Prescription Required 
Formulation : 
Description
Indications
The combination of canagliflozin and metformin is prescribed alongside a balanced diet and regular exercise to effectively manage type 2 diabetes. This medication not only aids in controlling blood sugar levels but also serves multiple purposes in patients with type 2 diabetes and heart or blood vessel disease. In addition to its role in diabetes management, this medication helps reduce the risk of heart attacks, strokes, and mortality in patients with type 2 diabetes and heart or blood vessel disease.
Canagliflozin acts on the kidneys to hinder the absorption of glucose (blood sugar), effectively reducing blood sugar levels. Metformin works by decreasing sugar absorption from the stomach, limiting the release of stored sugar from the liver, and enhancing the body’s ability to utilize sugar more efficiently.
Uses and Dosage
Adhere to your doctor’s instructions and take this medication orally, typically twice a day with meals. Consistent usage will ensure maximum benefits. To assist with adherence, take the medication at the same times each day.
Adequate hydration is essential while using this medication, unless your doctor advises otherwise.
The dosage is determined based on your medical condition, response to treatment, and concurrent medications. Your doctor may recommend starting with a low dose and gradually increasing it to minimize the risk of side effects like upset stomach. Comply diligently with your doctor’s instructions in this regard.
Your blood sugar levels should be regularly monitored as directed by your doctor. Keep a record of the results and share them with your healthcare provider. Inform your doctor if your blood sugar readings are consistently too high or too low. Adjustments to your diabetes medication, exercise routine, or diet may be necessary based on these results.
Side Effects
Some side effects may occur that usually do not need medical attention:
- bloated
- excess air or gas in the stomach or bowels
- full feeling
- indigestion
- passing gas
- constipation
Inform your healthcare provider immediately if you experience any serious side effects:
- bladder pain
- bloody or cloudy urine
- decreased appetite
- diarrhea
- difficult, burning, or painful urination
- fast, shallow breathing
- frequent urge to urinate
- frequent urination
- general feeling of discomfort
- increased urge to urinate during the night
- increased volume of pale, dilute urine
- itching of the vagina or genitals
- itching, stinging, or redness of the vaginal area
- lower back or side pain
- muscle pain or cramping
- nausea
- sleepiness
- stomach discomfort
- thick, white vaginal discharge with mild or no odor
- unusual tiredness or weakness
- waking to urinate at night
Caution
Prior to initiating this medication, inform your doctor or pharmacist about any known allergies to canagliflozin or metformin, or any other sensitivities you may have. Take note that this product might contain inactive ingredients that could trigger allergic reactions or other complications.
Before commencing usage, discuss your medical history with your doctor or pharmacist, especially if you have a history of breathing problems, blood disorders, dehydration, alcohol use/abuse, low blood pressure, heart failure, kidney disease, liver issues, or blood mineral imbalances. Also, if you have experienced yeast infections in the vagina or penis, share this information.
In the event that you have scheduled surgery or are undergoing X-ray/scanning procedures involving iodinated contrast, notify your doctor or dentist about all the products you use, including prescription drugs, nonprescription drugs, and herbal products. You may be required to temporarily discontinue this medication before the surgery/procedure. Seek instructions from your healthcare provider beforehand.
Be vigilant for potential effects on vision, dizziness, or drowsiness resulting from significantly low or high blood sugar levels. Refrain from operating vehicles, machinery, or engaging in activities that demand alertness and clear vision until you are confident in your ability to perform them safely.
Limit alcohol consumption while using this medication, as it may heighten the risk of lactic acidosis, low blood sugar, and elevated ketone levels.
Instances of dehydration may arise due to factors such as high fever, the use of “water pills” (diuretics like hydrochlorothiazide), excessive sweating, diarrhea, or vomiting. Such dehydration can increase the likelihood of lactic acidosis. If you experience persistent diarrhea or vomiting, discontinue this medication immediately and inform your doctor. Ensuring adequate fluid intake, unless otherwise directed by your doctor, is crucial to prevent dehydration.
During periods of bodily stress (e.g., fever, infection, injury, or surgery) or when reduced food intake occurs due to illness, elevated ketone levels may arise while taking this medication, potentially impacting blood sugar control. Consulting your doctor in such situations is vital, as it may necessitate adjustments to your treatment plan, medications, or blood sugar/ketone testing.
Older adults may be at an increased risk of experiencing side effects such as low blood sugar, dehydration, lactic acidosis, dizziness/fainting (especially when standing), or some bone loss.
Metformin has the potential to alter menstrual cycles by promoting ovulation, thus increasing the risk of pregnancy. If you are considering using this medication, consult your doctor or pharmacist regarding the appropriate use of reliable birth control methods.
For pregnant individuals, this medication should only be used when deemed necessary. Discuss the associated risks and benefits with your doctor. In certain instances, your doctor may recommend using insulin instead of this product during pregnancy.
While metformin may pass into breast milk in minimal quantities, the passage of canagliflozin into breast milk remains uncertain. If you are breastfeeding, consult your doctor before proceeding.
Form and Strength
Invokamet is available in the following forms and strengths:
-
Invokamet tablet:
- 50/500mg
- 150/500mg
- 50/1000mg
- 150/1000mg
FAQ
How long does it take for Invokamet to start working?
Invokamet starts to work within a few hours after taking your first dose. But it might take a few weeks before your A1C level improves.
Should Invokamet be taken with food?
Although you can take Invokamet with or without food, it’s best to take it before your first meal of the day, which is usually breakfast.
Resources
- https://www.healthline.com/health/drugs/invokana#dosage
- https://www.medbroadcast.com/drug/getdrug/invokamet#adverseeffects
- https://www.webmd.com/drugs/2/drug-166783/invokamet-oral/details
- https://www.mayoclinic.org/drugs-supplements/canagliflozin-and-metformin-oral-route/side-effects/drg-20112983
- https://www.drugs.com/invokamet.html
