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Canagliflozin/Metformin is available as an oral tablet that contains:

• Canagliflozin 50 mg and metformin HCl 500 mg
• Canagliflozin 50 mg and metformin HCl 1,000 mg
• Canagliflozin 150 mg and metformin HCl 500 mg
• Canagliflozin 150 mg and metformin HCl 1,000 mg

Canagliflozin/Metformin is a GLP-1 agonist and is used for the following:

• Type 2 diabetes
• Lower the risk of heart attack, stroke, and heart-related death in adults with type 2 diabetes and heart disease

Canagliflozin/Metformin is a glucagon-like peptide-1 (GLP-1) agonist, meaning it acts like the natural GLP-1 hormone in the body. This hormone works to lower your blood sugar by causing your pancreas to release more insulin, stopping your liver from releasing more sugar, and slowing down your digestion.

• In general, your dose will depend on your current medications a how well your kidneys are working
• Dosing for people who aren’t currently taking either Invokana (canagliflozin) or metformin is listed below
• Canagliflozin/Metformin: The typical starting dose is 50 mg/500 mg (Canagliflozin/Metformin) by mouth twice daily with meals
• Canagliflozin/Metformin XR: The typical starting dose is 100 mg/1,000 mg (Canagliflozin/Metformin) by mouth once daily with breakfast
• The maximum dose is 300 mg/2,000 mg (Canagliflozin/Metformin) per day

Canagliflozin/Metformin is a safe and effective treatment when used for FDA licensed indications. However, like all medications, they may give you unwanted side effects. You should always discuss potential side effects with your physician to ensure the medication is suitable and right for you. You should not use this medication if you have: Severe renal impairment (eGFR less than 30 mL/min/1.73 m2. Metabolic acidosis, including diabetic ketoacidosis. Serious hypersensitivity reaction to canagliflozin or metformin HCl.

Common side effects of Canagliflozin/Metformin:

• Nausea
• Diarrhea
• Vomiting
• Stomach pain
• Constipation

Serious side effects are rare with Canagliflozin/Metformin. Contact your healthcare provider immediately if you experience any of the following.

• Severe allergic reaction: rash; hives; trouble breathing; swelling of the face, lips, tongue, or throat
• Lactic acid buildup: dizziness, feeling very tired, nausea, stomach pain, unusual muscle pain, feel cold in the hands or feet, slow or irregular heartbeat, fast breathing
• High ketone levels in the blood: nausea, vomiting, stomach pain, tiredness, thirsty, dry mouth, fruity breath, trouble breathing

The following medications may interact with Canagliflozin/Metformin:

• Carbonic Anhydrase Inhibitors: May increase risk of lactic acidosis
• Consider more frequent monitoring
• Drugs that Reduce Metformin Clearance: May increase risk of lactic acidosis. Consider benefits and risks of concomitant use
• UGT enzyme inducers decrease canagliflozin exposure which may reduce the effectiveness of Canagliflozin/Metformin
• The risk of hypoglycemia is increased when INVOKANA is used concomitantly with insulin secretagogues (e.g., sulfonylurea) or insulin
• Canagliflozin/Metformin increases digoxin exposure
• Concomitant use of an SGLT2 inhibitor with lithium may decrease serum lithium concentrations

Various FDA-approved generic manufacturers

Based on animal data showing adverse renal effects from canagliflozin, Canagliflozin/Metformin or Canagliflozin/Metformin XR is not recommended during the second and third trimesters of pregnancy.

• Invokamet
• Invokamet XR