Similarities and Differences between Invokana and Metformin

Similarities and Differences between Invokana and Metformin

Pharmaceutical companies spend billions of dollars to develop drug for diseases that they can find treatments. Thousands of drugs go through the Federal food and Drug Administration (FDA) drug approval system in order to make it to human. Once they have passed trial phases, they will make it to market. FDA approved a new diabetic's drug in March 2013. The name of the drug is Invokana™, chemically known as canagliflozin, and it is usually prescribed as a supplement to an exercise-and-diet routine, for improving the control of glucose in diabetes type 2 adult patients (Drugs@FDA, 2013). Approval has not been gained for the treatment of diabetes type 1 and diabetic ketoacidosis. This drug works in a new way, by causing blood sugar to be excreted in the urine. Invokana ™ which is developed by Johnson & Johnson will have a wholesale price of $8.77 per tablet (Pollack, 2013).

Many other drugs that can treat type 2 diabetic mellitus work through different mechanism, by affecting supply or use of insulin. One of these drugs is Metformin which is in a class of Biguanide and has a greatest data in treating the disease as mono-therapy or in combination with other drugs. Reductions have been noticed in blood glucose and a1c levels from the effective use of Metformin. Since both medications treat type 2 diabetic mellitus, they have similarities as well as differences.

Some of the similarities between Invokana™ and Metformin are that they both have the same indication, treat type 2 Diabetic mellitus, reduce A1c and blood glucose levels, and decrease weight which is observed as one of their side effects. 100 mg of Invokana™ (low dosage) lowered A1c on average by 0.77%, and the high dose (300 mg) lowered A1c, on average 1.03% from base line, as seen by the results from a clinical study that was placebo-controlled for 26 weeks, in which Invokana™ was used for monotherapy. In addition, the low dose lowered fasting blood sugar from 172 mg/dl to 145 mg/dl and the high dose lowered fasting blood sugar from an average of 173 mg/dl to 138 mg/dl (INVOKANA (canagliflozin) tablet, 2013).

Metformin, on the other side, has net reductions in fasting glucose of 59 mg/dl, PPG (postprandial plasma glucose) of 83 mg/dl; A1c of 1.8%, in comparison with the placebo group (GLUCOPHAGE (Metformin hydrochloride) tablet, 2013). Even though Invokana™ is not as effective as Metformin, it does reduce blood sugar and A1c level. Both medications are not recommended for pregnant women. Metformin is teratogenic while the potential harm that Invokana™ could cause to unborn babies or its entrance into breast milk is not yet known (INVOKANA (canagliflozin) tablet, 2013).

One of their differences includes their mechanism of action. The mechanism of action of Invokana™ is by inhibiting the SGLT2 (Sodium GLucose co-Transporter 2) which is found in renal tubules (proximal) and plays an active role in most of the filtered glucose's reabsorption by the tubular ...