Farxiga vs. Invokana

Authored by The Rx Advocates, / Medically Reviewed by Dr. Conor Sheehy, PharmD, BCPS

 

Patients with Type 2 Diabetes have several medication options available to help control their blood sugar. You may be wondering about the differences between Farxiga and Invokana.

While these medications are similar, your doctor may prescribe one or the other for you based on your medical history. Let’s look at Farxiga and Invokana and see how they compare.

What is Farxiga?

Farxiga is classified as an SGLT-2 inhibitor. It is an oral medication for diabetes that doctors prescribe to control blood glucose levels.

This medication works by helping your kidneys remove glucose from your bloodstream. It is not for patients with Type 1 Diabetes, but if you have been diagnosed with Type 2 Diabetes, your doctor may consider prescribing you Farxiga.

Farxiga Side Effects

The most common side effects of Farxiga include:

  • Genital yeast infections
  • More frequent urination
  • Sore throat
  • Runny or stuffy nose

Some of these side effects may disappear once your body adjusts to the medication. But if you develop a genital yeast infection, please report it to your doctor immediately. Signs to look for are:

  • Tenderness
  • Swelling
  • Redness
  • Fever
  • Discharge
  • Odor
  • Itching
  • Burning

Less common side effects your doctor needs to know about right away include:

  • Kidney issues include swelling in your feet or ankles, shortness of breath, feeling tired, and not urinating as often as normal.
  • Bladder infection symptoms include pain or burning when urinating, blood in the urine, fever, and pain in the back or pelvis.
  • Ketoacidosis (too much acid in the blood) symptoms, including confusion, stomach pain, nausea, vomiting, and breathing problems.
  • Dehydration signs include excessive thirst, confusion, and dizziness.

If you have an allergic reaction to Farxiga, stop taking it right away and contact your doctor or go to your local emergency room. Hives, swelling of any part of the face, and breathing difficulties are all signs of an allergic reaction.

Benefits of Farxiga

Farxiga controls blood glucose levels in people with Type 2 Diabetes. This medication is recommended for use along with a healthy diet and exercise.

Your doctor may prescribe Farxiga if you also have heart disease. This medication lowers your risk of death from heart failure, stroke, or a heart attack. It may also help you avoid being hospitalized for heart failure.

Your doctor may recommend Farxiga if you have chronic kidney disease. Other, similar medications may make your condition worse.

What is Invokana?

Invokana is also classified as an SGLT-2 inhibitor medication. It works similarly to Farxiga and is prescribed to patients with Type 2 Diabetes to control blood sugar levels.

Invokana was the first medication to be brought to market in 2013.

Invokana is prescribed in two strengths – 100 mg and 300 mg. This medication works best in combination with a healthy diet and exercise.

Invokana Side Effects

The most common side effects of Invokana include frequent urination, low blood sugar levels, and genital infections.

More severe side effects include:

  • Symptoms of dehydration
  • Burning and pain when urinating
  • Feeling dizzy or lightheaded
  • Less frequent urination than normal
  • High potassium levels evidenced by an irregular heartbeat, loss of movement, nausea, and weakness
  • New sores or ulcers in your feet or legs
  • Symptoms of ketoacidosis

Taking Invokana may also increase your risk of bone fractures. Older adults are more likely to experience side effects with this medication.

Invokana may increase your risk of lower limb amputation.

If you experience an allergic reaction to Invokana or develop a genital infection, contact your doctor immediately.

Benefits of Invokana

Your doctor may prescribe Invokana if you also have heart disease to lower your risk of dying from a stroke, heart failure, or heart attack.

If you have kidney problems caused by Type 2 Diabetes, Invokana may be prescribed to reduce your risk of end-stage kidney disease.

Many patients taking Invokana found that it significantly lowered their A1C levels. Most clinical studies resulted in patients with A1Cs of less than 7%.

Farxiga vs. Invokana: A Comparison

Your doctor will consider your medical history before choosing between Farxiga and Invokana. Here’s how the two medications compare.

 FarxigaInvokana
Pros
  • Lowers A1C levels by as much as 1%.
  • May help you lose weight.
  • Reduced chance of low blood sugar levels.
  • May increase your good cholesterol levels.
  • Lowers A1C levels by as much as 1%.
  • Taken just once per day, before your first meal.
  • Available as Invokamet, which is Invokana combined with metformin. 
Cons
  • Doesn’t lower blood sugar levels as much as other similar medications.
  • Presents a higher risk of genital yeast infections.
  • Presents a higher risk of urinary tract infections.
  • You may need to avoid alcohol.
  • Increases your risk of broken bones.
  • Increases your risk of yeast infections.
  • Increases your risk of urinary tract infections.
  • Increased risk of pain/infections in the feet.
  • Rare but serious risk of foot and leg amputations.
  • Not recommended for patients with severe kidney problems.
  • May increase your cholesterol levels.
  • You may need to avoid alcohol.

According to Drugs.com, more patients preferred Invokana over Farxiga. 51% would not recommend Farxiga, and some reported:

  • Nearly constant yeast infections
  • The onset of sudden Diabetic Ketoacidosis
  • Hair loss
  • High blood pressure
  • Weight gain
  • Severe diarrhea and dehydration

Patients taking Invokana reported:

  • Weight loss
  • Yeast infections
  • Appetite suppression
  • Hair loss
  • Renal failure

The FDA has Strengthened Kidney Warnings for Both Medications

On June 14, 2016, the FDA issued stronger warnings for both Invokana and Farxiga regarding the risk of acute kidney problems.

They advised patients to talk with their doctors immediately if they noticed any signs or symptoms of kidney issues.

About half of all reported cases involved the onset of kidney-related issues within a month of starting either medication. Most patients saw improvement once the medication was stopped.

Farxiga vs. Invokana – Which is Right for You?

Your doctor will talk with you about whether Farxiga or Invokana is right for you. We encourage you to ask questions before making a decision.

You may want to consider a different medication for balancing your blood sugar. Ask your doctor for a recommendation.

How to Make Invokana or Farxiga More Affordable

Both Farxiga and Invokana are expensive brand-name medications. Even if you have health insurance, you may need financial assistance to pay for them.

At The Rx Advocates, we work directly with pharmaceutical patient assistance programs to lower the cost of prescription medications for our patients. You may qualify for help, and if so, your medication will be delivered to you free of charge every month. You only need to cover the minimal cost of our monthly fee.

If you want to learn more about getting help paying for Farxiga or Invokana, please contact us today.

  1. Drugs.com. Farxiga. November 22, 2022. Available at Drugs.com.
  2. Drugs.com. Invokana. September 21, 2022. Available at Drugs.com.
  3. Invokana. About Invokana – Important Safety Information. December 2021. Invokana.com.
  4. National Library of Medicine. Canagliflozin Treatment in Patients with Type 2 Diabetes Mellitus. October 18, 2015. Available at ncbi.nlm.nih.gov.
  5. Drugs.com. Comparing Farxiga vs Invokana. December 2, 2022. Available at Drugs.com.
  6. U.S. Food & Drug Administration. FDA strengthens kidney warnings for diabetes medicines canagliflozin (Invokana, Invokamet) and dapagliflozin (Farxiga, Xigduo XR). January 14, 2022. Available at FDA.gov.
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