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 Sep 3, 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
Individualize the starting dose of INVOKAMET or INVOKAMET XR based on the patient's current regimen and renal function . 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).
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 |
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|
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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.
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.
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.
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 . |
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 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 .
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