Comparative Pharmacology
Head-to-head clinical analysis: INVOKAMET versus STEGLATRO.
Peer-Reviewed Evidence
Head-to-head clinical analysis: INVOKAMET versus STEGLATRO.
INVOKAMET vs STEGLATRO
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
INVOKAMET is a combination of canagliflozin, an SGLT2 inhibitor, and metformin, a biguanide. Canagliflozin inhibits sodium-glucose cotransporter 2 in the renal proximal tubules, reducing glucose reabsorption and increasing urinary glucose excretion. Metformin decreases hepatic glucose production, decreases intestinal absorption of glucose, and improves insulin sensitivity.
Steglatro (ertugliflozin) is a sodium-glucose cotransporter 2 (SGLT2) inhibitor. It inhibits SGLT2 in the proximal renal tubule, reducing glucose reabsorption and increasing urinary glucose excretion, thereby lowering blood glucose.
Oral: Starting dose: 5 mg canagliflozin/500 mg metformin hydrochloride extended-release twice daily; titrate based on efficacy and tolerability, maximum 150 mg/1000 mg twice daily.
0.5 mg orally once daily for patients with type 2 diabetes; no dose adjustment for age, gender, or race.
None Documented
None Documented
Canagliflozin: 10–13 hours (multiple dosing); Metformin: 6.2 hours (plasma). Accumulation occurs in renal impairment.
Terminal elimination half-life is approximately 12.4 hours in patients with type 2 diabetes, supporting once-daily dosing. No accumulation occurs at steady state.
Canagliflozin (SGLT2 inhibitor): ~33% renal (1% unchanged, ~33% as glucuronide metabolites), ~52% fecal. Metformin (biguanide): 90% renal unchanged via tubular secretion.
Approximately 65% of the dose is excreted in the urine as unchanged drug via active tubular secretion, and 35% is excreted in the feces as unchanged drug, indicating minimal metabolism.
Category C
Category C
SGLT2 Inhibitor / Biguanide Combination
SGLT2 Inhibitor