The FDA has approved fixed-dose combinations of metformin with either canagliflozin (Invokamet) or dapagliflozin (Xigduo XR) (Table) for treatment of patients with type 2 diabetes not adequately controlled with any one of these drugs, or in those already being treated with both metformin and either canagliflozin or dapagliflozin (Box).
Metformin decreases hepatic glucose production and, to a lesser extent, increases peripheral glucose uptake. Canagliflozin and dapagliflozin inhibit SGLT2 (sodium-glucose co-transporter 2); they decrease renal glucose reabsorption, thereby increasing urinary glucose excretion.
Invokamet and Xigduo XR – Two New Combinations for Type 2 Diabetes. JAMA. 2015;313(6):620-621. doi:10.1001/jama.2015.349