Invokana vs. Glipizide
See how Invokana and Glipizide compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Invokana is an SGLT2 inhibitor with proven heart and kidney benefits, while glipizide is a sulfonylurea that only lowers blood sugar.
Invokana costs significantly more than glipizide, though it may lower cardiovascular and kidney risks that glipizide does not address.
Glipizide carries a higher risk of hypoglycemia and weight gain, while Invokana's main risks are genital infections and dehydration.
Invokana vs. Glipizide Drug Summary
Invokana
Invokana (canagliflozin) is an SGLT2 inhibitor that lowers blood sugar by causing the kidneys to remove excess glucose in the urine. It treats type 2 diabetes and can also reduce the risk of heart attack, stroke, kidney disease progression, and heart failure hospitalization in people with related conditions. It is taken as one tablet by mouth once daily before the first meal.
Glipizide
Glipizide is a second-generation sulfonylurea that lowers blood sugar by prompting the pancreas to release more insulin. It is approved to treat type 2 diabetes as an add-on to diet and exercise and has been used since the 1980s. It comes as an immediate-release tablet taken once or twice daily, or an extended-release tablet taken once daily.
Invokana vs. Glipizide Side Effects
Invokana
Glipizide
Invokana vs. Glipizide Dosage
Invokana
Glipizide
| STAGE | DOSE | WHEN |
| Starting dose | 100 mg once daily | At the start |
| Maximum dose | 100 mg once daily | Same as starting |
| Dose changes | None | Fixed dose |
| STAGE | DOSE | WHEN |
| Starting dose | 5 mg once daily | At the start |
| Maximum dose | 5 mg once daily | Same as starting |
| Dose changes | None | Fixed dose |
Invokana
| STAGE | DOSE | WHEN |
| Starting dose | 100 mg once daily | At the start |
| Maximum dose | 100 mg once daily | Same as starting |
| Dose changes | None | Fixed dose |
Glipizide
| STAGE | DOSE | WHEN |
| Starting dose | 5 mg once daily | At the start |
| Maximum dose | 5 mg once daily | Same as starting |
| Dose changes | None | Fixed dose |
Invokana vs. Glipizide Indications
Invokana
Invokana treats type 2 diabetes and also carries specific approvals for protecting the heart and kidneys. It is approved to reduce the risk of major cardiovascular events in adults with type 2 diabetes and existing heart disease. It is also approved to slow diabetic kidney disease and reduce heart failure hospitalization in people with protein in their urine.
Improves blood sugar control in adults and children 10+ with type 2 diabetes
Reduces risk of heart attack, stroke, or death with existing heart disease
Slows progression of diabetic kidney disease with albuminuria
Reduces hospitalization for heart failure in diabetic kidney disease
Not recommended for type 1 diabetes or diabetic ketoacidosis
Glipizide
Glipizide is approved only to help control blood sugar in adults with type 2 diabetes, used alongside diet and exercise. It does not carry any FDA-approved heart or kidney protection indication. It is not approved for type 1 diabetes or diabetic ketoacidosis.
Improves blood sugar control in adults with type 2 diabetes
Used as an adjunct to diet and exercise
Not approved for type 1 diabetes
Not approved for diabetic ketoacidosis
No FDA-approved cardiovascular or kidney indication
Invokana vs. Glipizide Pros and Cons
Invokana
Invokana's added heart and kidney protection sets it apart from older diabetes pills, but it comes with a higher price tag and a distinct set of side effects tied to how it works. Insurance coverage often requires prior authorization, though manufacturer savings programs can lower out-of-pocket costs.
Pros
Reduces risk of heart attack, stroke, and death in patients with heart disease
Slows kidney disease progression and cuts heart failure hospitalizations
Associated with modest weight loss
Simple once-daily oral dosing
Cons
Roughly $550 to $830 per month before insurance, far more than glipizide
Higher risk of genital yeast infections and urinary tract infections
Can cause dehydration or low blood pressure, especially with diuretics
Small increased risk of lower-limb amputation
Glipizide
Glipizide has been used for decades and is one of the most affordable oral diabetes medications available, but it does not offer any cardiovascular or kidney protection. Its main risk is low blood sugar, which means meal timing matters.
Pros
Roughly $10 to $35 per month, among the least expensive diabetes pills
Long track record of use since 1984
No added risk of urinary or genital infections
Available in flexible immediate-release or extended-release forms
Cons
No proven cardiovascular or kidney benefit
Risk of hypoglycemia, especially in elderly or malnourished patients
May cause weight gain
Sulfonylureas have been linked to increased cardiovascular mortality risk in older studies
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