Frequently asked questions about INVOKANA®, INVOKAMET® XR, and INVOKAMET®

INVOKANA, canagliflozin tablets logo

It's important to talk to your doctor for answers to any questions you may have about INVOKANA®—but here are some answers to some commonly asked questions.

Yes! INVOKANA® was the first SGLT2 inhibitor to be approved for use in the United States—SGLT2 inhibitors are a class of type 2 diabetes medicines that work with the kidneys, along with diet and exercise, to help lower A1C. In addition to significantly lowering A1C, INVOKANA® is the first type 2 diabetes pill approved to lower the risk of heart attack, stroke, and cardiovascular death in adults with type 2 diabetes and established cardiovascular disease.

INVOKANA® is the first type 2 diabetes medicine approved to lower the risks of end-stage kidney disease, worsening of kidney function, cardiovascular death, and hospitalization for heart failure in adults with type 2 diabetes and diabetic kidney disease (nephropathy) with a certain amount of protein in the urine. It’s the first type 2 diabetes medicine in almost 20 years approved to treat diabetic kidney disease in people with type 2 diabetes.

Because of the way SGLT2 inhibitors like INVOKANA® work, they can help lower your blood sugar by removing it from your body through urination. Only INVOKANA® has been proven to work with your kidneys to help you lose around 100 grams of sugar a day through the process of urination.

It’s important to keep track of your blood sugar levels as directed by your doctor. Consider keeping a journal and share your progress at your next appointment. Your doctor will check your diabetes with regular blood tests, including tests of your blood sugar levels, your A1C, and tests to measure your kidney function.

Take INVOKANA® by mouth 1 time each day exactly as your doctor tells you to take it. Your doctor will tell you when and how much INVOKANA® to take. Your doctor may change your dose if needed. It is best to take INVOKANA® before the first meal of the day.

If you miss a dose, take it as soon as you remember. If you do not remember until it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take 2 doses of INVOKANA® at the same time. If you have any questions about a missed dose, please speak to your doctor.

Although INVOKANA® is not a weight-loss medicine, and each person is different, adults can experience reduction in weight—on average 2–3%. Results may vary by dose and when used alone or with certain other diabetes medications.

INVOKANA® may increase your risk of lower limb amputations. Amputations mainly involve removal of the toe or part of the foot, however, amputations involving the leg, below and above the knee, have also occurred. Some people had more than one amputation, some on both sides of the body.

You may be at a higher risk of lower limb amputation if you:

  • have a history of amputation
  • have heart disease or are at risk for heart disease
  • have had blocked or narrowed blood vessels, usually in your leg
  • have damage to the nerves (neuropathy) in your leg
  • have had diabetic foot ulcers or sores

Call your doctor right away if you have new pain or tenderness, any sores, ulcers, or infections in your leg or foot. Your doctor may decide to stop your INVOKANA® for a while if you have any of these signs or symptoms.

Talk to your doctor about proper foot care.

Prescription medication is more likely to be safe and effective if you take the medication exactly as directed. Your doctor will tell you how much INVOKANA® to take, and when to take it. Always talk to your doctor before changing how you take your medication.

Yes. INVOKANA® will cause your urine to test positive for glucose (a type of sugar).

Yeast infections of the vagina may be minimized by avoiding douches, tight undergarments, and scented hygiene products. Yeast infections of the penis may be minimized by regular washing with soap and water, including under the foreskin if you are uncircumcised. Talk to your doctor about what to do if you get symptoms of a yeast infection of the vagina or penis.

It's important to talk to your doctor for answers to any questions you may have about INVOKAMET® XR or INVOKAMET®—but here are some answers to some commonly asked questions.

Yes. INVOKAMET® XR and INVOKAMET® contain INVOKANA® (canagliflozin), which is an SGLT2 inhibitor—a group of medicines that work with the kidneys to lower A1C. INVOKAMET® XR and INVOKAMET® also contain metformin, which helps decrease the amount of sugar your liver produces and improves your body’s response to insulin. Learn how INVOKAMET® XR and INVOKAMET® work.

It’s important to keep track of your blood sugar levels as directed by your doctor. Consider keeping a journal—and share your progress at your next appointment. Your doctor will check your diabetes with regular blood tests, including tests of your blood sugar levels, your A1C, and tests to measure your kidney function.

Take INVOKAMET® XR by mouth one time each day exactly as your doctor tells you to take it. Your doctor may change your dose if needed. It is best to take INVOKAMET® XR with your morning meal.

Take INVOKAMET® by mouth twice each day exactly as your doctor tells you to take it. It is best to take INVOKAMET® with meals. Your doctor will tell you when and how much INVOKAMET® to take. Your doctor may change your dose if needed.

Store INVOKAMET® XR or INVOKAMET® at room temperature between 68°F to 77°F (20°C to 25°C). Store in the original container to protect from moisture. Storage in a pill box or pill organizer is allowed for up to 30 days.

If you miss a dose, take it as soon as you remember. If you do not remember until it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take more than 2 tablets of INVOKAMET® XR at the same time. Do not take 2 doses of INVOKAMET® at the same time. If you have questions about a missed dose, please speak to your doctor.

Prescription medication is more likely to be safe and effective if you take the medication exactly as directed. Your doctor will tell you how much INVOKAMET® XR or INVOKAMET® to take and when to take it. Always talk to your doctor before changing how you take your medication.

Yes. INVOKAMET® XR and INVOKAMET® will cause your urine to test positive for glucose (a type of sugar).

INVOKAMET® XR and INVOKAMET® may increase your risk of lower limb amputations. Amputations mainly involve removal of the toe or part of the foot, however, amputations involving the leg, below and above the knee, have also occurred. Some people had more than one amputation, some on both sides of the body.

You may be at a higher risk of lower limb amputation if you:

  • have a history of amputation
  • have heart disease or are at risk for heart disease
  • have had blocked or narrowed blood vessels, usually in your leg
  • have damage to the nerves (neuropathy) in your leg
  • have had diabetic foot ulcers or sores

Call your doctor right away if you have new pain or tenderness, any sores, ulcers, or infections in your leg or foot. Your doctor may decide to stop your INVOKAMET® XR and INVOKAMET® for a while if you have any of these signs or symptoms.

Talk to your doctor about proper foot care.

Metformin, one of the medicines in INVOKAMET® XR and INVOKAMET®, can cause a rare but serious condition called lactic acidosis (a build-up of lactic acid in the blood) that can cause death. Lactic acidosis is a medical emergency and must be treated in the hospital.

Stop taking INVOKAMET® XR or INVOKAMET® and call your doctor right away if you have any of the following symptoms of lactic acidosis:

  • feel cold in your hands or feet
  • have a slow or irregular heartbeat
  • feel very weak or tired
  • have unusual (not normal) muscle pain
  • have trouble breathing
  • have unusual sleepiness or sleep longer than usual
  • have stomach pains, nausea, or vomiting
  • feel dizzy or lightheaded

Most people who have had lactic acidosis had other conditions that, in combination with metformin use, led to the lactic acidosis. Tell your doctor if you have any of the following, because you have a higher chance for getting lactic acidosis with INVOKAMET® XR or INVOKAMET® if you:

  • have severe kidney problems or your kidneys are affected by certain x-ray tests that use injectable dye.
  • have liver problems.
  • drink alcohol very often or drink a lot of alcohol in short-term "binge" drinking.
  • get dehydrated (lose a large amount of body fluids). This can happen if you are sick with a fever, vomiting, or diarrhea. Dehydration can also happen when you sweat a lot with activity or exercise and do not drink enough fluids.
  • have surgery.
  • have new or worsening symptoms of congestive heart failure such as shortness of breath or increased fluid or swelling of the legs.
  • have a heart attack, severe infection, or stroke.
  • are 65 years of age or older.

The best way to keep from having a problem with lactic acidosis from metformin is to tell your doctor if you have any of the problems in the list above. Your doctor will decide to stop your INVOKAMET® XR or INVOKAMET® for a while if you have any of these things.

For women, yeast infections may be minimized by avoiding douches, tight undergarments, and scented hygiene products. For men, yeast infections may be minimized by regular washing with soap and water, including under the foreskin if you are uncircumcised. Talk to your doctor about what to do if you get symptoms of a yeast infection of the vagina or penis.

Here are some brief answers to some commonly asked questions about the Janssen CarePath Savings Program and rebates.

The Janssen CarePath Savings Program for INVOKANA®, INVOKAMET® XR, and INVOKAMET® allows eligible patients using commercial or private insurance to save on out-of-pocket costs for INVOKANA®, INVOKAMET® XR, and INVOKAMET®. Depending on the health insurance plan, savings may apply toward co-pay, co-insurance, or deductible.

Eligible commercial patients pay $0 per month for INVOKANA®, INVOKAMET® XR, and INVOKAMET®, subject to monthly program benefit limits. There is no limit to this benefit for your first month of treatment, and then a $200 limit for each month thereafter. There is a $3,000 maximum program benefit per calendar year. Not valid for patients using Medicare, Medicaid, or other government-funded programs to pay for their medications. Terms expire at the end of each calendar year and may change. There is no income requirement. See full eligibility requirements.

Once you have registered for the Janssen CarePath Savings Program and activated your card, you should present the card at your pharmacy along with a valid prescription. Your eligibility to use the card is dependent upon meeting the program requirements each time you present the card when filling your prescription. If you filled your prescription without showing your card or if your pharmacy was unable to process the card and you paid your co-pay, you may be eligible for a rebate. You can complete, sign and return the rebate form, with the required proof of purchase, to receive a rebate check from the Janssen CarePath Savings Program. If you have a Janssen CarePath account you can log in and request a rebate online at MyJanssenCarePath.com.

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