Invokana vs Onglyza

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Introduction

For patients with type 2 diabetes, there are certain drugs available that help to control blood sugar levels by affecting the way in which insulin is used and glucose is processed in the body. Invokana and Onglyza are two such medications often prescribed for managing type 2 diabetes. They each function differently within the body but both have a positive effect on glycemic regulation. Invokana, also known as canagliflozin, belongs to a class of medication called sodium-glucose co-transporter 2 (SGLT2) inhibitors which work by preventing the kidneys from reabsorbing glucose back into the blood thus promoting its excretion through urine. On the other hand, Onglyza or saxagliptin falls under a different class of medicines known as dipeptidyl peptidase-4 (DPP-4) inhibitors; it works primarily by increasing production of insulin after meals and decreasing the amount of glucose produced by liver.

What is Invokana?

Canagliflozin (the generic name for Invokana) was the first drug of the SGLT2 inhibitor class, which marked a significant development in type 2 diabetes treatment. The FDA approved Canagliflozin in 2013. Invokana works by inhibiting the sodium-glucose co-transporter 2 (SGLT2), thus allowing blood sugar to be removed via urine and effectively reducing glucose levels in your bloodstream for longer than usual. It is prescribed for treating adults with type 2 diabetes.

On another note, Saxagliptin (generic name for Onglyza) belongs to a different class of medication known as DPP-4 inhibitors and was approved by the FDA years earlier than Canagliflozin, i.e., in 2009. Unlike Invokana's method of action, Onglyza works by increasing hormones that stimulate insulin release when blood sugar is high while simultaneously reducing glucose production from the liver.

While both drugs are designed to control blood sugar levels in Type II diabetics, they function differently within our bodies due to their distinct mechanisms of action—each having its potential side effects and considerations.

What conditions is Invokana approved to treat?

Invokana is indicated for the management of several conditions:

As an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus
To reduce the risk of major cardiovascular events such as heart attack, stroke or death in adults with type 2 diabetes mellitus who have known cardiovascular disease
To lower the risk of end-stage kidney disease (ESKD), worsening of kidney function, cardiovascular death, and hospitalization for heart failure in adults with type 2 diabetes mellitus and diabetic nephropathy with albuminuria.

How does Invokana help with these illnesses?

Invokana assists in managing diabetes by reducing the amount of sugar reabsorbed by the kidneys and increasing glucose excretion through urine. It accomplishes this by inhibiting a protein called SGLT2, which plays a key role in reabsorption of glucose from the renal tubules back into the bloodstream. Glucose balance is crucial for overall health, energy levels, and body weight regulation. In individuals with type 2 diabetes mellitus (T2DM), there's an overproduction of glucose due to insulin resistance or inadequate insulin secretion, leading to high blood sugar levels. Therefore, by inhibiting SGLT2, Invokana helps lower blood sugar levels and aids patients in managing their condition effectively.

What is Onglyza?

Onglyza is a brand name for saxagliptin, which is a Dipeptidyl peptidase-4 inhibitor (DPP-4 inhibitors), meaning it works to reduce blood sugar levels in type 2 diabetes patients by blocking the action of an enzyme called DPP-4. This leads to an increase in the levels of incretin hormones, which help lower post-meal glucose levels by increasing insulin production and reducing glucagon secretion. Saxagliptin was approved by the FDA in 2009.

Unlike Invokana (a SGLT2 inhibitor that works by helping kidneys remove more glucose from bloodstream), Onglyza does not lead to weight loss or have diuretic effects due its different mechanism of action. However, common side effects such as urinary tract infections and yeast infections associated with SGLT2 inhibitors like Invokana are typically less prevalent with DDP-4 inhibitors like Onglyza. The increased incretins resulting from Onglyza can also be beneficial for managing blood sugar levels throughout the day, particularly after meals.

What conditions is Onglyza approved to treat?

Onglyza has been approved by the FDA for use in managing:

Type 2 diabetes mellitus. This medication is typically used as part of a comprehensive treatment plan that may also include diet, exercise, weight control, regular blood sugar testing, and special medical care. Onglyza works by regulating the levels of insulin your body produces after eating.

How does Onglyza help with these illnesses?

Onglyza (Saxagliptin) is a drug that works by regulating the levels of insulin your body produces after eating. It belongs to a class of drugs known as DPP-4 inhibitors, which work by increasing the production and release of insulin from your pancreas and decreasing the amount of glucose produced by your liver, thus helping to control blood sugar levels. This differs from Invokana which operates via an entirely different mechanism - it reduces blood sugar by causing the kidneys to remove sugar from the body through urine. Onglyza does not work in this way; instead, it aids in managing blood glucose without necessarily promoting weight loss or significantly affecting kidney function. Therefore, Onglyza may be prescribed when a patient has renal concerns or when weight management isn't their primary objective.

How effective are both Invokana and Onglyza?

Canagliflozin (Invokana) and Saxagliptin (Onglyza) are both effective oral medications for managing type 2 diabetes, with the former approved by the FDA in 2013 and the latter in 2009. They act on different pathways to reduce blood glucose levels, making them useful under varying circumstances. Invokana works by blocking sodium-glucose co-transporter-2 (SGLT2), which results in increased glucose excretion through urine, while Onglyza acts as a DPP-4 inhibitor to increase insulin production and decrease glucagon release.

A direct comparison of Invokana and Onglyza's effectiveness was carried out in a clinical trial; it revealed that patients taking Invokana experienced more weight loss alongside blood sugar control than those taking Onglyza. However, there was no significant difference between the two drugs regarding lowering HbA1c levels after 52 weeks of treatment.

In terms of safety profiles, both drugs carry their unique risks: Canagliflozin has been linked with an elevated risk of lower limb amputations and bone fractures while Saxagliptin usage might slightly elevate heart failure risk. Nevertheless, they're well-tolerated overall.

Despite these potential side effects, Canagliflozin may be particularly beneficial for diabetic patients who also struggle with obesity due to its weight-loss facilitation property. On the other hand, Saxagliptin could be favorable if urinary tract infections or genital mycotic infections - common side effects associated with SGLT2 inhibitors like Invokana - need to be avoided.

abstract image of a researcher studying a bottle of drug.

At what dose is Invokana typically prescribed?

Oral dosages of Invokana range from 100-300 mg/day, but most people with type 2 diabetes will find that a dose of 100 mg/day taken before the first meal of the day is adequate. However, if necessary, this dosage can be increased to a maximum of 300 mg/day. On the other hand, Onglyza is typically prescribed at a dose of 5mg once daily and can be taken without regard for meals. If patients have kidney problems or are on dialysis, they may require a lower dosage such as 2.5mg per day under their doctor's guidance. As always, it's important not to exceed the recommended maximum dosage unless advised by your healthcare professional.

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At what dose is Onglyza typically prescribed?

Onglyza therapy is typically started at a dosage of 2.5-5 mg/day, taken once daily. It can be consumed without regard to meals. The recommended maximum dose is 5 mg per day, which may be used right from the start if the patient has normal kidney function or only mild renal impairment. However, for patients with moderate or severe renal impairment or with end-stage renal disease, a lower starting dose of 2.5 mg per day should be considered due to reduced drug clearance in these conditions—this may also apply if there's no adequate response to treatment at this initial dosage after a few weeks.

What are the most common side effects for Invokana?

Common side effects of Invokana may include:

Frequent urination
Thirst and dehydration
Yeast infections (in both men and women)
Urinary tract infections
Changes in cholesterol levels
Nausea
Constipation

On the other hand, Onglyza users might experience these common side effects:

Upper respiratory tract infection
Urinary tract infection
Headache -Dizziness -Joint pain
-Sore throat or runny nose

Always consult your doctor if you notice any new or worsening symptoms.

abstract image of a patient experiencing side effect

Are there any potential serious side effects for Invokana?

While Invokana and Onglyza are both used to control blood sugar levels in people with type 2 diabetes, they can have different side effects. Watch out for the following when taking Invokana:

Signs of severe allergic reaction: rash, itching or hives on the skin; shortness of breath, wheezing or difficulty breathing; swelling of the face, lips, tongue or other parts of the body
Changes in urination patterns such as frequent urination or a need to urgently urinate
Unusual thirst accompanied by dry mouth
Rapid heartbeat (tachycardia)
Nausea and vomiting indicating ketoacidosis (high levels of acid in your blood), which may also include abdominal pain, excessive fatigue and rapid breathing.
Sudden pain in lower back region that might indicate kidney problems

On the other hand beware these symptoms while using Onglyza:

Swelling around neck and throat causing difficulty swallowing
Shortness of breath with mild exertion
Swollen hands or feet Although very rare some serious side-effects could be pancreatitis indicated by severe abdominal pain extending to your back along with nausea & vomiting.

If you experience any such symptoms contact your healthcare provider immediately.

What are the most common side effects for Onglyza?

Onglyza, a medication for type 2 diabetes, can potentially cause several side effects. Some users may experience symptoms like:

Headaches or dizziness
Upper respiratory tract infections leading to stuffy nose and sore throat
Joint pain
Urinary tract infections which could result in increased urination
Hypoglycemia (low blood sugar) that might manifest as trembling, sweating and feeling anxious or nervous
Pancreatitis with severe abdominal pain The rare but serious side effects include skin reactions such as rash, hives or swelling of the face, lips or throat which require immediate medical attention. It's also worth noting that unintentional weight loss is not a typical outcome of Onglyza use - if this occurs it should be discussed urgently with your healthcare provider.

Are there any potential serious side effects for Onglyza?

Onglyza, though generally well-tolerated, can cause serious side effects in some patients. These include:

Symptoms of pancreatitis: severe abdominal pain that radiates to the back, nausea and vomiting
Heart failure: symptoms may include shortness of breath (even at rest), swelling in your feet or ankles, rapid weight gain
Hypoglycemia or low blood sugar levels: dizziness, confusion, shaking, hunger pangs are typical signs
Severe joint pain
Skin reactions such as rash or hives.

If you experience any of these side effects while taking Onglyza for type 2 diabetes management, it is important to seek immediate medical attention.

Contraindications for Invokana and Onglyza?

Both Invokana and Onglyza, like other diabetes medications, may cause complications in some people. If you notice your blood sugar levels becoming unstable or if symptoms of high or low blood sugar become more severe, please seek immediate medical attention.

Neither Invokana nor Onglyza can be taken if you are taking SGLT2 inhibitors (for example: dapagliflozin) or DPP-4 inhibitors (like saxagliptin), respectively. Always tell your physician which medications you are taking; these drugs will require a careful monitoring to prevent dangerous interactions with both Invokana and Onglyza.

Invokana has been associated with an increased risk for lower limb amputations compared to other antidiabetic drugs while Onglyza has been linked to heart failure. Hence it is important for those patients who have a history of cardiovascular disease or peripheral vascular disease to discuss these risks thoroughly with their healthcare provider before starting on any of these two medications.

How much do Invokana and Onglyza cost?

For the brand name versions of these drugs:

The price of 30 tablets of Invokana (100 mg) averages around $500, which works out to approximately $16–17/day.
The price of 30 tablets of Onglyza (5mg) is about $470, working out to approximately $15/day.

Thus, if you are in the higher dosage range for Invokana (i.e., 300 mg/day), then brand-name Onglyza could be less expensive on a per-day treatment basis. Please note that cost should not be a primary consideration in determining which of these drugs is right for you.

Currently, there are no generic versions available for either Invokana or Onglyza within United States. However when choosing between medications it's important to consider other factors like side effects and how well they work in addition to cost.

Popularity of Invokana and Onglyza

Canagliflozin, available under the brand name Invokana, was prescribed to approximately 1.3 million people in the United States in 2020. This medication is part of a class known as sodium-glucose co-transporter 2 (SGLT2) inhibitors and accounted for around 14% of prescriptions within this class that year. The use of canagliflozin has been generally increasing since its approval by the FDA in 2013 due to its dual benefit of controlling blood sugar levels and reducing cardiovascular risk in patients with type 2 diabetes.

On the other hand, saxagliptin, marketed under brand names such as Onglyza, was prescribed to an estimated .9 million individuals across America during the same period. As part of a different drug class called dipeptidyl peptidase-4 (DPP-4) inhibitors, saxagliptin accounts for roughly about 15% of overall prescriptions within this group. The prevalence of saxagliptin prescriptions has remained fairly steady over recent years despite it having fewer benefits compared to SGLT2 inhibitors like canagliflozin.

Conclusion

Both Invokana (canagliflozin) and Onglyza (saxagliptin) are widely used in the management of type 2 diabetes. They have been proven effective through numerous clinical studies, indicating they are more beneficial than placebo treatments. These two medications work differently: Invokana is a sodium-glucose co-transporter 2 inhibitor that works by helping the kidneys get rid of glucose from your bloodstream, while Onglyza is a dipeptidyl peptidase-4 inhibitor that increases the production of insulin and reduces the amount of sugar made by the body.

Invokana can also contribute to weight loss and lowering blood pressure but does carry a risk for genital yeast infections, urinary tract infections, and low blood pressure. On the other hand, Onglyza may be preferable for patients with kidney disease or heart failure as it doesn't affect kidney function like Invokana might do.

The cost will vary based on insurance coverage; however both drugs come in generic forms which offers significant savings particularly for those who pay out-of-pocket.

It's important to note that starting any new medication requires an adjustment period where effects may not be immediately noticeable. Both medications generally have good tolerability profiles but side effects should always be discussed with healthcare providers before initiating therapy.

Patients must closely monitor their blood sugar levels when starting treatment with either drug, especially if taking them alongside other antidiabetic agents due to potential hypoglycemia risk (low blood sugar). Medical attention should be sought immediately if severe side effects occur such as signs of pancreatitis or allergic reactions.