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INVOKAMET XR is the brand name for canagliflozin and metformin hydrochloride and is available as an extended-release oral tablet.

INVOKAMET XR is available as an extended-release 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

INVOKAMET XR is a SGLT2 inhibitor / Biguanide and is used for the following:

• Type 2 diabetes
• To lower the risk of major heart events (e.g., heart attack, stroke) in adults with Type 2 diabetes and heart disease
• To lower the risk of hospitalization for heart failure, death due to heart problems, and worsening of kidney problems in certain adults with Type 2 diabetes and diabetic kidney disease

INVOKAMET XR is a combination of two medications that work together to lower blood sugar levels. Canagliflozin is a sodium-glucose cotransporter 2 (SGLT2) inhibitor. It works in the kidneys to lower blood sugar by causing your body to get rid of excess sugar through your urine. Canagliflozin might also improve blood flow through the heart and kidneys by blocking sodium (salt) reabsorption in the kidneys. This might help lower your risk of heart and kidney complications. Metformin is a biguanide. It works by lowering the amount of sugar your liver makes and helps your body respond better to insulin. It also lowers absorption of sugar from your gut.

• In general, your dose will depend on your current medications — if you’re currently taking either Invokana (canagliflozin), metformin, or both. Your dose will also depend on how well your kidneys are working
• Dosing for people who aren’t currently taking either Invokana (canagliflozin) or metformin is listed below.
• Invokamet: The typical starting dose is 50 mg/500 mg (canagliflozin/metformin) by mouth twice daily with meals
• Invokamet 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

INVOKAMET XR 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 INVOKAMET XR:

• Vaginal yeast infection in females
• Urinary tract infections
• More urination
• Male genital yeast or fungal infections
• Diarrhea

Serious side effects are rare with INVOKAMET XR. 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 INVOKAMET XR:

• 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 Invokamet XR.
• The risk of hypoglycemia is increased when INVOKANA is used concomitantly with insulin secretagogues (e.g., sulfonylurea) or insulin
• Invokamet XR increases digoxin exposure.
• Concomitant use of an SGLT2 inhibitor with lithium may decrease serum lithium concentrations

Janssen Pharmaceuticals

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

• Canagliflozin/Metformin