Invokana (canagliflozin)
The best weekly exercise routine for healthy,... Invokana tablets contain the active ingredient canagliflozin, which is a medicine used to help control blood sugar levels in people with type 2 diabetes. Read on for advice on its use and possible side effects. Type 2 diabetes (non-insulin dependent diabetes) in adults aged 18 years and over. Invokana tablets can be used on their own to improve blood sugar control in people whose blood sugar is not controlled by changes to their diet and exercise alone, and who can't take an antidiabetic medicine called metformin. Invokana tablets can also be used for people with type 2 diabetes whose blood sugar is not sufficiently controlled by other antidiabetic medicines. It can be added to treatment with medicines such as metformin , a sulphonylurea such as gliclazide or glibenclamide , or to treatment with insulin . Invokana tablets contain the active ingredient canagliflozin, which is a type of medicine called an SGLT2 inhibitor. In type 2 diabetes the cells in the bodybecome resistant to the action of insulin.Insulin is the main hormone responsible for controlling the level of sugar (glucose)in the blood. It makes cells in the body remove sugar from the blood. When the cells are resistant to insulin this makes blood sugar levels rise too high. Canagliflozin works in the kidneys, where it allows the body to excrete excess glucose from the blood into the urine. Normally, when the kidneys filter and clean the blood, glucose is filtered out of the blood at the same time. The glucose is then reabsorbed back into the blood by a mechanism called the sodium-glucose co-transporter 2 (SGLT2). The kidneys normally reabsorb glucose back into the blood even when the levels of glucose in the blood are too high, as in diabetes. Canagliflozin wo Continue reading >>
What’s Invokana? 10 Things You Need To Know
Invokana (canagliflozin) is one of the new oral medications for adult onset diabetes. It’s expensive but has many upsides. Taken usually in combination with metformin it is a rising star in the treatment of diabetes. Here is what you need to know to help you decide: worth it or not? Invokana is taken as a 100 mg tablet once daily before breakfast, increasing to a 300 mg tablet once a day if you have normal kidney function. Invokana can be taken with or without food. Invokana is not yet recommended for use alone in the treatment of diabetes; it should be given as a second agent in addition to metformin or as a third-line treatment. Invokana works on the kidneys and tells the proximal tubule to resorb approximately 90 percent of the filtered glucose load. So, Invokana promotes dumping of glucose from the kidneys to the urine. Invokana used alone doesn’t lower blood sugars (measured by the A1C blood test) enough to make it effective as a single agent for diabetes. In studies it lowers A1C by 0.5 to 0.7 percentage points, making it a relatively weak glucose lowering agent. When should Invokana be added? It has been shown to be effective in lowering A1C when metformin alone is not achieving the goal A1C of < 7.0. Invokana 300 mg compared to Januvia 100 mg mixed with metformin was better at lowering blood sugar and helped with weight loss. Will I lose weight on Invokana? Yes, in most studies Invokana (used with metformin) resulted in a 6.5 pound weight loss at 12 weeks and an almost 10 pound weight loss at the end of a year. That’s quite a plus. The huge downside of Invokana is the frequency of genital fungal infections, which are almost sixfold higher. This means there is an increased risk of genital yeast infections: vulvovaginal candidiasis (vaginal yeast infections) Continue reading >>
Invokana Superior As Second Add-on To Metformin
Home / Therapies / SGLT-2 Therapy Center / Invokana Superior As Second Add-on to Metformin Invokana Superior As Second Add-on to Metformin New study indicates canagliflozin superior to glimepiride in lowering A1C. Over a one-year study, glycemic control was improved and body weight and blood pressure were reduced with Invokana (canagliflozin, Janssen) as add-on therapy to metformin in patients with type 2 diabetes, according to a presentation at AACE. Assessment of noninferiority of Invokana to glimepiride was based on a pre-specified noninferiority margin of 0.3%. If noninferiority was shown, the protocol specified a step-down assessment of superiority on the basis of an upper bound of the 95% CI for the difference of each Invokana dose vs glimepiride of less than 0.0%. Mean daily dose=5.6 mg. Glimepiride titration up to 6 mg or 8 mg was allowed throughout the study. Invokana 100 mg difference from glimepiride: 0.01% (95% CI: 0.11, 0.09) Invokana 300 mg difference from glimepiride: 0.12% (95% CI: 0.22, 0.02) Secondary endpoint at 52 weeks: Percent of patients who achieved the A1C goal of <7.0% vs glimepiride:. In the randomized, double blind study, researchers from Janssen Scientific Affairs evaluated data from 1,450 adults (mean age, 56.2 years) with type 2 diabetes (mean HbA1c, 7.8%; mean BMI, 31 kg/m2) on background metformin randomly assigned to Invokana (100 mg or 300 mg) or glimepiride for 52 weeks to determine the effects of the treatments on metabolic syndrome components. Participants were further diagnosed with metabolic syndrome if they met two or more of the following criteria: triglyceride levels of at least 150 mg/dL; HDL cholesterol less than 40 mg/dL for men and less than 50 mg/dL for women; waist circumference at least 102 cm for non-Asian men, at leas Continue reading >>
Important Safety Information
INVOKAMET®/INVOKAMET® XR can cause serious side effects, including: Amputations. INVOKAMET®/INVOKAMET® XR may increase your risk of lower-limb amputations. Amputations mainly involve removal of the toe or part of the foot; however, amputations involving the leg, below and above the knee, have also occurred. Some people had more than one amputation, some on both sides of the body. You may be at a higher risk of lower-limb amputation if you: have a history of amputation, have heart disease or are at risk for heart disease, have had blocked or narrowed blood vessels (usually in leg), have damage to the nerves (neuropathy) in the leg, or have had diabetic foot ulcers or sores. Call your doctor right away if you have new pain or tenderness, any sores, ulcers, or infections in your leg or foot. Your doctor may decide to stop your INVOKAMET®/INVOKAMET® XR for a while if you have any of these signs or symptoms. Talk to your doctor about proper foot care. Lactic Acidosis. Metformin, one of the medicines in INVOKAMET®/INVOKAMET® XR, can cause a rare but serious condition called lactic acidosis (a build-up of lactic acid in the blood) that can cause death. Lactic acidosis is a medical emergency and must be treated in the hospital. Call your doctor right away if you have any of the following symptoms, which could be signs of lactic acidosis: feel cold in your hands or feet; feel very weak or tired; have unusual (not normal) muscle pain; have trouble breathing; have unusual sleepiness or sleep longer than usual; have stomach pains, nausea, or vomiting; feel dizzy or lightheaded; or have a slow/irregular heartbeat You have a higher chance of getting lactic acidosis with INVOKAMET®/INVOKAMET® XR if you have conditions such as: severe kidney problems, or your kidneys are affe Continue reading >>
Fda Approves A Highly Questionable New Diabetes Drug, Invokana
The FDA just gave its approval to the first drug in a new class of diabetes drugs, Johnson & Johnson's canagliflozin, which will be marketed in the U.S. as Invokana. New York Times: FDA Approves a New Diabetes Drug From J.&J. (May require subscription) Reuters: U.S. FDA approves Johnson & Johnson diabetes drug, canagliflozin This class of drugs, the sodium-glucose co-transporter-2 (SGLT2) inhibitors, lowers blood sugar by blocking reabsorption of glucose by the kidney and increasing its excretion in urine. The manufacturer also claims that it causes weight loss--always a potent selling point for a diabetes drug. As is the case with all new diabetes drugs, now that the drug is approved, drug company flacks will start saturation bombing family physicians with materials that make it sound like they should put every patient with Type 2 on this wonderful, new drug, which is priced at $8.77 a pill or $263.10 for a monthly supply. They shouldn't. The committee of "experts" who reviewed this drug were ambivalent about it because the company's own, [most likely, statistically manipulated], clinical study of patients at especially high risk of cardiovascular disease showed that within the first 30 days, 13 patients taking canagliflozin suffered a major cardiovascular event [mainly strokes and some heart attacks] compared with just one patient taking a placebo. After that, the imbalance was reversed, though the drug then caused a slight increase in LDL cholesterol. However, as the New York Times report notes, " F.D.A. spokeswoman said Friday that the significance of those findings was unclear, and the label of the drug includes no warnings about heart attacks or strokes." That means that busy family physicians who are conscientious enough to review the FDA Prescribing Information Continue reading >>
Combination Metformin, Invokana Reduces Hba1c, Body Weight
Combination metformin, Invokana reduces HbA1c, body weight Rosenstock J, et al. Diabetes Care. 2016;doi:10.2337/dc15-1736. In drug-naive patients with type 2 diabetes, a combination of Invokana and metformin was more effective than monotherapy with either drug, according to recent findings. Researchers also found Invokana (canagliflozin, Janssen) monotherapy noninferior to metformin monotherapy. Julio Rosenstock, MD, director of the Dallas Diabetes and Endocrine Center at Medical City, and colleagues evaluated data from a phase 3 study conducted at 158 centers in 12 countries from May 2013 to December 2014 on 1,186 drug-naive patients (mean age, 54.9 years) with type 2 diabetes (mean duration, 3.3 years) to determine the safety and efficacy of therapy with the sodium-glucose cotransporter 2 inhibitor canagliflozin combined with metformin or monotherapy with each drug. Participants were randomly assigned 100 mg canagliflozin plus metformin (n = 237), 300 mg canagliflozin plus metformin (n = 237), 100 mg canagliflozin (n = 237), 300 mg canagliflozin (n = 238) or metformin (n = 237). Greater reductions in HbA1c were found with the combination therapies compared with metformin alone and canagliflozin alone (P = .001 for all). At week 26, compared with metformin alone, more participants had HbA1c less than 7% in the canagliflozin 100 mg plus metformin group (P = .027) and the canagliflozin 300 mg plus metformin group (P = .016). Compared with metformin alone, significant reductions in body weight were found in the combination therapy groups (P = .001 for both). Serious adverse events were low across all groups ( 3%). [Canagliflozin 100 mg] and [canagliflozin 300 mg] in combination with [metformin] provided significantly greater reductions in HbA1c and body weight compared w Continue reading >>
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Urgent Invokana Advice
I am going to see my doctor this afternoon and I would like to go on Invokana. My A1C is around a 6.5 my fasting numbers are around 110 to 120. The only numbers that are high during the day are my after dinner numbers ranging from 150 to 170 after 2 hrs. I need to bring them down to below 140 and bring my A1C to any where in the 5's. The questions are as follows for those of you on Invokana: 1. Does invokana deplete sugar in your body when high sugars are present, or does it just remove what ever sugar is in your system therefore lowering your numbers to unsafe levels if you are already low to begin with? 2. How many mgs does a low dose of invokana lower blood sugar? (I realize we are all different, but an estimate will do) 3. Anyone have issues with the side affects, yeast infection, urinary tract infections. So to sum it up, what I am asking is if my numbers throughout the day are at around 100 to 120 mg and I take Invokana will it bring me to unsafe levels? When I have dinner will the Invokana kick in and assist with my high dinner numbers? D.D. Family Glucose Disregulation since 2005 Invokana works by keeping glucose from being reabsorbed by the kidneys and hence it is excreted. Studies seem to show that 70-90g of glucose are excreted. Higher levels of glucose will be excreted after meals when you have higher blood sugars but my experience being on Invokana for going on six months is that you excrete substantial glucose even when fasting with blood sugars under 100 mg/dl. There is no way to know how you will respond to Invokana. Invokana alone will not cause hypos however if you use it with insulin or one the insulin secretagogues you may experience hypos and need to reduce your dosages. I found my insulin requirements dropped 30-40%. I've not experienced any side Continue reading >>
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Type 2 - Victoza And Invokana | Diabetes Forum The Global Diabetes Community
Diabetes Forum The Global Diabetes Community Find support, ask questions and share your experiences. Join the community Are you taking any of the following drugs? I've been a diabetic for 10 years now type two. Was originally just on metformin 1g then 2g then after 7 years or so added sitagliptin 100mg. my HB1c started at 6 in old money and steadily went up until last year it was 65 in new money. I was a regular weekend drinker since my teens but stopped drinking completely 25/12/2016. I am now 44. 2016 not long after I gave up alcohol my HB1c went to 6.3 in old money but my recent test (before Christmas 2017 and April 2017) showed it had gone up to 65 in new money. My weight is 120kg I'm 5'9" and have been this weight for at least 15 years. I'm not a big sweet eater I just tend to eat a large main course but that's it. I don't snack at all between meal times. My doctor put me on Lyxumia 10 then 20mg in December 2017. But I've been regularly checking my levels and my glucose is always 10-11 first thing in the morning before breakfast so the Lyxumia is not having any affect. I'm still on sitagliptin and metformin 2g daily as well. I'm seeing my diabetic doctor this week and I'd like to try Invokana or foxigia with victoza and metformin. Is this possible or can I only take either victoza or Invokana? Has anyone else here been put on this combination? I do not want to take insulin because I am a safety critical rail worker and would not be allowed to work then. Ultimately I need to loose weight and Invokana/victoza will hopefully do that in combination with my diet and exercise routine. Just wonder what your thoughts are on this? I have a artificial aortic Heart valve and take warfarin to control my coagulation (I self test for this) and a slightly reduced heart function Continue reading >>
Invokana?
I saw an endocrinologist, and I think he is overreacting. I have type II, and my numbers have been fairly good the last several months. I still have a ways to go, but getting there. My GP had me on metformin, 1000 mg/day, and glyburide, 5 mg AM and 5 mg PM. She referred me to an endo, but it took several months to get in to see him. When I did see him, my numbers had gone down quite a bit. My fasting is usually 80--90, PP one hour around 200, pp 2 hours around 150--160. Well, I felt we should have given the metformin a better try. I suggested we increase the metformin to 2000 mg/day, split AM and PM. I do agree we should cut out the glyburide, which could exhaust the pancreas. Instead, this endo wanted to do everything at once-- Well, instead, I have cut out glyburide, and increased metformin to 2000 mg/day. In the last week, I have seen an improvement in my PP numbers, now about 180--150. Still not reaching the desired 140, but headed in the right direction. I understand it takes Metformin about a month to really work. Perhaps if it doesn't then we could add other meds, Has anyone here taken either Victoza or Invokana? What was your experiences? Looks like they're doing post-marketing studies for Invokana, which I have no desire to participate in! Many, many years ago, I had a rheumatologist prescribe a then-new drug for rheumatoid, cuprimine. It was then in post-clinical trial status. He took great care to explain what that meant---FDA had approved it, but only certain doctors could prescribe it. We had tried everything else available at the time with no benefit, so we felt taking a risk with a relatively unproven drug to be acceptable. It fizzled---didn't help one bit! But we were so depserate, we were willing to take some risks. However, I don't feel Invokana is ri Continue reading >>
U.s. Fda Approves Invokamet (canagliflozin/metformin Hcl) For The Treatment Of Adults With Type 2 Diabetes | Johnson & Johnson
U.S. FDA Approves INVOKAMET (canagliflozin/metformin HCl) for the Treatment of Adults with Type 2 Diabetes In Phase 3 studies, INVOKANA plus metformin lowered blood sugar and reduced secondary endpoints of body weight and systolic blood pressure to a greater degree than metformin alone RARITAN, N.J., August 8, 2014 Janssen Pharmaceuticals, Inc. announced today the U.S. Food and Drug Administration (FDA) has approved INVOKAMET, a fixed-dose therapy combining canagliflozin and metformin hydrochloride in a single tablet, for the treatment of adults with type 2 diabetes. INVOKAMET provides the clinical attributes of INVOKANA (canagliflozin), the first sodium glucose co-transporter 2 (SGLT2) inhibitor available in the United States, together with metformin, which is commonly prescribed early in the treatment of type 2 diabetes. INVOKAMET is the first fixed-dose combination of an SGLT2 inhibitor with metformin approved in the United States. INVOKAMET combines, in one tablet, two complementary therapeutic approaches proven effective for managing type 2 diabetes, said Richard Aguilar, M.D.*, Medical Director of Diabetes Nation. "Canagliflozin works with the kidney to promote the loss of glucose in the urine, whereas metformin decreases the production of glucose in the liver and improves the bodys response to insulin. INVOKAMET is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus who are not adequately controlled by treatment that includes either canagliflozin or metformin, or who are already being treated with both canagliflozin and metformin as separate medications. INVOKAMET should not be used in patients with type 1 diabetes or for the treatment of diabetic ketoacidosis. Study results demonstrated that administr Continue reading >>
A Trial On The Effect Of Combining Victoza And Invokana On Glycemic Control In Type 2 Diabetes
A Trial on the Effect of Combining Victoza and Invokana on Glycemic Control in Type 2 Diabetes This four-month trial is testing the effect of combining Victoza (liraglutide) and Invokana (canagliflozin) on several outcomes, including A1c and the livers production of glucose in people with type 2 diabetes. Victoza is a once-daily GLP-1 agonist (taken as an injection) made by Novo Nordisk, and Invokana is a once-daily SGLT-2 inhibitor (taken as a pill) made by Johnson & Johnson. Its great from our view to see these two therapies from such major competitors being tested together. In this study, the primary outcome is measuring the combinations effect on the livers glucose production. The trial will also examine the combinations effects on A1c, fasting glucose level, and oral glucose tolerance (as measured by the oral glucose tolerance test ), and body fat. There are currently no approved combination drugs of GLP-1 agonist + SGLT-2 inhibitors, but there is one other trial (still recruiting!) testing combination therapy using Bydureon (GLP-1 agonist, exenatide once-weekly) and Farxiga (SGLT-2 inhibitor, dapagliflozin once-daily) AstraZeneca makes both compounds. In theory, combining these two different classes might improve the overall efficacycompared to using either drug alone. The trial aims to enroll 90 participants with type 2 diabetes. To participate, volunteers must be between 18 and 70 years of age, have an A1c between 7.0% and 10.0%, have a stable weight (no more than three pounds gained or lost) throughout the previous three months, and be drug nave (not taking other drugs for diabetes) or on a stable dose of metformin for at least three months. Exclusion criteria include taking drugs known to affect metabolism (other than metformin) and having known evidence of r Continue reading >>
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Invokana And Metformin Drug Interactions - Drugs.com
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Canagliflozin, Invokana
Is canagliflozin safe to take if I'm pregnant or breastfeeding? What is canagliflozin, and how does it work (mechanism of action)? Canagliflozin is an oral drug that reduces blood sugar (glucose) levels in patients with type 2 diabetes. It is a new type of diabetes medication in a class of medications called sodium-glucose co-transporter 2 (SGLT2) inhibitors. Under normal conditions, glucose is filtered out of the blood and into the kidney tubules as blood passes through the kidneys. The glucose then as absorbed from the tubules back into the blood so that glucose is not lost in the urine. SGLT2 is an enzyme in the kidney tubule that causes glucose to be reabsorbed from urine. Canagliflozin blocks the action of SGLT2. Therefore, canagliflozin reduces the reabsorption of glucose from renal tubules, leading to more excretion of glucose in urine. Canagliflozin was approved by the FDA in March 2013. What are the side effects of canagliflozin? AND PRECAUTIONSThe most common side effects of canagliflozin are: Other side effects of canagliflozin include: Diabetes Diet: Healthy Meal Plans for Diabetes-Friendly Eating What is the dosage for canagliflozin? Canagliflozin should be taken before the first meal of the day. The recommended starting dose is 100 mg once daily and the maximum dose is 300 mg once daily. Renal function should be assessed prior to starting canagliflozin and periodically during treatment, and the dose of canagliflozin should be modified based on renal function. Which drugs or supplements interact with canagliflozin? : Canagliflozin may slightly increase the concentration of digoxin (Lanoxin) in the body when both drugs are being taken. Digoxin concentrations should be monitored appropriately. Rifampin, phenytoin (Dilantin, Dilantin-125, phenobarbital, and ri Continue reading >>
Invokana Side Effects Center
Invokana (canagliflozin) is a sodium-glucose co-transporter 2 (SGLT2) inhibitor used to control blood sugar in people with type 2 diabetes mellitus, in addition to diet and exercise. Common side effects of Invokana include: urinary tract infections, increased urination, yeast infections, vaginal itching, thirst, constipation, nausea, fatigue, weakness, skin sensitivity to sunlight, hypersensitivity reactions (including skin redness, rash, itching, hives, and swelling), bone fractures, and kidney problems. The recommended starting dose of Invokana is 100 mg once daily, taken before the first meal of the day. Doses may be increased to 300 mg in patients who are able to tolerate Invokana at 100 mg doses. Invokana may interact with rifampin or digoxin. Tell your doctor all medications you use. Invokana should only be given to a pregnant woman if the benefit of the drug justifies the risk of harm to the fetus. Breastfeeding women should decide with their doctors whether to breastfeed or to discontinue taking Invokana. Our Invokana (canagliflozin) Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication. This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. Continue reading >>
New Metformin Combo Drug Approved For Type 2 Diabetes
On August 8, the U.S. Food and Drug Administration approved the oral combination medicine canagliflozin/metformin (brand name Invokamet) for Type 2 diabetes. Invokamet, manufactured by Johnson & Johnson subsidiary Janssen Pharmaceuticals, combines the SGLT2 inhibitor canagliflozin with the commonly prescribed diabetes drug metformin. Invokamet is the first medicine to combine an SGLT2 inhibitor and metformin available in the United States. In the process of filtering the blood, the kidneys typically reabsorb all the filtered glucose and return it to the bloodstream. One of the main proteins responsible for this reabsorption is SGLT2. By inhibiting the action of SGLT2, canagliflozin blocks the reabsorption of glucose by the kidneys, promoting a loss of glucose in the urine and lowering blood glucose levels. Metformin works by decreasing glucose production by the liver, as well as improving insulin sensitivity in the liver, muscle, and fat cells. Invokamet tablets are approved for use in conjunction with diet and exercise in adults with Type 2 diabetes whose condition is not sufficiently controlled with either canagliflozin or metformin alone or who are already taking both medicines. Studies of Invokamet indicated that taking the medicine was equivalent to taking corresponding doses of canagliflozin and metformin as individual tablets. Invokamet comes in tablet strengths containing 50 milligrams or 150 milligrams of canagliflozin and 500 milligrams or 1,000 milligrams of metformin, to be taken twice daily. This medicine should not be used to treat Type 1 diabetes or diabetic ketoacidosis (a potentially life-threatening condition marked by a chemical imbalance in the body). The most common side effects of canagliflozin are female genital fungal infections, urinary tract in Continue reading >>
