sub">25</span>FO <span class="Sub">5</span>S∙1/2 H <span class="Sub">2</span>O and 453.53, respectively. The structural formula for canagliflozin is: </p><div class="Figure"><img alt="Chemical Structure" src="invokamet-01.jpg"/></div><p>Canagliflozin is practically insoluble in aqueous media from pH 1.1 to 12.9.</p></div><div class="Section" data-sectioncode="42229-5"><a name="section-10.2"></a><p></p><p class="First"><span class="Underline">Metformin HCl</span></p><p>Metformin HCl is a biguanide chemically known as 1,1-Dimethylbiguanide hydrochloride and its molecular formula and weight are C <span class="Sub">4</span>H <span class="Sub">11</span>N <span class="Sub">5 </span>∙ HCl and 165.62, respectively. The structural formula for metformin HCl is: </p><div class="Figure"><img alt="Chemical Structure" src="invokamet-02.jpg"/></div></div><div class="Section" data-sectioncode="42229-5"><a name="section-10.3"></a><p></p><p class="First"><span class="Underline">INVOKAMET and INVOKAMET XR</span></p><ul class="Disc"><li>INVOKAMET/INVOKAMET XR are supplied as film-coated tablets for oral administration. Each 50 mg/500 mg tablet and 50 mg/1,000 mg tablet contains 51 mg of canagliflozin equivalent to 50 mg canagliflozin (anhydrous) and 500 mg or 1,000 mg metformin HCl (equivalent to metformin 389.93 mg and 779.86 mg, respectively). </li><li>Each 150 mg/500 mg tablet and 150 mg/1,000 mg tablet contains 153 mg of canagliflozin equivalent to 150 mg canagliflozin (anhydrous) and 500 mg or 1,000 mg metformin HCl (equivalent to metformin 389.93 mg and 779.86 mg, respectively).</li></ul><p>INVOKAMET contains the following inactive ingredients: croscarmellose sodium, hypromellose, magnesium stearate, and microcrystalline cellulose. The magnesium stearate is vegetable-sourced. The tablets are finished with a commercially available film-coating consisting of the following inactive ingredients: macrogol/PEG3350, polyvinyl alcohol (partially hydrolyzed), talc, titanium dioxide, iron oxide yellow (50 mg/1,000 mg and 150 mg/500 mg tablets only), iron oxide red (50 mg/1,000 mg, 150 mg/500 mg and 150 mg/1,000 mg tablets only), and iron oxide black (150 mg/1,000 mg tablets only).</p><p>INVOKAMET XR contains the following inactive ingredients: croscarmellose sodium, hydroxypropyl cellulose, hypromellose, lactose anhydrous, magnesium stearate (vegetable-sourced), microcrystalline cellulose, polyethylene oxide, and silicified microcrystalline cellulose (50 mg/500 mg and 50 mg/1,000 mg tablets only). The tablets are finished with a commercially available film-coating consisting of the following inactive ingredients: macrogol/PEG3350, polyvinyl alcohol (partially hydrolyzed), talc, titanium dioxide, iron oxide red, iron oxide yellow, and iron oxide black (50 mg/1,000 mg and 150 mg/1,000 mg tablets only).</p><p>INVOKAMET XR tablets provide canagliflozin for immediate-release and metformin HCl for extended-release. Each bilayer tablet is compressed from two separate granulates, one for each active ingredient of the tablet, and finished with a film-coating. The metformin HCl extended-release layer is based on a polymer matrix which controls the drug release by passive diffusion through the swollen matrix in combination with tablet erosion.</p></div></section>

INVOKAMET

Invokamet

canagliflozin

canagliflozin / metformin

canagliflozin 150 MG / metformin hydrochloride 1000 MG Oral Tablet

canagliflozin 150 MG / metformin hydrochloride 1000 MG Oral Tablet [Invokamet]

metformin

Inpefa is an oral tablet taken once daily, and it contains sotagliflozin. It can be used to lower the chances of cardiovascular death, hospitalization due to heart failure, and urgent heart failure-related visits in adults dealing with heart failure, type 2 diabetes mellitus, chronic kidney disease, and other cardiovascular risk factors.

Inpefa received approval on May 26, 2023.

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Instructions For Use: Risk Reduction in CV death & hospitalization

Invokamet is a medication that combines two active ingredients, canagliflozin and metformin. These components are both oral medications designed to help manage and regulate blood sugar levels.

Invokamet is prescribed to adults with type 2 diabetes mellitus, and it is typically used in conjunction with dietary adjustments and physical activity to enhance blood sugar management. Additionally, Invokamet is employed to decrease the likelihood of heart attack, stroke, or heart failure-related mortality in individuals with type 2 diabetes who also have heart disease.

Furthermore, Invokamet is utilized to lower the risk of end-stage kidney disease and the occurrence of hospitalization or death due to heart issues in adults who have kidney problems attributed to type 2 diabetes.

It's important to note that Invokamet is not intended for the treatment of type 1 diabetes.

Inpefa®(sotagliflozin)	Invokamet®(canagliflozin / metformin)

Prescription Only Inpefa is an oral tablet taken once daily, and it contains sotagliflozin. It can be used to lower the chances of cardiovascular death, hospitalization due to heart failure, and...	Prescription Only Invokamet is a medication that combines two active ingredients, canagliflozin and metformin. These components are both oral medications designed to help manage and regulate blood...
Dosage & Administration
Administration
Oral . Learn more.	Oral. Learn more.
Dosing
200 mg daily and titrate to 400 mg as tolerated.. Learn more.	One tablet, twice daily with meals, recommended starting dose of canagliflozin is 50 mg twice daily and metformin HCl 500 mg twice daily. Learn more.
Latin Shorthand
Take 200 mg qd, increase to 400 mg qd if tolerated.. Learn more.	1 tab BID with meals. Starting dose: canagliflozin 50 mg BID, metformin HCl 500 mg BID.. Learn more.
Financial Assistance
Out-Of-Pocket Costs With Copay Card
$10. Learn more.	$0. Learn more.
Annual Cap
$2,600. Learn more.	$3,000 and $200 per month. Learn more.
Assistance Expiration
12/31/25. Learn more.	Calendar year. Learn more.
Generics
No lower-cost generic available	No lower-cost generic available
Physician Advisory
Adverse Reactions
Most common adverse reactions (incidence ≥ 5%) are urinary tract infection, volume depletion, diarrhea, and hypoglycemia. . Learn more.	Most common adverse reactions associated with canagliflozin (5% or greater incidence): female genital mycotic infections, urinary tract infection, and increased urination. Most common adverse reactions associated with metformin HCl (5% or greater incidence) are diarrhea, nausea, vomiting, flatulence, asthenia, indigestion, abdominal discomfort, and headache. . Learn more.
Mechanism of Actions (MoA)
SGLT2 Inhibitors. Learn more.	SGLT2 Inhibitors. Learn more.
Special Populations

Inpefa® Alternatives