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Ozempic® Alternatives

Ozempic®(semaglutide)
Invokamet®(canagliflozin / metformin)
Prescription Only
Ozempic (semaglutide) is a once-weekly injection that helps improve blood sugar levels in adults with type 2 diabetes mellitus. It also reduces the risk of major cardiovascular...
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
Subcutaneous. Learn more.
Oral. Learn more.
Dosing
0.25 mg SC injection q/week for 4 weeks. After 4 weeks, increase to 0.5 mg SC q/week. • If more control needed after 4 weeks on 0.5 mg, increase to 1 mg SC q/week • If further control needed after 4 weeks on 1 mg, increase to 2 mg SC q/week (max dose). . 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
0.25 mg SC injection q/week for 4 weeks. After 4 weeks, increase to 0.5 mg SC q/week. • If more control needed after 4 weeks on 0.5 mg, increase to 1 mg SC q/week • If further control needed after 4 weeks on 1 mg, increase to 2 mg SC q/week (max dose). . 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
Annual Cap
$150 for 1 month supply; $300 for 2 month supply; $450 for 3 month supply. Learn more.
$3,000 and $200 per month. Learn more.
Assistance Expiration
24 months. Learn more.
Calendar year. Learn more.
Generics
No lower-cost generic available
No lower-cost generic available
Physician Advisory
Adverse Reactions
The most common adverse reactions, reported in ≥5% of patients treated with OZEMPIC® are: nausea, vomiting, diarrhea, abdominal pain and constipation.. 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)
GLP-1 Receptor Agonists. Learn more.
SGLT2 Inhibitors. Learn more.
Special Populations
What is the risk of using OZEMPIC® during pregnancy?

Limited data exist on the use of semaglutide in pregnant women, making it challenging to determine the potential drug-associated risk for adverse developmental outcomes. Poorly controlled diabetes during pregnancy poses risks for both the mother and fetus. OZEMPIC® should be used during pregnancy only if the potential benefits outweigh the potential risks.

What are the potential risks to the fetus from exposure to semaglutide during pregnancy?

Based on animal studies, there may be potential risks to the fetus from exposure to semaglutide during pregnancy. In pregnant rats, exposure to semaglutide during organogenesis led to embryofetal mortality, structural abnormalities, and growth alterations. Similar findings were observed in rabbits and cynomolgus monkeys.

What is the estimated background risk of birth defects and miscarriage in pregnant women?

In the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2 to 4% and 15 to 20%, respectively. For women with pre-gestational diabetes, the estimated background risk of major birth defects is 6 to 10% with a peri-conceptional HbA1c >7 and can be as high as 20 to 25% with a peri-conceptional HbA1c >10.

What are the disease-associated risks for pregnant women with poorly controlled diabetes?

Poorly controlled diabetes during pregnancy increases the risk of hypoglycemia, hyperglycemia, diabetic ketoacidosis, pre-eclampsia, spontaneous abortions, preterm delivery, and delivery complications. It also increases the fetal risk for major birth defects, stillbirth, and macrosomia-related morbidity.

What do the animal data reveal about the effects of semaglutide exposure during pregnancy?

Animal data indicate that exposure to semaglutide during pregnancy in rats, rabbits, and cynomolgus monkeys can result in embryofetal mortality, structural abnormalities, and alterations in growth. These effects were observed at various dose levels and exposures in different animal species.

What is known about semaglutide exposure during lactation?

There is no information available regarding the presence of semaglutide in human milk or its effects on breastfed infants or milk production. Semaglutide was detected in the milk of lactating rats, but the clinical relevance of these findings is not clear.

Should OZEMPIC® be discontinued in women planning a pregnancy?

OZEMPIC® should be discontinued in women at least 2 months before planning a pregnancy due to the long washout period required for semaglutide.

Is OZEMPIC® safe for pediatric use?

Safety and efficacy of OZEMPIC® have not been established in pediatric patients (younger than 18 years).

Is OZEMPIC® safe for geriatric use?

No overall differences in safety or efficacy have been detected between older and younger patients in clinical trials. However, caution should be exercised in geriatric patients.

Is OZEMPIC® safe for patients with renal impairment?

No dose adjustment of OZEMPIC® is recommended for patients with renal impairment. Semaglutide pharmacokinetics have not shown clinically relevant changes in subjects with renal impairment, including end-stage renal disease.

Is OZEMPIC® safe for patients with hepatic impairment?

No dose adjustment of OZEMPIC® is recommended for patients with hepatic impairment. Semaglutide pharmacokinetics have not shown clinically relevant changes in subjects with varying degrees of hepatic impairment.