What is Invokamet?

Invokamet, known as Vokanamet internationally, is a combination medication containing Canagliflozin and Metformin. Canagliflozin belongs to the drug class called sodium-glucose transport protein 2 (or SGLT2) inhibitors and Metformin belongs to the drug class of biguanides. It comes in the form of an oral tablet; each tablet containing a fixed amount of Canagliflozin and Metformin. It can be purchased as the brand-name medication, Invokamet, in 50mg/1000mg at My Drug Center, available to those with a valid prescription.

What is Invokamet used for?

Along with proper diet and exercise, Invokamet is used to help improve and control high blood sugar levels in patients with type 2 diabetes. Maintaining proper blood sugar levels is important to help avoid further complications such as kidney damage often resulting in dialysis, eye damage which can lead to permanent blindness, as well as an increased risk for heart disease or stroke. If you have diabetes and already developed heart disease, Invokamet can be used to help lower the risk of death from heart attack, stroke, or heart failure. Additionally, Invokamet can be used to reduce the risk of reaching end-stage of kidney disease.

How does Invokamet work?

Due to the two different active ingredients, Invokamet works in a few different ways to control your blood sugar.

The SGLT2 inhibitor (Canagliflozin) works by inhibiting the SGLT2, the major transport protein which influences the re-absorption of glucose back into blood circulation. This protein transporter is responsible for about 90% of the glucose that is re-absorbed from the kidneys. When the SGLT2 transporter is blocked, about 119 grams of blood glucose (per day) is passed through urination and out of the body instead of being recycled into the blood stream, thereby lowering the total amount of blood sugar.

The biguanide (Metformin) works by reducing the amount of glucose released into the blood stream by your liver. Though, the exact mechanism of action has always been unclear, there have been some recent studies that suggest how Metformin may work. Glucose is produced by our liver during time of fasting (not eating) to maintain normal levels and once we eat, the pancreas will release insulin to regulate the glucose absorption. During this time, the liver will stop producing glucose as the body can now get it from the food you are eating. However, this isn’t the case for those with diabetes type 2; the liver fails to recognize that insulin has been released and continues to produce glucose from the pancreas, resulting in high levels of blood sugar. This is caused by an error in the messages sent between the pancreas and the liver. Recent studies have suggested that Metformin works directly in the liver cells and regulates the genes that control the production of blood sugar; it may mimic a protein called CBP that communicates between the liver and the pancreas. This may help the liver recognize insulin release and can now respond to it properly.

How to use Invokamet

Invokamet should be used exactly as directed by your doctor. Consult with your doctor if you are unsure how to use this medication.

Swallow the tablet whole by mouth, usually taken twice per day with meals. Do not crush, chew, or break the tablet open. Your doctor may also require you to take vitamin B12; take only the prescribed amount of vitamin B12. 

Before starting treatment, ensure you and close friends or family members know how to use a glucagon injection kit if one has been prescribed along with Invokamet. It should be used in the case of severe hypoglycemia.

You should also watch for signs of hyperglycemia, such as increased thirst or urination.

If you have surgery or medical tests scheduled, tell all doctors caring for you that you are taking Invokamet. You may be required to discontinue treatment for 3 days before a surgery can be done.

Do not use Invokamet (Canagliflozin & Metformin)

This medication should not be used by patients who have severe kidney disease, diabetic ketoacidosis, or those who are allergic to Canagliflozin or Metformin.

Using this medication in the second or third trimester of pregnancy can cause harm to the unborn baby. It should not be used during pregnancy or when breastfeeding.

Invokamet should never be given to a person under the age of 18 years old.

Dose adjustment or special precautions may be required

It is important to tell your doctor if you have heart problems, a diabetic foot ulcer or amputation, liver or kidney disease, low levels of vitamin B12 or calcium in your blood, bladder infections or other urination problems, a pancreas disorder or surgery, a change in your diet, or if you are currently on a low-salt diet.

Risks

This medication can increase the risk of amputation to the lower leg. This risk is higher in those who have had a prior amputation, a foot ulcer, heart disease, circulation problems, or nerve damage.

It may also cause serious infections in the penis or vagina. If you experience burning, itching, odor, discharge, pain, tenderness, redness, or swelling of the genital area or rectal area, fever, or if you do not feel well, consult with your doctor right away.

Finally, this medication can also cause lactic acidosis, a serious and dangerous condition where a build-up of lactic acid occurs in your blood. If you experience unusual muscle pain, troubles breathing, stomach pain, dizziness, or feeling cold or very weak, consult with your doctor right away.

Other cautions

You will need to temporarily discontinue treatment if you need any type of x-ray or CT scan that includes injecting a dye into your veins.

Common side effects of Invokamet (Canagliflozin/Metformin) may include:

more frequent urination; headache, weakness; gas, stomach pain, indigestion; nausea, vomiting; or diarrhea.

The above side effects should not alarm you.

Serious side effects of Invokamet (Canagliflozin/Metformin) may include:

new pain, tenderness, sores, ulcers, or infections in your legs or feet; little or no urination; or a light-headed feeling, like you may pass out.

If you have any of the above side effects, contact your doctor right away.

Please note this is not a complete list of side effects. Not everyone experiences side effects; they are not guaranteed. If you do have side effects and they become unmanageable, consult your doctor about alternate medications.

Contact your doctor if you notice signs of…

High potassium levels: nausea, weakness, tingly feeling, chest pain, irregular heartbeats, muscle weakness;

Ketoacidosis: nausea, vomiting, stomach pain, confusion, unusual drowsiness, or trouble breathing; or

Bladder infection: pain or burning when you urinate, urine that looks cloudy, pain in pelvis or back.

What is inside Invokamet?

Invokamet contains two different active ingredients. Canagliflozin and Metformin, which belong to the drug classes of SGLT2 inhibitors and biguanides, respectively. Since these two drugs belong to different drug classes, they each have different mechanisms of action to lower and maintain blood sugar levels. This allows the medication to treat the condition in multiple ways to help boost efficiency of the medication.

What does Invokamet treat?

Invokamet treats high blood sugar levels in patients with type 2 diabetes. This is a condition where the body does not know how to properly use insulin, a natural hormone that helps regulate the glucose (sugar) in our blood. Since patients with type 2 diabetes can’t properly respond to insulin, the insulin cannot regulate their glucose, resulting in high blood sugar levels. This can lead to further complications such as kidney disease, heart disease, and vision loss, among others. Using Invokana can help reduce these further complications, or if patients have already began having complications such as heart disease, Invokamet can help reduce the risk of heart attack, stroke, or heart failure.

What does Invokamet do?

Invokana helps to lower and maintain high blood sugar a few different ways. Canagliflozin allows more glucose (sugar) to be passed through the urine by reducing the re-absorption of it from the renal tubules (kidneys). Metformin reduces the amount of glucose produced and released in your bloodstream by your liver and helps your body respond to the naturally-produced insulin better. Insulin is a hormone which helps to control the level of sugar in your blood. 

What are the side effects of Invokamet?

Some common side effects of Invokamet include headache, weakness, gas, stomach pain, indigestion, having to urinate more frequently, or nausea and vomiting. Keep in mind, not all side effects have been listed here. If you do experience side effects, such as the ones previously mentioned, they should not alarm you. However, if they become unmanageable or do not subside over time, you may want to consult with your doctor.

How much Invokamet can I take?

Due to many personal factors, only your doctor can determine how much Invokamet you can take. It will also depend on if you are currently taking Canagliflozin or Metformin alone and are switching to the combination medication as well as your renal function. Most patients are directed to take one tablet twice per day with meals.

What does Invokamet look like?

Invokamet comes as a capsule shaped tablet with certain colors depending on the strength of the tablet. We carry the 50mg/1000mg tablet which typically comes as a beige tablet. Other colors of tablets include white, yellow, and purple. However, keep in mind that the appearance of tablets may vary, especially when purchasing them internationally.

When will Invokamet go generic?

Invokamet was only approved for marketing in 2014 making it a fairly new medication. Due to this, there may not be a generic available for quite some time. However, to save money on your medication in the meantime, you can commonly find generic-like prices for brand-name medications when you order internationally. My Drug Center offers you Invokamet at an international price of $2.90 per tablet; in the United States, tablets would cost about 3.5 times as much per tablet for the same brand-name medication.

How long does Invokamet take to work?

Invokamet may begin to work within 4-5 days of treatment. However, keep in mind, due to personal factors such as age, weight, additional medications you take, as well as many others can influence how long it takes for clinical effectiveness to show. The exact length of time will vary between each individual.

How long does Invokamet stay in your system?

Invokamet will remain in the system for up to 50 hours following your last dose. Though, the exact length of time will vary between each individual due to many personal factors. It takes the medication about 10 hours to clear the system by half (50%).

How to take Invokamet?

Consult with your doctor if you are unsure how to use this medication; Invokamet should be used exactly as directed by your doctor. Each tablet should be swallowed whole without crushing, chewing, or breaking it in half, taken with meals unless otherwise directed. You may also be required to take vitamin B12; take only the prescribed amount. During treatment, ensure you monitor yourself for both hyperglycemia and hypoglycemia; you and at least one other should know how to use a glucagon injection kit if it has been prescribed along with Invokamet. It should be used in the case of severe hypoglycemia.

How much does Invokamet cost?

It depends on where you buy your supply from; if you purchase the medication locally (in the United States) or internationally. Most medications can be found for cheaper internationally oppose to being purchased from local pharmacies in the United States. For example, when you order internationally through My Drug Center, you can find 180 (50mg/1000mg) tablets of brand-name Invokamet for $522.00; in the United States, the exact same supply would cost close to 3.5 times as much, on average.

Can I take Invokamet when pregnant?

You should refrain from using Invokamet if you are pregnant (as well as breastfeeding) as it is not currently known if the medication can harm the unborn baby (or if it can pass through breast milk). You should only take this medication when pregnant if your doctor has recommended it; you will need to discuss all the possible risks and benefits of using Invokamet while pregnant before proceeding with treatment.