Drug Catalog - Product Detail
INVOKAMET TABS 150-1000MG 60CT CPLT
| NDC | Mfr | Size | Str | Form |
|---|---|---|---|---|
| 50458-0543-60 | JANSSEN | 60 | 150-1000MG | TABLET |
PACKAGE FILES
Generic Name
CANAGLIFLOZIN AND METFORMIN HYDROCHLORIDE
Substance Name
CANAGLIFLOZIN
Product Type
HUMAN PRESCRIPTION DRUG
Route
ORAL
Application Number
NDA204353
Description
11 DESCRIPTION INVOKAMET ® (canagliflozin and metformin HCl immediate-release tablets) and INVOKAMET ® XR (canagliflozin and metformin HCl extended-release tablets) contain canagliflozin and metformin HCl. Canagliflozin Canagliflozin is an inhibitor of SGLT2, the transporter responsible for reabsorbing the majority of glucose filtered by the kidney. Canagliflozin is chemically known as (1 S )-1,5-anhydro-1-[3-[[5-(4-fluorophenyl)-2-thienyl]methyl]-4-methylphenyl]-D-glucitol hemihydrate and its molecular formula and weight are C 24 H 25 FO 5 S∙1/2 H 2 O and 453.53, respectively. The structural formula for canagliflozin is: Canagliflozin is practically insoluble in aqueous media from pH 1.1 to 12.9. Chemical Structure Metformin HCl Metformin HCl is a biguanide chemically known as 1,1-Dimethylbiguanide HCl and its molecular formula and weight are C 4 H 11 N 5 ∙ HCl and 165.62, respectively. The structural formula for metformin HCl is: Chemical Structure INVOKAMET and INVOKAMET XR INVOKAMET or INVOKAMET XR are supplied as film-coated tablets for oral administration. Each 50 mg/500 mg tablet and 50 mg/1,000 mg tablet contains 51 mg of canagliflozin equivalent to 50 mg canagliflozin (anhydrous) and 500 mg or 1,000 mg metformin HCl (equivalent to metformin 389.93 mg and 779.86 mg, respectively). Each 150 mg/500 mg tablet and 150 mg/1,000 mg tablet contains 153 mg of canagliflozin equivalent to 150 mg canagliflozin (anhydrous) and 500 mg or 1,000 mg metformin HCl (equivalent to metformin 389.93 mg and 779.86 mg, respectively). INVOKAMET contains the following inactive ingredients: croscarmellose sodium, hypromellose, magnesium stearate, and microcrystalline cellulose. The magnesium stearate is vegetable-sourced. The tablets are finished with a commercially available film-coating consisting of the following inactive ingredients: macrogol/PEG3350, polyvinyl alcohol (partially hydrolyzed), talc, titanium dioxide, iron oxide yellow (50 mg/1,000 mg and 150 mg/500 mg tablets only), iron oxide red (50 mg/1,000 mg, 150 mg/500 mg and 150 mg/1,000 mg tablets only), and iron oxide black (150 mg/1,000 mg tablets only). INVOKAMET XR contains the following inactive ingredients: croscarmellose sodium, hydroxypropyl cellulose, hypromellose, lactose anhydrous, magnesium stearate (vegetable-sourced), microcrystalline cellulose, polyethylene oxide, and silicified microcrystalline cellulose (50 mg/500 mg and 50 mg/1,000 mg tablets only). The tablets are finished with a commercially available film-coating consisting of the following inactive ingredients: macrogol/PEG3350, polyvinyl alcohol (partially hydrolyzed), talc, titanium dioxide, iron oxide red, iron oxide yellow, and iron oxide black (50 mg/1,000 mg and 150 mg/1,000 mg tablets only). INVOKAMET XR tablets provide canagliflozin for immediate-release and metformin HCl for extended-release. Each bilayer tablet is compressed from two separate granulates, one for each active ingredient of the tablet, and finished with a film-coating. The metformin HCl extended-release layer is based on a polymer matrix which controls the drug release by passive diffusion through the swollen matrix in combination with tablet erosion.
How Supplied
16 HOW SUPPLIED/STORAGE AND HANDLING INVOKAMET ® tablets are available in bottles of 60 in the strengths listed below: INVOKAMET TABLET STRENGTH canagliflozin/metformin HCl tablets 50 mg/500 mg 50 mg/1,000 mg 150 mg/500 mg 150 mg/1,000 mg Color White Beige Yellow Purple Tablet Identification CM CM CM CM 155 551 215 611 Capsule-shaped, film-coated tablets NDC 50458-540-60 50458-541-60 50458-542-60 50458-543-60 INVOKAMET ® XR tablets are available in bottles of 60 in the strengths listed below: INVOKAMET XR TABLET STRENGTH canagliflozin/metformin HCl extended-release tablets 50 mg/500 mg 50 mg/1,000 mg 150 mg/500 mg 150 mg/1,000 mg Color Almost White to Light Orange Pink Orange Reddish Brown Tablet Identification CM1 CM3 CM2 CM4 Oblong, biconvex, film-coated tablets, a thin line on the tablet side may be visible. NDC 50458-940-01 50458-941-01 50458-942-01 50458-943-01 Storage and Handling Keep out of reach of children. Store at 20°C to 25°C (68°F to 77°F); excursions permitted between 15°C to 30°C (59°F to 86°F) [see USP Controlled Room Temperature] . Store and dispense in the original container. Storage in a pill box or pill organizer is allowed for up to 30 days.
Indications & Usage
1 INDICATIONS AND USAGE INVOKAMET and INVOKAMET XR are a combination of canagliflozin and metformin HCl indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus. Canagliflozin is indicated to reduce the risk of major adverse cardiovascular events (cardiovascular death, nonfatal myocardial infarction and nonfatal stroke) in adults with type 2 diabetes mellitus and established cardiovascular disease (CVD). Canagliflozin is indicated to reduce the risk of end-stage kidney disease (ESKD), doubling of serum creatinine, cardiovascular (CV) death, and hospitalization for heart failure in adults with type 2 diabetes mellitus and diabetic nephropathy with albuminuria greater than 300 mg/day. INVOKAMET and INVOKAMET XR are a combination of canagliflozin, a sodium-glucose co-transporter 2 (SGLT2) inhibitor, and metformin HCl, a biguanide, indicated: As an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus ( 1 ) Canagliflozin is indicated to reduce the risk of major adverse cardiovascular events in adults with type 2 diabetes mellitus and established cardiovascular disease ( 1 ) Canagliflozin is indicated to reduce the risk of end-stage kidney disease, doubling of serum creatinine, cardiovascular death, and hospitalization for heart failure in adults with type 2 diabetes mellitus and diabetic nephropathy with albuminuria ( 1 ) Limitations of Use: Not recommended for use to improve glycemic control in patients with type 1 diabetes mellitus ( 1 ) Limitations of Use INVOKAMET or INVOKAMET XR is not recommended for use to improve glycemic control in patients with type 1 diabetes mellitus [see Warnings and Precautions (5.2) ] .
Dosage and Administration
2 DOSAGE AND ADMINISTRATION Individualize starting dose based on the patient's current regimen and renal function ( 2.2 , 2.3 , 2.4 ) Initiation of INVOKAMET or INVOKAMET XR is not recommended in patients with an eGFR less than 45 mL/min/1.73 m 2 , due to the metformin component ( 2.4 ) INVOKAMET: one tablet, twice daily with meals, recommended starting dose of canagliflozin is 50 mg twice daily and metformin HCl 500 mg twice daily ( 2.2 ) INVOKAMET XR: two tablets, once daily with the morning meal. Swallow whole. Never crush, cut, or chew ( 2.2 ) Canagliflozin dose can be increased to a total daily dose of 300 mg in patients tolerating 100 mg who have an eGFR of 60 mL/min/1.73 m 2 or greater and require additional glycemic control. Do not exceed a total daily canagliflozin dose of 300 mg ( 2.2 ) Gradually escalate metformin HCl dose to reduce the gastrointestinal side effects while not exceeding a total daily dose of 2,000 mg ( 2.3 ) Assess renal function before initiating and as clinically indicated ( 2.1 , 2.3 ) Dose adjustment for patients with renal impairment may be required ( 2.4 ) See full prescribing information for INVOKAMET and INVOKAMET XR dosage modifications due to drug interactions. ( 2.5 ) May need to be discontinued at time of, or prior to, iodinated contrast imaging procedures ( 2.6 ) Withhold INVOKAMET or INVOKAMET XR at least 3 days, if possible, prior to surgery or procedures associated with prolonged fasting ( 2.7 ) 2.1 Prior to Initiation of INVOKAMET or INVOKAMET XR Assess renal function before initiating INVOKAMET or INVOKAMET XR and as clinically indicated [see Dosage and Administration (2.4) and Warnings and Precautions (5.1 , 5.4) , Contraindications (4) ]. In patients with volume depletion, correct this condition before initiating INVOKAMET or INVOKAMET XR [see Warnings and Precautions (5.4) and Use in Specific Populations (8.5 , 8.6) ] . 2.2 Dosage Overview INVOKAMET Take one tablet of INVOKAMET orally twice daily with meals [see Dosage and Administration (2.3) ] . INVOKAMET XR Take two tablets of INVOKAMET XR orally once daily with the morning meal [see Dosage and Administration (2.3) ] . Swallow each tablet whole and never crush, cut, or chew. 2.3 Recommended Dosage and Administration Individualize the starting dose of INVOKAMET or INVOKAMET XR based on the patient's current regimen and renal function [see Dosage and Administration (2.4) ] . Table 1 presents the recommended starting dosage of INVOKAMET and INVOKAMET XR based on the patient's current regimen. For the available strengths of the canagliflozin and metformin components in INVOKAMET and INVOKAMET XR, see Dosage Forms and Strengths (3) . Table 1: Recommended Starting Dosage Based on the Patient's Current Regimen Current Regimen INVOKAMET Recommended Dosage Administered as one tablet, orally, twice daily with meals INVOKAMET XR Recommended Dosage Administered as two tablets, orally, once daily with the morning meal Not treated with either canagliflozin or metformin HCl Total daily dosage is canagliflozin 100 mg and metformin HCl 1,000 mg Metformin HCl For patients taking an evening dosage of metformin HCl extended-release tablets, skip the last dose before starting INVOKAMET or INVOKAMET XR the following morning. Total daily dosage is canagliflozin 100 mg and the nearest appropriate total daily dosage of metformin HCl Canagliflozin The same total daily dosage of canagliflozin and a total daily dosage of metformin HCl 1,000 mg Canagliflozin and metformin HCl The same total daily dosage of canagliflozin and the nearest appropriate total daily dosage of metformin HCl Recommended Dosage for Additional Glycemic Control INVOKAMET Canagliflozin may be increased to the maximum recommended dosage of 150 mg twice daily in patients tolerating 50 mg twice daily and metformin may be increased to the maximum recommended dosage of 1,000 mg twice daily, with gradual escalation to reduce gastrointestinal adverse reactions with metformin [see Adverse Reactions (6.1) ]. INVOKAMET XR Canagliflozin may be increased to the maximum recommended dosage of 300 mg once daily in patients tolerating 100 mg once daily and metformin may be increased to the maximum recommended dosage of 2,000 mg once daily, with gradual escalation to reduce gastrointestinal adverse reactions with metformin [see Adverse Reactions (6.1) ]. 2.4 Recommended Dosage for Patients with Renal Impairment Initiation of INVOKAMET or INVOKAMET XR is not recommended in patients with an eGFR less than 45 mL/min/1.73 m 2 , due to the metformin component. Table 2 provides dosage recommendations for patients with renal impairment, based on eGFR [see Use in Specific Populations (8.6) and Clinical Studies (14.3) ]. Table 2: Recommended Dosage in Patients with Renal Impairment Estimated Glomerular Filtration Rate [eGFR (mL/min/1.73 m 2 )] Recommended Dosage eGFR 45 to less than 60 The maximum recommended dosage of canagliflozin is 100 mg daily. eGFR 30 to less than 45 Assess the benefit risk of continuing INVOKAMET or INVOKAMET XR. The maximum recommended dosage of canagliflozin is 100 mg daily. eGFR less than 30 Contraindicated. If eGFR falls below 30 during treatment; discontinue INVOKAMET or INVOKAMET XR [see Contraindications (4) ] . 2.5 Concomitant Use with UDP-Glucuronosyltransferase (UGT) Enzyme Inducers When co-administering INVOKAMET or INVOKAMET XR with an inducer of UGT (e.g., rifampin, phenytoin, phenobarbital, ritonavir), increase the total daily dosage of canagliflozin based on renal function [see Drug Interactions (7) ] : In patients with eGFR 60 mL/min/1.73 m 2 or greater, increase the total daily dosage of canagliflozin to 200 mg in patients currently tolerating a total daily dosage of canagliflozin 100 mg. The maximum recommended dosage of canagliflozin is 300 mg daily. In patients with eGFR less than 60 mL/min/1.73 m 2 , increase the total daily dosage of canagliflozin to a maximum of 200 mg in patients currently tolerating a total daily dosage of canagliflozin 100 mg. 2.6 Discontinuation for Iodinated Contrast Imaging Procedures Discontinue INVOKAMET or INVOKAMET XR at the time of, or prior to, an iodinated contrast imaging procedure in patients with an eGFR of less than 60 mL/min/1.73 m 2 ; in patients with a history of liver disease, alcoholism or heart failure; or in patients who will be administered intra-arterial iodinated contrast. Re-evaluate eGFR 48 hours after the imaging procedure; restart INVOKAMET or INVOKAMET XR if renal function is stable [see Warnings and Precautions (5.1) ] . 2.7 Temporary Interruption for Surgery Withhold INVOKAMET or INVOKAMET XR at least 3 days, if possible, prior to surgery or procedures associated with prolonged fasting. Resume INVOKAMET or INVOKAMET XR when the patient is clinically stable and has resumed oral intake [see Warnings and Precautions (5.2) and Clinical Pharmacology (12.2) ].