Invokana for Type 2 Diabetes
What is Invokana?
Invokana is a medication designed to help people with type 2 diabetes manage their blood sugar levels when combined with a proper diet and exercise regimen. Invokana contains canagliflozin as the active ingredient and belongs to a class of drugs known as sodium-glucose co-transporter 2 (SGLT2) inhibitors.
Invokana is not meant for individuals with type 1 diabetes or those who are dealing with a serious condition called diabetic ketoacidosis, which can occur when diabetes is uncontrolled.
How Invokana Works for Type 2 Diabetes Mellitus
Invokana operates by helping the body eliminate excess sugar through urine. It prevents the kidneys from reabsorbing sugar, allowing this sugar to be expelled from the body through urination. This action helps lower blood sugar levels and improve A1C, a test that measures average blood sugar levels in the past 3 months.
Typical Side Effects of Invokana
Many side effects of Invokana are linked to the medication's mechanism of action, which involves increasing the excretion of sugar in urine. Since you're expelling more sugar through urine, it can create an environment in the genital area that's conducive to the growth of bacteria and yeast, raising the risk of infection.
The most frequently reported side effects of Invokana include:
- Genital fungal (yeast) infections: This risk is higher in women compared to men
- Urinary tract infections
- Increased urination (frequency and/or volume)
Weight Loss from Invokana
Many people with type 2 diabetes are interested in medications that can potentially help with weight loss. Some SGLT2 inhibitors are known to have this side effect, although it may not be as pronounced as with other medications. However, it's important to note that during clinical trials assessing the efficacy and safety of Invokana, it did not demonstrate any significant impact on weight.
Warnings About Taking Invokana
As this medication makes changes to the body, it comes with possible risks. While rare, these risks can be dangerous, so is it important to be aware and watchful.
These risks include:
- Low blood sugar (Hypoglycemia)
When used in combination with other diabetes medications like insulin or sulfonylureas, Invokana can sometimes lower blood sugar levels too much, causing hypoglycemia.
- High Potassium
Abnormally high potassium levels in the body is a rare but serious side effects of Invokana. This is of greatest risk in individuals with poor kidney function, and therefore these individuals should have their potassium levels monitored if using Invokana.
- Kidney Injury
Invokana has been associated with acute injury to the kidneys in certain situations, specifically when experiencing some kind of fluid disruption while taking the medication. This most often includes situations such as reduced intake of food or drink, or increased fluid loss, such as extreme diarrhea or vomiting. In this situation a healthcare provider may temporarily hold Invokana use and monitor your kidney function until the situation subsides.
Ketoacidosis is a rare condition that occurs when your blood becomes too acidic because of a build-up of “ketones”. This happens when your body can’t use sugars for energy, and instead starts using up fat, which breaks down to ketones. This causes the blood to be very acidic and is dangerous if not treated quickly.
- Lower limb amputations
There have been reports suggesting an increased risk of lower limb amputations (such as toes or part of the foot) in people taking Invokana. This risk is generally higher for those with a history of amputation, peripheral vascular disease, or neuropathy. It’s also important to monitor any changes while taking the medication, such as pain or sores on the lower limbs.
Invokana Combination Pills: Invokamet and Invokamet XR
Invokana is also available as combinations pills: Invokamet and Invokamet XR, which combine canagliflozin with metformin. Metformin is a commonly prescribed medication for type 2 diabetes and is often recommended as a first-line treatment. Since SGLT2 inhibitors are often added to the diabetes treatment regimen, combining them into a single pill can be quite convenient. Instead of managing two separate pills, you can simplify your routine with a combination product, which many people find preferable.
"XR" in Invokamet XRstands for extended-release, meaning the medication is released more slowly into your body. This allows for less frequent dosing, as Invokamet XR is taken once a day compared to the standard Invokamet, which is taken twice a day.
However, there is a trade-off to this added convenience. While it's more user-friendly, it can make adjusting your doses a bit trickier. For instance, if you want to maintain your metformin dose but increase the canagliflozin, you may need to switch to a different combination pill that suits your needs, or possibly go back to taking the individual pills to achieve the desired dose. It ultimately depends on your personal preferences and needs.
Cost of Invokana
Invokana is available only as a brand-name medication, and there are no generic alternatives currently on the market. The cost of a 30-tablet supply of Invokana at retail prices often exceeds $700. Regrettably, many insurance plans do not include coverage for this medication, making it unaffordable for a significant number of individuals.
When Will There Be a Generic For Invokana?
When a new medication hits the market, it typically comes with a brand name, and the company that developed it is granted a specific period during which they can exclusively sell the drug. This exclusivity allows them to recoup the costs of developing the medication. However, this exclusivity period can be quite lengthy, leaving only one costly option on the market.
Once this exclusivity period expires, other companies can create their own versions of the branded medication that are therapeutically equivalent. These generic versions are typically more affordable, benefiting consumers and providing competition in the market.
So, when can we expect Invokana to become available as a more cost-effective generic option? Unfortunately, it appears we'll have to wait quite a while. The final patent protecting Invokana is set to expire on May 11, 2031, which is almost a decade away. Regrettably, this means that Invokana is likely to remain expensive for the foreseeable future. You can learn more about altearntives for Invokana here.
To learn more about Invokana, and how to get a prescription from Marley Drug, call us at 1-800-810-7790.
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- Diabetes & DKA (ketoacidosis). American Diabetes Association. (n.d.). Retrieved September 30, 2023, from https://diabetes.org
- Invokamet (canagliflozin and metformin hydrochloride) tablets, for oral use. Food and Drug Administration. (2014; Revised 07/2017). Retrieved September 30, 2023, from https://www.accessdata.fda.gov
- Invokamet XR (canagliflozin and metformin hydrochloride extended-release) tablets, for oral use. Food and Drug Administration. (2016; Revised 09/2016). Retrieved September 30, 2023, from https://www.accessdata.fda.gov
- Invokana (canagliflozin). GoodRx. (n.d.). Retrieved September 30, 2023, from: https://www.goodrx.com
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