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

Most common
Genital yeast infection (up to 11%)
Urinary tract infection (up to 6%)
Increased urination (up to 5%)
Male genital yeast infection (up to 4%)

Glipizide

Most common
Dizziness (up to 2%)
Drowsiness (up to 2%)
Headache (up to 2%)
Nausea (up to 1.4%)

Invokana vs. Glipizide Dosage

Invokana

Dosage
Dosage Table
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

Dosage
Dosage Table
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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