Invokana

New Diabetes Medications, Part 1: An In-Depth Comparison and Review

New diabetes medications, part 1

For millions of Americans working to manage their type 2 diabetes, new diabetes medications bring hope as well as confusion. Your healthcare provider is interested in finding the most effective option for managing blood glucose levels and preventing diabetes complications. You have to wonder, though, about the potential side effect risks that come with some of these new diabetes medications.

First up in our in-depth look, we’ll compare Invokana® to the following new diabetes medications: Januvia®, Farxiga® and Jardiance®. You’ve probably seen the ads while watching TV — now it’s time to learn how these new diabetes medications actually work.

To find out which type 2 diabetes treatment could be right for you, let’s compare each one with Invokana below.

New Diabetes Medications: Invokana vs Januvia

Invokana and Januvia belong to different drug classes and don’t use the exact same action mechanisms to control blood sugar. Januvia (generic name: sitagliptin) is a dipeptidyl peptidase-4 enzyme inhibitor that increases your insulin secretion response after you’ve eaten food. The enzyme DPP-4 metabolizes two proteins called GLP-1 and GIP, which then causes your pancreas to release more blood sugar. Inhibiting the DPP-4 enzyme allows more GIP and GLP-1 hormones to stay active in your body longer after eating food. That way, your body can release enough insulin to stabilize your blood sugar back to normal levels again after eating.

Invokana (generic name: canagliflozin), which belongs to the SGLT-2 inhibitor drug class, works a little differently. New diabetes medications like Invokana in this drug class allow you to get rid of extra blood sugar through urine. Normally, your kidneys just re-absorb any extra glucose and store it for later; Invokana’s action mechanism blocks that specific process. The U.S. Food and Drug Administration approved Januvia to treat high blood sugar in type 2 diabetes patients in 2006.

Januvia’s Major Benefits: Does not cause weight gain, unlike some new diabetes medications. Januvia generally avoids low blood sugar issues some type 2 diabetics experience with certain other medications, like Starlix or Glucotrol.

Januvia’s Major Side Effect Risks: The FDA reports that DPP-4 inhibitors like Januvia may cause severe joint pain and impair kidney function. Studies associate Januvia with increased risk for developing pancreatitis, but have not found a direct causal link between the two.

New Diabetes Medications: Invokana vs Farxiga

Invokana and Farxiga (generic: dapagliflozin) are both SGLT2 inhibitors, which means they help you release excess blood sugar through urine. Because both new diabetes medications have the same action mechanism, Invokana and Farxiga carry almost identical health risks for patients. These include kidney damage but not the increased risk for lower-limb losses through amputation, according to recent CANVAS study data.) In June 2016, the FDA issued an Invokana warning as well as one for Farxiga about increased kidney damage risks. According to the FDA, acute kidney injury is a possibility when taking Invokana or Farxiga to lower your blood sugar.

These new diabetes medications can increase creatinine levels, which indicates your kidneys aren’t working all that well. Whenever creatinine levels rise sharply, you’re at increased risk for acute kidney injury (AKIs indicate at least 30% function loss). The FDA recommends doctors consider any acute kidney injury risk factors before prescribing these specific two new diabetes medications, including:

  • Increased blood volume
  • Chronic kidney disease (CKD)
  • Previous AKIs
  • Congestive heart failure

If you’re taking Invokana or Farxiga, here are some signs you’ve sustained an AKI and need a kidney function test:

  • Decreased urine production
  • Swollen hands or feet
  • Feeling more tired than usual/overall fatigue
  • Shortness of breath
  • Nausea

If you experience any symptoms listed above, contact your doctor immediately.

Farxiga’s Major Benefits: It lowers blood sugar just like Invokana, but without doubling your foot, toe and leg amputation risks.

Farxiga’s Major Side Effect Risks: Identical to Invokana in almost every way, including increased kidney damage and diabetic ketoacidosis risks. If you aren’t familiar with diabetic ketoacidosis, learn more about this potentially fatal condition here. While diabetic ketoacidosis is rare in type 2 diabetics, it’s one possible side effect with Invokana, Jardiance and Farxiga.

New Diabetes Medications: Invokana vs Jardiance

Jardiance (generic: empagliflozin) is the only SGLT2 inhibitor that doesn’t increase your risk for limb amputations or sudden kidney damage. If you want Invokana’s benefits without worrying about losing a toe, foot or leg, Jardiance is your best bet. If you’re comparing it to Farxiga, the kidney damage risks are slightly lower (and Jardiance is the cheapest SGLT2 inhibitor).

After a close advisory panel vote, the FDA approved a new Jardiance indication for type 2 diabetics with heart disease. The FDA also updated Jardiance’s label to reflect results from the EMPA-REG OUTCOME clinical trial published in June 2016. Data published in the New England Journal of Medicine showed fewer heart-related deaths in Jardiance patients than the placebo group.

Like Invokana and Farxiga, Jardiance improves blood glucose control through urination. Yet Jardiance alone among all new diabetes medications is now FDA-approved for reducing heart disease-related deaths in type 2 diabetics.

Jardiance’s Major Benefits: Fewer heart attacks and non-fatal strokes in type 2 diabetics with other heart disease risk factors.

Jardiance’s Major Side Effect Risks: Like other drugs in this class, Jardiance can cause sudden AKIs or long-term kidney damage. However, studies show that kidney disease progresses more slowly in Jardiance patients than those taking Invokana to lower blood sugar. While Jardiance belongs to the SGLT2 inhibitor drug class, it doesn’t double your risk for losing a toe, foot or leg below the ankle to amputation.

How Injured Invokana Patients Can Qualify for Compensation

If you or someone you love lost a toe, foot or lower leg while taking Invokana, you may qualify for a cash settlement. To check your eligibility instantly online, start your free Invokana claim review now. Once you submit your information, an experienced lawyer will call to discuss your case and possible compensation options. You’ll receive a private, in-person consultation to help you get the justice and financial compensation you deserve.

Come back tomorrow to read our second installment in this series, New Diabetes Meds, Part 2: Understanding Side Effect Risks.

Related: Are SGLT2 Inhibitors like Invokana Worth the Risk?