Invokana (canagliflozin) Side Effects, Cost, Mechanism, Weight Loss

Category: Diabetes by Kiran Mangat-Sohi - May 29, 2013 | Views: 9250 | Likes: 1 | Comment: 0

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Invokana | canagliflozinInvokana for tyoe 2 diabetes

Medication Class: Sodium-glucose co-transporter 2 (SGLT2) inhibitor
Similar Drugs: Farxiga
Manufactured by: Janssen Pharmaceuticals
Approval Date: March 29, 2013

What is Invokana and its mechanism of action                                                     

Invokana is a new type of oral diabetes medication. The mechanism of action of Invokana is inhibition of sodium-glucose co-transporter 2 (SGLT2) in kidneys. This means that Invokana blocks the process that the kidney uses to reabsorb glucose from filtered urine into the blood stream. Therefore, Invokana increases glucose excretion in urine, reducing blood glucose levels in patients with diabetes who have excessively high blood glucose levels.

What does Invokana treat

Invokana is a prescription medicine used along with diet and exercise to lower blood sugar in adults with Type-2 diabetes but it is not for people with Type-1 diabetes and diabetic ketoacidosis.  It should not be used in patients with renal disease or who are on dialysis. 

How effective is Invokana

Invokana 100 and 300 mg once daily were compared to placebo (sugar pill) in a 26-week study of 584 patients with type-2 diabetes. Average changes in fasting glucose were -8 mg/dl for placebo, -27 mg/dl for Invokana 100 mg, and -35 mg/dl for Invokana 300 mg. Both doses provided greater average reductions in hemoglobin A1C (HbA1C) than placebo. Reduction in HbA1C less than 7% was achieved in 21% of patients on placebo, 45% with Invokana 100 mg, and 62% with Invokana 300 mg. Average weight loss was 0.6 kg for placebo, 2.8 kg for Invokana 100 mg, and 3.9 kg for Invokana 300 mg. 

Invokana 100 mg provided similar reductions in HbA1C from baseline as compared to glimepiride when added to metformin therapy. Invokana 300 mg provided a greater reduction from baseline in HbA1C compared to glimepiride, and the relative treatment difference was -0.12%. Reduction in HbA1C less than 7% was achieved in 56% of patients on glimepiride, 54% with Invokana 100 mg, and 60% with Invokana 300 mg.

Also Read: Invokana and Farxiga for Weight Loss Management

Interesting facts about Invokana

  • Invokana is the first diabetes treatment approved in a new class of drugs known as sodium-glucose co-transporter 2 (SGLT2) inhibitors.
  • Dapagliflozin, which is also sodium glucose co-transporter, was rejected by the FDA on safety grounds, which raised questions about the safety of Invokana.
  • Invokana is associated with weight loss. 
  • Invokana reduces blood pressure (-3.7 to -5.4 mmHg).

What are Invokana side effects

Serious: Kidney problems, dehydration (loss of body water), hypoglycemia (low blood sugar), hyperkalemia (high levels of potassium in blood), hypotension (low blood pressure).

Common: Vaginal or penis yeast infections, urinary tract infections, and increased urination.

What is the dosage of Invokana

Invokana is available in 100 mg and 300 mg tablets. The starting dose of invokana is 100 mg once daily, taken before the first meal of the day. The dosage can be increased to 300 mg once daily if kidney function is 60 mL/min/1.73 m2 or greater and if additional glucose control is needed. 

The dose of Invokana is limited to 100 mg once daily in patients whose renal function is 45 to 60 mL/min/1.73 m2.  Invokana should not be started or should be stopped if kidney function is below 45 mL/min/1.73 m2. 

What are Invokana Drug Interactions

UGT Enzyme Inducers (UDP glucuronosyl transferases [UGT] are involved in the process of glucuronidation in the body which makes several drugs dissolvable in water enhancing their excretion). Combining Invokana with UGT inducers (e.g., rifampin, phenytoin, phenobarbital, ritonavir) may reduce blood levels of effect of Invokana. 

Digoxin levels may increase when combined with Invokana. 

What is the cost of Invokana

Wholesale price is $8.77 per tablet, or $263.10 for a one-month supply.

How to obtain prescription assistance for Invokana

For prescription assistance or to see if you qualify visit Janssen Prescription Assistance

Invokana Care Path Path support program includes cost saving card, resources, meal planning, recipes, medication reminders, and wellness tips.

References

Invokana (canagliflozin) Tablets, http://www.invokana.com

Invokana Prescribing Information (package insert)

 
This medication summary is for information only and is not a substitute for medical advice, diagnosis or treatment provided by a qualified health care provider.

 

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