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 Dec 30, 2024.
Prior to Initiation of INVOKAMET or INVOKAMET XR
Assess renal function before initiating INVOKAMET or INVOKAMET XR and as clinically indicated.
In patients with volume depletion, correct this condition before initiating INVOKAMET or INVOKAMET XR .
Recommended Dosage and Administration
INVOKAMET and INVOKAMET XR
- INVOKAMET and INVOKAMET XR contain canagliflozin and metformin HCl. For the available strengths of the canagliflozin and metformin HCl components in INVOKAMET and INVOKAMET XR, see Dosage Forms and Strengths (3).
- Individualize the starting dosage of INVOKAMET or INVOKAMET XR based on the patient's current regimen as presented in Table 1 and based on renal function as presented in Table 2 .
INVOKAMET XR
Take two tablets of INVOKAMET XR orally once daily with the morning meal. Swallow each tablet whole and never crush, cut, or chew.
Table 1 presents the recommended starting dosage of INVOKAMET and INVOKAMET XR based on the patient's current regimen.
| Current Regimen | INVOKAMET Recommended Dosage |
INVOKAMET XR Recommended Dosage |
|---|---|---|
|
||
| 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 in Adults and Pediatric Patients Aged 10 Years and Older
INVOKAMET
The dosage of canagliflozin in INVOKAMET may be increased to the maximum total daily dosage of 300 mg (150 mg orally twice daily) in patients tolerating a dosage of 100 mg (50 mg twice daily) of canagliflozin.
The dosage of metformin HCl in INVOKAMET may be increased to the maximum total daily dosage of 2,000 mg (1,000 mg orally twice daily), with gradual escalation to reduce the risk of gastrointestinal adverse reactions with metformin HCl.
INVOKAMET XR
The dosage of canagliflozin in INVOKAMET XR may be increased to the maximum total daily dosage of 300 mg orally once daily in patients tolerating a 100 mg once daily dosage of canagliflozin.
The dosage of metformin HCl in INVOKAMET XR may be increased to the maximum total daily dosage of 2,000 mg once daily, with gradual escalation to reduce the risk of gastrointestinal adverse reactions with metformin HCl.
Recommended Dosage in Adults and Pediatric Patients Aged 10 Years and Older with Renal Impairment
- Initiation of INVOKAMET or INVOKAMET XR is not recommended in adults or pediatric patients aged 10 years and older with an eGFR less than 45 mL/min/1.73 m 2, due to the metformin component.
- Table 2 provides dosage recommendations for adults and pediatric patients aged 10 years and older with renal impairment, based on eGFR.
| Estimated Glomerular Filtration Rate [eGFR (mL/min/1.73 m 2)] |
Recommended Dosage of INVOKAMET or INVOKAMET XR * |
|---|---|
|
|
| eGFR 45 to less than 60 | The maximum total daily dosage of canagliflozin is 100 mg. |
| eGFR 30 to less than 45 | Assess the benefit risk of continuing INVOKAMET or INVOKAMET XR. The maximum total daily dosage of canagliflozin is 100 mg. |
| eGFR less than 30 | Contraindicated. If eGFR falls below 30 during treatment; discontinue INVOKAMET or INVOKAMET XR . |
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 :
- 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 total daily dosage of canagliflozin is 300 mg.
- 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 .
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