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

Sodium-Glucose Cotransporter 2 Inhibitor

Sodium-Glucose Transporter 2 Inhibitors

<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">JARDIANCE tablets for oral use contain empagliflozin, an inhibitor of the SGLT2.</p><p>The chemical name of empagliflozin is D-Glucitol,1,5-anhydro-1-C-[4-chloro-3-[[4-[[(3S)-tetrahydro-3-furanyl]oxy]phenyl]methyl]phenyl]-, (1S).</p><p>Its molecular formula is C<span class="Sub">23</span>H<span class="Sub">27</span>ClO<span class="Sub">7</span> and the molecular weight is 450.91. The structural formula is:</p><p><img alt="Chemical Structure" src="jardiance-01.jpg"/></p><p>Empagliflozin is a white to yellowish, non-hygroscopic powder. It is very slightly soluble in water, sparingly soluble in methanol, slightly soluble in ethanol and acetonitrile, soluble in 50% acetonitrile/water, and practically insoluble in toluene.</p><p>Each film-coated tablet of JARDIANCE contains 10 mg or 25 mg of empagliflozin (free base) and the following inactive ingredients: colloidal silicon dioxide, croscarmellose sodium, hydroxypropyl cellulose, lactose monohydrate, magnesium stearate, and microcrystalline cellulose. In addition, the film coating contains the following inactive ingredients: hypromellose, polyethylene glycol, talc, titanium dioxide, and yellow ferric oxide.</p></section>

Jardiance

empagliflozin

empagliflozin 10 MG Oral Tablet

empagliflozin 10 MG Oral Tablet [Jardiance]

empagliflozin 25 MG Oral Tablet

empagliflozin 25 MG Oral Tablet [Jardiance]

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.

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Instructions For Use: Diabetes

Jardiance (empagliflozin) is an FDA-approved tablet used to manage blood sugar levels in individuals aged 10 and above with type 2 diabetes. It is also employed to lower the risk of cardiovascular issues in adults with heart failure or cardiovascular disease and type 2 diabetes. Jardiance operates by reducing blood glucose levels (HbA1c) through increased glucose elimination in the urine. When prescribed for type 2 diabetes, it should be used alongside diet and exercise. Jardiance belongs to the SGLT-2 inhibitor class (sodium-glucose cotransporter-2 inhibitors). It functions by inhibiting SGLT-2 proteins found in the renal tubules of the kidneys, responsible for reabsorbing glucose into the bloodstream.

Jardiance is available in 10mg and 25mg tablet forms.

The mechanism through which Jardiance reduces the risk of cardiovascular problems or heart failure is believed to involve altering heart muscle metabolism. This shift favors a balanced combination of fatty acids, ketone bodies (ketones), branched-chain amino acids (BCAA), and glucose over relying solely on glucose. Jardiance also enhances the heart's diastolic stiffness and function.

Type 2 diabetes is a chronic condition where elevated blood sugar levels (HbA1c) result from the body's inability to produce or utilize insulin properly. Prolonged high blood sugar levels can lead to severe health issues, including heart disease, vision impairment, and kidney disease. Maintaining better control of blood sugar levels helps mitigate the risk of diabetes-related complications.

Invokamet ®(canagliflozin / metformin)	Jardiance®(empagliflozin)

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...	Prescription Only Jardiance (empagliflozin) is an FDA-approved tablet used to manage blood sugar levels in individuals aged 10 and above with type 2 diabetes. It is also employed to lower the risk...
Dosage & Administration
Administration
Oral. Learn more.	Oral . Learn more.
Dosing
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.	Recommended dosage is 10 mg once daily in the morning, taken with or without food. For additional glycemic control, dosage may be increased to 25 mg.. Learn more.
Latin Shorthand
1 tab BID with meals. Starting dose: canagliflozin 50 mg BID, metformin HCl 500 mg BID.. Learn more.	Recommended: 10mg qd in AM, with or without food. May increase to 25mg for better glycemic control.. Learn more.
Financial Assistance
Out-Of-Pocket Costs With Copay Card
$0. Learn more.	$10. Learn more.
Annual Cap
$3,000 and $200 per month. Learn more.	$175 per month. Learn more.
Assistance Expiration
Calendar year. Learn more.	Learn more.
Generics
No lower-cost generic available	No lower-cost generic available
Physician Advisory
Adverse Reactions
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.	Most common adverse reactions (5% or greater incidence) were urinary tract infections and female genital mycotic infections. . Learn more.
Mechanism of Actions (MoA)
SGLT2 Inhibitors. Learn more.	SGLT2 Inhibitors. Learn more.
Special Populations

Invokamet ® Alternatives