Short answer: Both pair an SGLT2 inhibitor with metformin.12 Xigduo XR uses dapagliflozin and is one extended-release tablet each morning. Invokamet uses canagliflozin and is taken twice daily with meals, or as Invokamet XR, two tablets with the morning meal. Both are approved from age 10 and carry a lactic acidosis boxed warning. Neither label reports a trial against the other.
| Xigduo XR | Invokamet | |
|---|---|---|
| Paired with metformin | Dapagliflozin1 | Canagliflozin2 |
| How taken | Once daily in the morning with food, swallowed whole1 | Invokamet twice daily with meals; Invokamet XR two tablets once daily with the morning meal, swallowed whole2 |
| Maximum daily dose | Dapagliflozin 10 mg and metformin 2,000 mg1 | Canagliflozin 300 mg and metformin 2,000 mg; canagliflozin capped at 100 mg with an eGFR of 30 to under 602 |
| Other uses in adults with type 2 diabetes | Kidney decline and heart events in chronic kidney disease, heart death and heart failure events in heart failure, heart failure hospital stays with heart disease or several risk factors1 | Major heart events in established heart disease; kidney failure, heart death and heart failure hospital stays in diabetic kidney disease with albuminuria above 300 mg/day2 |
| Kidney limits | Not used with an eGFR below 30; starting not recommended at 30 to 451 | Not used with an eGFR below 30; starting not recommended below 452 |
| Side effects in label trials | Pool of 8 trials with metformin: female genital yeast infection 9.3% on 10 mg vs 1.5% on placebo, urinary tract infection 5.5% vs 3.6%1 | Pool of four 26-week trials, most with metformin: female genital yeast infection 10.6% on 100 mg vs 2.8% on placebo, urinary tract infection 5.9% vs 3.8%, more urination 5.1% vs 0.7%2 |
| Boxed warning | Lactic acidosis1 | Lactic acidosis2 |
Mostly. Both labels list lactic acidosis, ketoacidosis, fluid loss, urinary and genital infections including Fournier's gangrene, low blood sugar with insulin or a sulfonylurea, and lower vitamin B12.12 The Invokamet label also lists lower limb amputation and bone fracture.2 Both say to hold the tablet for at least 3 days, if possible, before surgery with long fasting.12 These numbers come from separate trials with different people, lengths and methods, so they are not a head-to-head comparison.
Which, if either, fits is for your prescriber. More detail: Xigduo XR side effects, Invokamet side effects, the Xigduo XR and Invokamet dosing schedules, and Synjardy vs Xigduo XR: how do the two SGLT2 and metformin tablets differ?.