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Invokamet Dosage

Generic name: CANAGLIFLOZIN 50mg, METFORMIN HYDROCHLORIDE 500mg
Dosage form: tablet, film coated
Drug class: Antidiabetic combinations

Medically reviewed by Drugs.com. Last updated on Jan 30, 2024.

Prior to Initiation of INVOKAMET or INVOKAMET XR

Assess renal function before initiating INVOKAMET or INVOKAMET XR and as clinically indicated [see Dosage and Administration (2.4)and Warnings and Precautions (5.1, 5.4), Contraindications (4)].

In patients with volume depletion, correct this condition before initiating INVOKAMET or INVOKAMET XR [see Warnings and Precautions (5.4)and Use in Specific Populations (8.5, 8.6)] .

Dosage Overview

​INVOKAMET

​Take one tablet of INVOKAMET orally twice daily with meals [see Dosage and Administration (2.3)] .

​INVOKAMET XR

​Take two tablets of INVOKAMET XR orally once daily with the morning meal [see Dosage and Administration (2.3)] . Swallow each tablet whole and never crush, cut, or chew.

Recommended Dosage and Administration

​Individualize the starting dose of INVOKAMET or INVOKAMET XR based on the patient's current regimen and renal function [see Dosage and Administration (2.4)] . Table 1 presents the recommended starting dosage of INVOKAMET and INVOKAMET XR based on the patient's current regimen. For the available strengths of the canagliflozin and metformin components in INVOKAMET and INVOKAMET XR, see Dosage Forms and Strengths (3).

Table 1: Recommended Starting Dosage Based on the Patient's Current Regimen
Current Regimen INVOKAMET
Recommended Dosage
Administered as one tablet, orally, twice daily with meals		 INVOKAMET XR
Recommended Dosage
Administered as two tablets, orally, once daily with the morning meal
*
For patients taking an evening dosage of metformin HCl extended-release tablets, skip the last dose before starting INVOKAMET or INVOKAMET XR the following morning.
Not treated with either canagliflozin or metformin HCl Total daily dosage is canagliflozin 100 mg and metformin HCl 1,000 mg
Metformin HCl * Total daily dosage is canagliflozin 100 mg and the nearest appropriate total daily dosage of metformin HCl
Canagliflozin The same total daily dosage of canagliflozin and a total daily dosage of metformin HCl 1,000 mg
Canagliflozin and metformin HCl * The same total daily dosage of canagliflozin and the nearest appropriate total daily dosage of metformin HCl

​Recommended Dosage for Additional Glycemic Control

​INVOKAMET

​Canagliflozin may be increased to the maximum recommended dosage of 150 mg twice daily in patients tolerating 50 mg twice daily and metformin may be increased to the maximum recommended dosage of 1,000 mg twice daily, with gradual escalation to reduce gastrointestinal adverse reactions with metformin [see Adverse Reactions (6.1)].

​INVOKAMET XR

​Canagliflozin may be increased to the maximum recommended dosage of 300 mg once daily in patients tolerating 100 mg once daily and metformin may be increased to the maximum recommended dosage of 2,000 mg once daily, with gradual escalation to reduce gastrointestinal adverse reactions with metformin [see Adverse Reactions (6.1)].

Recommended Dosage for Patients with Renal Impairment

  • ​Initiation of INVOKAMET or INVOKAMET XR is not recommended in patients with an eGFR less than 45 mL/min/1.73 m 2, due to the metformin component.
  • Table 2 provides dosage recommendations for patients with renal impairment, based on eGFR [see Use in Specific Populations (8.6)and Clinical Studies (14.3)].
Table 2: Recommended Dosage in Patients with Renal Impairment
Estimated Glomerular Filtration Rate
[eGFR (mL/min/1.73 m 2)]		 Recommended Dosage
eGFR 45 to less than 60 The maximum recommended dosage of canagliflozin is 100 mg daily.
eGFR 30 to less than 45 Assess the benefit risk of continuing INVOKAMET or INVOKAMET XR. The maximum recommended dosage of canagliflozin is 100 mg daily.
eGFR less than 30 Contraindicated. If eGFR falls below 30 during treatment; discontinue INVOKAMET or INVOKAMET XR [see Contraindications (4)] .

Concomitant Use with UDP-Glucuronosyltransferase (UGT) Enzyme Inducers

​When co-administering INVOKAMET or INVOKAMET XR with an inducer of UGT (e.g., rifampin, phenytoin, phenobarbital, ritonavir), increase the total daily dosage of canagliflozin based on renal function [see Drug Interactions (7)] :

  • ​In patients with eGFR 60 mL/min/1.73 m 2or greater, increase the total daily dosage of canagliflozin to 200 mg in patients currently tolerating a total daily dosage of canagliflozin 100 mg. The maximum recommended dosage of canagliflozin is 300 mg daily.
  • ​In patients with eGFR less than 60 mL/min/1.73 m 2, increase the total daily dosage of canagliflozin to a maximum of 200 mg in patients currently tolerating a total daily dosage of canagliflozin 100 mg.

Discontinuation for Iodinated Contrast Imaging Procedures

Discontinue INVOKAMET or INVOKAMET XR at the time of, or prior to, an iodinated contrast imaging procedure in patients with an eGFR of less than 60 mL/min/1.73 m 2; in patients with a history of liver disease, alcoholism or heart failure; or in patients who will be administered intra-arterial iodinated contrast. Re-evaluate eGFR 48 hours after the imaging procedure; restart INVOKAMET or INVOKAMET XR if renal function is stable [see Warnings and Precautions (5.1)] .

Temporary Interruption for Surgery

​Withhold INVOKAMET or INVOKAMET XR at least 3 days, if possible, prior to major surgery or procedures associated with prolonged fasting. Resume INVOKAMET or INVOKAMET XR when the patient is clinically stable and has resumed oral intake [see Warnings and Precautions (5.2)and Clinical Pharmacology (12.2)].

Further information

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