Invokamet (Canagliflozin/metformin)

Description

Invokamet is a medication made up of canagliflozin and metformin hydrochloride. It's used in combination with diet and exercise to treat type 2 diabetes in adults. 

Canagliflozin is used to decrease the risk of serious cardiovascular events in adults who have type 2 diabetes and heart disease. It's also used to decrease risk of end-stage kidney disease, doubling serum creatinine levels, death caused by cardiovascular reasons, and hospitalization for adults with type 2 diabetes, heart failure, and diabetic kidney disease who have albumin in the urine.

Adults with type 1 diabetes should not take Invokamet as this may increase their risk for a serious condition called diabetic ketoacidosis.

Directions

The instructions that your doctor gives you and the information provided with your Invokamet prescription should be read and followed. If you have any questions or concerns, talk to your doctor or pharmacist. 

Invokamet oral tablets come in the following strengths:

• Canagliflozin 50 mg and metformin HCl 500 mg
• Canagliflozin 50 mg and metformin HCl 1,000 mg
• Canagliflozin 150 mg and metformin HCl 500 mg
• Canagliflozin 150 mg and metformin HCl 1,000 mg

The recommended initial dose is Invokamet (canagliflozin 50 mg and metformin 500 mg) orally twice daily. Invokamet should be taken with a meal. Depending on kidney function and response to the medication, the dose may be adjusted. 

Ingredients

Canagliflozin, a sodium-glucose co-transporter 2 (SGLT2) inhibitor, and metformin, a biguanide, are the active ingredients contained in each Invokamet tablet. Croscarmellose sodium, hypromellose, magnesium stearate, and microcrystalline cellulose are the inactive ingredients. Macrogol/PEG3350, polyvinyl alcohol (hydrolyzed partially), talc, titanium dioxide, iron oxide yellow (50 mg/1,000 mg and 150 mg/500 mg tablets), iron oxide red (50 mg/1,000 mg, 150 mg/500 mg, and 150 mg/1,000 mg tablets), and iron oxide black (150 mg/1,000 mg tablets) are the ingredients that make up the film-coating of the tablet.

Contraindications

If you have severe kidney problems or if you are on dialysis, you should not take Invokamet.

If you have metabolic acidosis such as diabetic ketoacidosis, you should not take Invokamet.

If you have an allergy to canagliflozin, metformin, or any of the other ingredients or excipients contained in Invokamet, avoid taking Invokamet.

Cautions

• Before you begin taking Invokamet, tell your doctor:
• About any medications you take, including prescription and nonprescription medications as well as vitamins and herbal supplements.
• About any allergies you may have
• If you have any medical conditions
• About your pregnancy and breastfeeding status
• If you have any upcoming imaging procedures
• Risk of lower limb amputations has been associated with canagliflozin. Your risk factors for lower limb amputations should be discussed with your doctor before you begin taking Invokamet. Immediately talk to your doctor if you have pain, tenderness, sores, or ulcers on your feet.
• Invokamet can cause volume depletion. If you have kidney problems, are elderly, or if you take certain fluid pills, your risk may be increased.
• Ketoacidosis, a severe condition that can be fatal, can occur with the use of Invokamet. Immediately seek emergency medical attention if you have nausea, vomiting, stomach pain, general discomfort, and trouble breathing.
• Invokamet may cause urinary tract infections and kidney infections that may require hospitalization. Immediately talk to your doctor if you have burning upon urination, frequent urination, urination that looks cloudy, bright pink, or red, urine with a strong odor, pelvic pain, fever, nausea, or back pain.
• Invokamet can cause low blood sugar, especially if taken with insulin or other medications that can lower blood sugar. Your blood sugar should be monitored and you should treat low blood sugar as your doctor has instructed. 
• Although rare, necrotizing fasciitis of the perineum (Fournier's gangrene), a severe and potentially fatal necrotizing infection that warrants surgery, can occur while taking Invokamet. Immediately seek emergency medical attention if you have fever or discomfort and pain, tenderness, redness, or swelling in the general or perineal area. 
• Invokamet can cause genital fungal infections.
• Invokamet can induce serious allergic reactions. Immediately seek medical attention if you have a rash, rapid heart rate, trouble breathing, or swelling of your face, lips, tongue, or throat.
• Your risk of bone fractures can be increased during treatment with Invokamet.
• Your vitamin B12 levels can be decreased during treatment with Invokamet. 

Side Effects

The most common Invokamet side effects include genital fungal infections in women, urinary tract infections, frequent urination, diarrhea, nausea, vomiting, gas, weakness, indigestion, stomach discomfort, and headache; however, these are not all the possible side effects that can occur during treatment.

Immediately speak to your doctor if you develop persistent or bothersome side effects. 

Reference:

1. Invokamet (canagliflozin and metformin hydrochloride tablets), for oral use. Titusville, NJ: Janssen Pharmaceuticals, Inc.; 2020.

About Dr. Savannah Muncy (Page Author)

Dr. Muncy (PharmD) studied science and education as an undergraduate before attending the Appalachian College of Pharmacy where she completed her PharmD in three years. She is currently using her pharmacy and healthcare expertise to write medical content for clients all around the world. She is focused on delivering the most current, accurate, and engaging information to healthcare professionals and patients. Read More....