New Metformin Combination Medicine Approved for Type 2 Diabetes

On September 21, the U.S. Food and Drug Administration (FDA) approved the oral combination medicine canagliflozin/metformin extended-release (brand name Invokamet XR) for Type 2 diabetes. Invokamet XR, manufactured by Johnson & Johnson subsidiary Janssen Pharmaceuticals, combines the SGLT2 inhibitor canagliflozin with the commonly prescribed diabetes drug metformin XR.

In the process of filtering the blood, the kidneys typically reabsorb all the filtered glucose and return it to the bloodstream. One of the main proteins responsible for this reabsorption is SGLT2. By inhibiting the action of SGLT2, canagliflozin blocks the reabsorption of glucose by the kidneys, promoting a loss of glucose in the urine and lowering blood glucose levels. Metformin works by decreasing glucose production by the liver, as well as improving insulin sensitivity in the liver, muscle, and fat cells.


Invokamet XR tablets are approved for use along with diet and exercise in adults with Type 2 diabetes. Studies of Invokamet XR indicated that taking the medicine was equivalent to taking corresponding doses of canagliflozin and metformin XR as individual tablets.

Invokamet XR comes in four tablet strengths, containing 50 milligrams or 150 milligrams of canagliflozin and 500 milligrams or 1,000 milligrams of metformin XR. The typical dose is two tablets once daily with the morning meal.

This medicine should not be used to treat Type 1 diabetes or diabetic ketoacidosis (a potentially life-threatening condition marked by a chemical imbalance in the body).

The most common side effects of canagliflozin are female genital fungal infections, urinary tract infections, and increased urination, while the most common side effects of metformin are diarrhea, nausea and vomiting, flatulence, lack of energy, indigestion, abdominal discomfort, and headache. Like metformin XR alone, Invokamet XR carries a small but serious risk of lactic acidosis (a potentially fatal condition in which lactic acid builds up in the blood, depriving the body’s tissues of oxygen).

For more information, see the press release on the Janssen website.

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  • seant426

    The FDA needs to approve SGLT2 inhibitors in Type 1’s immediately. As a Type 1, my doctor prescribed Jardiance (an SGLT2-inhibitor drug) for me and it helped dramatically in lowering my A1C, controlling my blood sugars to the point where they never spiked above 160, and helped to either maintain my weight or assisted in weight loss.

  • antiliberal00

    So, why would anyone want to pay more for a single pill than taking two others ? Just sounds like a way to increase healthcare costs.