Commercial Payer Information

Commercial Payer Information

Payers create their own policies with regard to product coverage. Since information varies by payer, it is important to contact the payer directly or consult its Web site to obtain product-specific coverage.

Commercial and Medicare Part D payers each have their own forms and requirements for requesting prior authorization of a prescription drug. In the Commercial table below are links to payer Web sites where you may obtain more information on the approval process, policies and direct links to drug prior authorization forms. For Medicare Part D, click on the link for Contact Janssen CarePath Support. It is important to contact the payer directly or consult its Web site to obtain product-specific information.

Uniform Prescription Drug Prior Authorization Request Form & Notification Requirements for Health Plans

California, Colorado and Oregon require that certain health plans must use the uniform Prior Authorization (PA) Request Form. In addition, there are new rules regarding the PA process. The rules are effective based on the type of health plan for each state. Click on the PDF below for more information:

Disclaimer: Clicking on any of the links below will take you to a Web site to which this privacy policy does not apply. We encourage you to read the Privacy Policy of every Web site you visit.

Payer Prior Authorization Information
Aetna Pharmacy Clinical Policy Bulletins and Prior Authorization
Health Care Professional (Pharmacy) Forms
Arkansas Blue Cross and Blue Shield Prior Authorization Request Form
Provider Forms
Blue Cross of Idaho Provider Prior Authorization Requirements: Pharmacy Requests
Blue Cross and Blue Shield of Alabama Specialty Pharmacy Form
Prescription Drug Guides
Blue Cross Blue Shield of Arizona Prior Authorization Guidelines (Standard Pharmacy Plans)
Prior Authorization Guidelines (Employer Sponsored Plans)
Blue Cross and Blue Shield of Florida/Florida Blue Medication Guides
Quantity Limit Request Form
Specialty Pharmacy Request Form
Blue Cross and Blue Shield of Illinois Prior Authorization and Step Therapy Programs
Blue Cross and Blue Shield of Kansas Prescription Drugs
Precertification / Pre-authorization
Blue Cross and Blue Shield of Minnesota Prescription Drugs
Minnesota Uniform Form for PA Requests and Formulary Exceptions
Blue Cross and Blue Shield of Montana Provider Forms and Documents
Prior Authorization and Step Therapy Programs
Blue Cross and Blue Shield of Nebraska Policies & Forms: Pre-Authorization Forms
Blue Cross and Blue Shield of New Mexico Prior Authorization and Step Therapy Programs
Blue Cross and Blue Shield of North Carolina Prior Review and Limitations
Blue Cross and Blue Shield of Oklahoma Prior Authorization and Step Therapy Programs
BlueCross BlueShield of South Carolina Drug Management and Prior Authorization
BlueCross BlueShield of Texas Prior Authorization and Step Therapy Programs
Blue Cross Blue Shield of Wyoming Pharmacy Guide & Forms
CareFirst BlueCross BlueShield Prior Authorization/Step Therapy
Pharmacy Forms
Cigna Pharmacy Resources and Forms
CVS Caremark Prior Authorization Information
Electronic Prior Authorization
Electronic Prior Authorization FAQs
Clinical Prior Authorization Criteria Request Form
Geisinger Health/Geisinger Health Plan Prior Authorization Form
Gundersen Health Plan Pharmacy Forms for Healthcare Providers: Prior Authorization
Highmark (formerly Blue Cross of Northeastern Pennsylvania) Provider Rx Prior Authorization Form
Drug Utilization Management Criteria
Humana Pharmacy Prior Authorizations
Independence Blue Cross Prior Authorization: Pharmacy Benefit
Midwest Health Plan, Inc. Pharmacy Approval Criteria
Pharmacy Documents
Medical Mutual of Ohio Provider Home
Prior Approval List
Prior Approval Form
Neighborhood Health Plan Standardized Prior Authorization Request Form
Regence BlueCross BlueShield Prior Authorization Form
Wellmark Blue and Cross Blue Shield Provider Drug Information
Provider Prior Authorization

R2

Medicare Part D

Contact Janssen CarePath Support

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The information provided presents no statement, promise, or guarantee by Janssen Pharmaceuticals, Inc., concerning levels of reimbursement, payment, or charge. Please consult your payer organizations with regard to local or actual coverage and reimbursement policies and determination processes.

 

Commercial Payer: State-Specific Information

 

Alabama Commercial Payer Information

Please refer to the full Prescribing Information for INVOKANA® (canagliflozin) tablets.
Commercial
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2 Yes   For more information
Cigna   2     For more information
Humana   2, Group B Yes   For more information
UnitedHealthcare   2 Yes Yes For more information
Medicare Part D
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2, 3 Yes   For more information
Cigna   3 Yes   For more information
UnitedHealthcare   3 Yes   For more information

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Alaska Commercial Payer Information

Please refer to the full Prescribing Information for INVOKANA® (canagliflozin) tablets.
Commercial
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2 Yes   For more information
Cigna   2     For more information
Humana   2, Group B Yes   For more information
UnitedHealthcare   2 Yes Yes For more information
Medicare Part D
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2, 3 Yes   For more information
Cigna   3 Yes   For more information
UnitedHealthcare   3 Yes   For more information

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Arizona Commercial Payer Information

Please refer to the full Prescribing Information for INVOKANA® (canagliflozin) tablets.
Commercial
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2 Yes   For more information
Cigna   2     For more information
Humana   2, Group B Yes   For more information
UnitedHealthcare   2 Yes Yes For more information
Medicare Part D
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2, 3 Yes   For more information
Cigna   3 Yes   For more information
UnitedHealthcare   3 Yes   For more information

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Arkansas Commercial Payer Information

Please refer to the full Prescribing Information for INVOKANA® (canagliflozin) tablets.
Commercial
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2 Yes   For more information
Cigna   2     For more information
Humana   2, Group B Yes   For more information
UnitedHealthcare   2 Yes Yes For more information
Medicare Part D
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2, 3 Yes   For more information
Cigna   3 Yes   For more information
UnitedHealthcare   3 Yes   For more information

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California Commercial Payer Information

California requires that certain health plans must use the uniform Prior Authorization (PA) Request Form. In addition, there are new rules in California regarding the PA process. The rules are effective October 1, 2014 or January 1, 2015, depending on the type of health plan. Click on the PDF below for more information.

Uniform Prescription Drug Prior Authorization Request Form & Notification Requirements for Health Plans in California

Please refer to the full Prescribing Information for INVOKANA® (canagliflozin) tablets.
Commercial
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2 Yes   For more information
Anthem Blue Cross of California Yes 3 Yes Yes For more information
Cigna   2     For more information
Health Net   2     For more information
Humana   2, Group B Yes   For more information
UnitedHealthcare   2 Yes Yes For more information
Medicare Part D
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2, 3 Yes   For more information
Cigna   3 Yes   For more information
Health Net   2, 3     For more information
Kaiser Permanente   4      
UnitedHealthcare   3 Yes   For more information

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Colorado Commercial Payer Information

Colorado requires that certain health plans must use the uniform Prior Authorization (PA) Request Form. In addition, there are new rules in Colorado regarding the PA process. The rules are effective January 1, 2015. Click on the PDF below for more information.

Uniform Prescription Drug Prior Authorization Request Form & Notification Requirements for Health Plans in Colorado

Please refer to the full Prescribing Information for INVOKANA® (canagliflozin) tablets.
Commercial
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2 Yes   For more information
Cigna   2     For more information
Humana   2, Group B Yes   For more information
UnitedHealthcare   2 Yes Yes For more information
Medicare Part D
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2, 3 Yes   For more information
Cigna   3 Yes   For more information
UnitedHealthcare   3 Yes   For more information

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Connecticut Commercial Payer Information

Please refer to the full Prescribing Information for INVOKANA® (canagliflozin) tablets.
Commercial
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2 Yes   For more information
Cigna   2     For more information
Humana   2, Group B Yes   For more information
UnitedHealthcare   2 Yes Yes For more information
Medicare Part D
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2, 3 Yes   For more information
Cigna   3 Yes   For more information
UnitedHealthcare   3 Yes   For more information

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Delaware Commercial Payer Information

Please refer to the full Prescribing Information for INVOKANA® (canagliflozin) tablets.
Commercial
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2 Yes   For more information
Cigna   2     For more information
Humana   2, Group B Yes   For more information
UnitedHealthcare   2 Yes Yes For more information
Medicare Part D
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2, 3 Yes   For more information
Cigna   3 Yes   For more information
UnitedHealthcare   3 Yes   For more information

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District of Columbia DC Commercial Payer Information

Please refer to the full Prescribing Information for INVOKANA® (canagliflozin) tablets.
Commercial
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2 Yes   For more information
Cigna   2     For more information
Humana   2, Group B Yes   For more information
UnitedHealthcare   2 Yes Yes For more information
Medicare Part D
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2, 3 Yes   For more information
Cigna   3 Yes   For more information
UnitedHealthcare   3 Yes   For more information

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Florida Commercial Payer Information

Please refer to the full Prescribing Information for INVOKANA® (canagliflozin) tablets.
Commercial
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2 Yes   For more information
Blue Cross and Blue Shield of Florida, Inc./Florida Blue   2 Yes Yes For more information
Cigna   2     For more information
Humana   2, Group B Yes   For more information
SantaFe HealthCare, Inc./AvMed Health Plans   2 Yes   For more information
UnitedHealthcare   2 Yes Yes For more information
Medicare Part D
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2, 3 Yes   For more information
Blue Cross and Blue Shield of Florida, Inc./Florida Blue   3 Yes   For more information
Cigna   3 Yes   For more information
Humana   3 Yes   For more information
SantaFe HealthCare, Inc./AvMed Health Plans   3 Yes   For more information
UnitedHealthcare   3 Yes   For more information

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Georgia Commercial Payer Information

Please refer to the full Prescribing Information for INVOKANA® (canagliflozin) tablets.
Commercial
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2 Yes   For more information
Cigna   2     For more information
Humana   2, Group B Yes   For more information
UnitedHealthcare   2 Yes Yes For more information
Medicare Part D
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2, 3 Yes   For more information
Cigna   3 Yes   For more information
UnitedHealthcare   3 Yes   For more information

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Hawaii Commercial Payer Information

Please refer to the full Prescribing Information for INVOKANA® (canagliflozin) tablets.
Commercial
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2 Yes   For more information
Cigna   2     For more information
Humana   2, Group B Yes   For more information
UnitedHealthcare   2 Yes Yes For more information
Medicare Part D
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2, 3 Yes   For more information
Cigna   3 Yes   For more information
UnitedHealthcare   3 Yes   For more information

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Idaho Commercial Payer Information

Please refer to the full Prescribing Information for INVOKANA® (canagliflozin) tablets.
Commercial
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2 Yes   For more information
Cigna   2     For more information
Humana   2, Group B Yes   For more information
UnitedHealthcare   2 Yes Yes For more information
Medicare Part D
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2, 3 Yes   For more information
Cigna   3 Yes   For more information
UnitedHealthcare   3 Yes   For more information

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Illinois Commercial Payer Information

Please refer to the full Prescribing Information for INVOKANA® (canagliflozin) tablets.
Commercial
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2 Yes   For more information
Blue Cross and Blue Shield of Illinois   Brand Yes   For more information
Cigna   2     For more information
Health Alliance Medical Plans of Illinois   3 Yes Yes  
Humana   2, Group B Yes   For more information
UnitedHealthcare   2 Yes Yes For more information
Medicare Part D
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2, 3 Yes   For more information
Blue Cross and Blue Shield of Illinois   3 Yes   For more information
Cigna   3 Yes   For more information
Health Alliance Medical Plans of Illinois   3 Yes Yes  
UnitedHealthcare   3 Yes   For more information

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Indiana Commercial Payer Information

Please refer to the full Prescribing Information for INVOKANA® (canagliflozin) tablets.
Commercial
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2 Yes   For more information
Cigna   2     For more information
Humana   2, Group B Yes   For more information
UnitedHealthcare   2 Yes Yes For more information
Medicare Part D
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2, 3 Yes   For more information
Cigna   3 Yes   For more information
UnitedHealthcare   3 Yes   For more information

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Iowa Commercial Payer Information

Please refer to the full Prescribing Information for INVOKANA® (canagliflozin) tablets.
Commercial
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2 Yes   For more information
Cigna   2     For more information
Humana   2, Group B Yes   For more information
UnitedHealthcare   2 Yes Yes For more information
Medicare Part D
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2, 3 Yes   For more information
Cigna   3 Yes   For more information
UnitedHealthcare   3 Yes   For more information

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Kansas Commercial Payer Information

Please refer to the full Prescribing Information for INVOKANA® (canagliflozin) tablets.
Commercial
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2 Yes   For more information
Cigna   2     For more information
Humana   2, Group B Yes   For more information
UnitedHealthcare   2 Yes Yes For more information
Medicare Part D
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2, 3 Yes   For more information
Cigna   3 Yes   For more information
UnitedHealthcare   3 Yes   For more information

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Kentucky Commercial Payer Information

Please refer to the full Prescribing Information for INVOKANA® (canagliflozin) tablets.
Commercial
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2 Yes   For more information
Cigna   2     For more information
Humana   2, Group B Yes   For more information
UnitedHealthcare   2 Yes Yes For more information
Medicare Part D
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2, 3 Yes   For more information
Cigna   3 Yes   For more information
UnitedHealthcare   3 Yes   For more information

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Louisiana Commercial Payer Information

Please refer to the full Prescribing Information for INVOKANA® (canagliflozin) tablets.
Commercial
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2 Yes   For more information
Cigna   2     For more information
Humana   2, Group B Yes   For more information
UnitedHealthcare   2 Yes Yes For more information
Medicare Part D
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2, 3 Yes   For more information
Cigna   3 Yes   For more information
UnitedHealthcare   3 Yes   For more information

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Maine Commercial Payer Information

Please refer to the full Prescribing Information for INVOKANA® (canagliflozin) tablets.
Commercial
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2 Yes   For more information
Cigna   2     For more information
Humana   2, Group B Yes   For more information
UnitedHealthcare   2 Yes Yes For more information
Medicare Part D
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2, 3 Yes   For more information
Cigna   3 Yes   For more information
UnitedHealthcare   3 Yes   For more information

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Maryland Commercial Payer Information

Please refer to the full Prescribing Information for INVOKANA® (canagliflozin) tablets.
Commercial
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2 Yes   For more information
Cigna   2     For more information
Humana   2, Group B Yes   For more information
UnitedHealthcare   2 Yes Yes For more information
Medicare Part D
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2, 3 Yes   For more information
Cigna   3 Yes   For more information
UnitedHealthcare   3 Yes   For more information

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Massachusetts Commercial Payer Information

Please refer to the full Prescribing Information for INVOKANA® (canagliflozin) tablets.
Commercial
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2 Yes   For more information
Cigna   2     For more information
Humana   2, Group B Yes   For more information
UnitedHealthcare   2 Yes Yes For more information
Medicare Part D
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2, 3 Yes   For more information
Cigna   3 Yes   For more information
UnitedHealthcare   3 Yes   For more information

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Michigan Commercial Payer Information

Please refer to the full Prescribing Information for INVOKANA® (canagliflozin) tablets.
Commercial
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2 Yes   For more information
Cigna   2     For more information
Humana   2, Group B Yes   For more information
UnitedHealthcare   2 Yes Yes For more information
Medicare Part D
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2, 3 Yes   For more information
Cigna   3 Yes   For more information
UnitedHealthcare   3 Yes   For more information

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Minnesota Commercial Payer Information

Please refer to the full Prescribing Information for INVOKANA® (canagliflozin) tablets.
Commercial
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2 Yes   For more information
Cigna   2     For more information
Humana   2, Group B Yes   For more information
UnitedHealthcare   2 Yes Yes For more information
Medicare Part D
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2, 3 Yes   For more information
Cigna   3 Yes   For more information
UnitedHealthcare   3 Yes   For more information

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Mississippi Commercial Payer Information

Please refer to the full Prescribing Information for INVOKANA® (canagliflozin) tablets.
Commercial
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2 Yes   For more information
Cigna   2     For more information
Humana   2, Group B Yes   For more information
UnitedHealthcare   2 Yes Yes For more information
Medicare Part D
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2, 3 Yes   For more information
Cigna   3 Yes   For more information
UnitedHealthcare   3 Yes   For more information

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Missouri Commercial Payer Information

Please refer to the full Prescribing Information for INVOKANA® (canagliflozin) tablets.
Commercial
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2 Yes   For more information
Cigna   2     For more information
Humana   2, Group B Yes   For more information
UnitedHealthcare   2 Yes Yes For more information
Medicare Part D
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2, 3 Yes   For more information
Cigna   3 Yes   For more information
UnitedHealthcare   3 Yes   For more information

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Montana Commercial Payer Information

Please refer to the full Prescribing Information for INVOKANA® (canagliflozin) tablets.
Commercial
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2 Yes   For more information
Cigna   2     For more information
Humana   2, Group B Yes   For more information
UnitedHealthcare   2 Yes Yes For more information
Medicare Part D
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2, 3 Yes   For more information
Cigna   3 Yes   For more information
UnitedHealthcare   3 Yes   For more information

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Nebraska Commercial Payer Information

Please refer to the full Prescribing Information for INVOKANA® (canagliflozin) tablets.
Commercial
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2 Yes   For more information
Cigna   2     For more information
Humana   2, Group B Yes   For more information
UnitedHealthcare   2 Yes Yes For more information
Medicare Part D
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2, 3 Yes   For more information
Cigna   3 Yes   For more information
UnitedHealthcare   3 Yes   For more information

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Nevada Commercial Payer Information

Please refer to the full Prescribing Information for INVOKANA® (canagliflozin) tablets.
Commercial
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2 Yes   For more information
Cigna   2     For more information
Humana   2, Group B Yes   For more information
UnitedHealthcare   2 Yes Yes For more information
Medicare Part D
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2, 3 Yes   For more information
Cigna   3 Yes   For more information
UnitedHealthcare   3 Yes   For more information

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New Hampshire Commercial Payer Information

Please refer to the full Prescribing Information for INVOKANA® (canagliflozin) tablets.
Commercial
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2 Yes   For more information
Cigna   2     For more information
Humana   2, Group B Yes   For more information
UnitedHealthcare   2 Yes Yes For more information
Medicare Part D
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2, 3 Yes   For more information
Cigna   3 Yes   For more information
UnitedHealthcare   3 Yes   For more information

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New Jersey Commercial Payer Information

Please refer to the full Prescribing Information for INVOKANA® (canagliflozin) tablets.
Commercial
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2 Yes   For more information
Cigna   2     For more information
Humana   2, Group B Yes   For more information
UnitedHealthcare   2 Yes Yes For more information
Medicare Part D
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2, 3 Yes   For more information
Cigna   3 Yes   For more information
UnitedHealthcare   3 Yes   For more information

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New Mexico Commercial Payer Information

Please refer to the full Prescribing Information for INVOKANA® (canagliflozin) tablets.
Commercial
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2 Yes   For more information
Cigna   2     For more information
Humana   2, Group B Yes   For more information
UnitedHealthcare   2 Yes Yes For more information
Medicare Part D
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2, 3 Yes   For more information
Cigna   3 Yes   For more information
UnitedHealthcare   3 Yes   For more information

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New York Commercial Payer Information

Please refer to the full Prescribing Information for INVOKANA® (canagliflozin) tablets.
Commercial
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2 Yes   For more information
Cigna   2     For more information
EmblemHealth   Preferred     For more information
Empire BlueCross BlueShield   3 Yes Yes For more information
Excellus BlueCross BlueShield   2 Yes   For more information
Humana   2, Group B Yes   For more information
UnitedHealthcare   2 Yes Yes For more information
Medicare Part D
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2, 3 Yes   For more information
Cigna   3 Yes   For more information
Excellus BlueCross BlueShield   2, 3 Yes   For more information
UnitedHealthcare   3 Yes   For more information

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North Carolina Commercial Payer Information

Please refer to the full Prescribing Information for INVOKANA® (canagliflozin) tablets.
Commercial
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2 Yes   For more information
Cigna   2     For more information
Humana   2, Group B Yes   For more information
UnitedHealthcare   2 Yes Yes For more information
Medicare Part D
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2, 3 Yes   For more information
Cigna   3 Yes   For more information
UnitedHealthcare   3 Yes   For more information

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North Dakota Commercial Payer Information

Please refer to the full Prescribing Information for INVOKANA® (canagliflozin) tablets.
Commercial
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2 Yes   For more information
Cigna   2     For more information
Humana   2, Group B Yes   For more information
UnitedHealthcare   2 Yes Yes For more information
Medicare Part D
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2, 3 Yes   For more information
Cigna   3 Yes   For more information
UnitedHealthcare   3 Yes   For more information

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Ohio Commercial Payer Information

Please refer to the full Prescribing Information for INVOKANA® (canagliflozin) tablets.
Commercial
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2 Yes   For more information
Cigna   2     For more information
Humana   2, Group B Yes   For more information
UnitedHealthcare   2 Yes Yes For more information
Medicare Part D
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2, 3 Yes   For more information
Cigna   3 Yes   For more information
UnitedHealthcare   3 Yes   For more information

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Oklahoma Commercial Payer Information

Please refer to the full Prescribing Information for INVOKANA® (canagliflozin) tablets.
Commercial
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2 Yes   For more information
Cigna   2     For more information
Humana   2, Group B Yes   For more information
UnitedHealthcare   2 Yes Yes For more information
Medicare Part D
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2, 3 Yes   For more information
Cigna   3 Yes   For more information
UnitedHealthcare   3 Yes   For more information

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Oregon Commercial Payer Information

Oregon requires that certain health plans must use the uniform Prior Authorization (PA) Request Form. In addition, there are new rules in Oregon regarding the PA process. The rules are effective July 1, 2015. Click on the PDF below for more information.

Uniform Prescription Drug Prior Authorization Request Form & Notification Requirements for Health Plans in Oregon

Please refer to the full Prescribing Information for INVOKANA® (canagliflozin) tablets.
Commercial
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2 Yes   For more information
Cigna   2     For more information
Humana   2, Group B Yes   For more information
UnitedHealthcare   2 Yes Yes For more information
Medicare Part D
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2, 3 Yes   For more information
Cigna   3 Yes   For more information
UnitedHealthcare   3 Yes   For more information

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Pennsylvania Commercial Payer Information

Please refer to the full Prescribing Information for INVOKANA® (canagliflozin) tablets.
Commercial
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2 Yes   For more information
Cigna   2     For more information
Humana   2, Group B Yes   For more information
UnitedHealthcare   2 Yes Yes For more information
Medicare Part D
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2, 3 Yes   For more information
Cigna   3 Yes   For more information
UnitedHealthcare   3 Yes   For more information

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Rhode Island Commercial Payer Information

Please refer to the full Prescribing Information for INVOKANA® (canagliflozin) tablets.
Commercial
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2 Yes   For more information
Cigna   2     For more information
Humana   2, Group B Yes   For more information
UnitedHealthcare   2 Yes Yes For more information
Medicare Part D
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2, 3 Yes   For more information
Cigna   3 Yes   For more information
UnitedHealthcare   3 Yes   For more information

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South Carolina Commercial Payer Information

Please refer to the full Prescribing Information for INVOKANA® (canagliflozin) tablets.
Commercial
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2 Yes   For more information
Cigna   2     For more information
Humana   2, Group B Yes   For more information
UnitedHealthcare   2 Yes Yes For more information
Medicare Part D
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2, 3 Yes   For more information
Cigna   3 Yes   For more information
UnitedHealthcare   3 Yes   For more information

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South Dakota Commercial Payer Information

Please refer to the full Prescribing Information for INVOKANA® (canagliflozin) tablets.
Commercial
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2 Yes   For more information
Cigna   2     For more information
Humana   2, Group B Yes   For more information
UnitedHealthcare   2 Yes Yes For more information
Medicare Part D
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2, 3 Yes   For more information
Cigna   3 Yes   For more information
UnitedHealthcare   3 Yes   For more information

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Tennessee Commercial Payer Information

Please refer to the full Prescribing Information for INVOKANA® (canagliflozin) tablets.
Commercial
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2 Yes   For more information
Cigna   2     For more information
Humana   2, Group B Yes   For more information
UnitedHealthcare   2 Yes Yes For more information
Medicare Part D
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2, 3 Yes   For more information
Cigna   3 Yes   For more information
UnitedHealthcare   3 Yes   For more information

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Texas Commercial Payer Information

Please refer to the full Prescribing Information for INVOKANA® (canagliflozin) tablets.
Commercial
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2 Yes   For more information
Cigna   2     For more information
Humana   2, Group B Yes   For more information
Scott & White Health Plan   3      
UnitedHealthcare   2 Yes Yes For more information
Medicare Part D
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2, 3 Yes   For more information
Cigna   3 Yes   For more information
Scott & White Health Plan   4      
UnitedHealthcare   3 Yes   For more information

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Utah Commercial Payer Information

Please refer to the full Prescribing Information for INVOKANA® (canagliflozin) tablets.
Commercial
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2 Yes   For more information
Cigna   2     For more information
Humana   2, Group B Yes   For more information
UnitedHealthcare   2 Yes Yes For more information
Medicare Part D
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2, 3 Yes   For more information
Cigna   3 Yes   For more information
UnitedHealthcare   3 Yes   For more information

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Vermont Commercial Payer Information

Please refer to the full Prescribing Information for INVOKANA® (canagliflozin) tablets.
Commercial
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2 Yes   For more information
Cigna   2     For more information
Humana   2, Group B Yes   For more information
UnitedHealthcare   2 Yes Yes For more information
Medicare Part D
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2, 3 Yes   For more information
Cigna   3 Yes   For more information
UnitedHealthcare   3 Yes   For more information

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Virginia Commercial Payer Information

Please refer to the full Prescribing Information for INVOKANA® (canagliflozin) tablets.
Commercial
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2 Yes   For more information
Cigna   2     For more information
Humana   2, Group B Yes   For more information
UnitedHealthcare   2 Yes Yes For more information
Medicare Part D
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2, 3 Yes   For more information
Cigna   3 Yes   For more information
UnitedHealthcare   3 Yes   For more information

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Washington Commercial Payer Information

Please refer to the full Prescribing Information for INVOKANA® (canagliflozin) tablets.
Commercial
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2 Yes   For more information
Cigna   2     For more information
Humana   2, Group B Yes   For more information
UnitedHealthcare   2 Yes Yes For more information
Medicare Part D
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2, 3 Yes   For more information
Cigna   3 Yes   For more information
UnitedHealthcare   3 Yes   For more information

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West Virginia Commercial Payer Information

Please refer to the full Prescribing Information for INVOKANA® (canagliflozin) tablets.
Commercial
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2 Yes   For more information
Cigna   2     For more information
Humana   2, Group B Yes   For more information
UnitedHealthcare   2 Yes Yes For more information
Medicare Part D
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2, 3 Yes   For more information
Cigna   3 Yes   For more information
UnitedHealthcare   3 Yes   For more information

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Wisconsin Commercial Payer Information

Please refer to the full Prescribing Information for INVOKANA® (canagliflozin) tablets.
Commercial
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2 Yes   For more information
Cigna   2     For more information
Humana   2, Group B Yes   For more information
UnitedHealthcare   2 Yes Yes For more information
Medicare Part D
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2, 3 Yes   For more information
Cigna   3 Yes   For more information
UnitedHealthcare   3 Yes   For more information

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Wyoming Commercial Payer Information

Please refer to the full Prescribing Information for INVOKANA® (canagliflozin) tablets.
Commercial
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2 Yes   For more information
Cigna   2     For more information
Humana   2, Group B Yes   For more information
UnitedHealthcare   2 Yes Yes For more information
Medicare Part D
Payer Prior
Authorization
Tier Quantity
Limits
Step Therapy Exception & Appeals Process Information
Aetna   2, 3 Yes   For more information
Cigna   3 Yes   For more information
UnitedHealthcare   3 Yes   For more information

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R4

INDICATION AND USAGE

INVOKANA® (canagliflozin) is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus.

INVOKANA® is not recommended in patients with type 1 diabetes or for the treatment of diabetic ketoacidosis.

Important Safety Information For INVOKANA®

IMPORTANT SAFETY INFORMATION

CONTRAINDICATIONS

  • History of a serious hypersensitivity reaction to INVOKANA®, such as anaphylaxis or angioedema
  • Severe renal impairment (eGFR <30 mL/min/1.73 m2 ), end-stage renal disease, or patients on dialysis

WARNINGS and PRECAUTIONS

  • Hypotension: INVOKANA® causes intravascular volume contraction. Symptomatic hypotension can occur after initiating INVOKANA®, particularly in patients with impaired renal function (eGFR <60 mL/min/1.73 m2 ), elderly patients, patients on either diuretics or medications that interfere with the renin-angiotensin-aldosterone system, or patients with low systolic blood pressure. Before initiating in patients with ≥1 of these characteristics, volume status should be assessed and corrected. Monitor for signs and symptoms after initiating.
  • Ketoacidosis: Reports of ketoacidosis, a serious life-threatening condition requiring urgent hospitalization, have been identified in patients with type 1 and 2 diabetes mellitus receiving SGLT2 inhibitors, including INVOKANA®. Fatal cases of ketoacidosis have been reported in patients taking INVOKANA®. Before initiating INVOKANA®, consider factors in patient history that may predispose to ketoacidosis, including pancreatic insulin deficiency, caloric restriction disorders, and alcohol abuse. In patients treated with INVOKANA®, consider monitoring for ketoacidosis and temporarily discontinuing in clinical situations known to predispose to ketoacidosis (eg, prolonged fasting due to acute illness or surgery).
  • Acute Kidney Injury and Impairment in Renal Function: INVOKANA® causes intravascular volume contraction and can cause renal impairment. Postmarketing reports of acute kidney injury, some requiring hospitalization and dialysis, were reported; some reports involved patients younger than 65 years of age. Before initiation, consider factors that may predispose patients to acute kidney injury including hypovolemia, chronic renal insufficiency, congestive heart failure and concomitant medications. Consider temporarily discontinuing INVOKANA® in any setting of reduced oral intake or fluid losses; monitor patients for signs and symptoms of acute kidney injury. If acute kidney injury occurs, discontinue promptly and institute treatment.

    INVOKANA® increases serum creatinine and decreases eGFR. Patients with hypovolemia may be more susceptible to these changes. Renal function abnormalities can occur after initiation. Renal function should be evaluated prior to initiation and periodically thereafter. Dose adjustment and more frequent renal function monitoring are recommended in patients with an eGFR <60 mL/min/1.73 m2.

  • Hyperkalemia: INVOKANA® can lead to hyperkalemia. Patients with moderate renal impairment who are taking medications that interfere with potassium excretion or medications that interfere with the renin-angiotensin-aldosterone system are more likely to develop hyperkalemia. Monitor serum potassium levels periodically in patients with impaired renal function and in patients predisposed to hyperkalemia due to medications or other medical conditions.
  • Urosepsis and Pyelonephritis: There have been reports of serious urinary tract infections, including urosepsis and pyelonephritis, requiring hospitalization in patients receiving SGLT2 inhibitors, including INVOKANA®. Treatment with SGLT2 inhibitors increases this risk. Evaluate patients for signs and symptoms and treat promptly.
  • Hypoglycemia With Concomitant Use With Insulin and Insulin Secretagogues: INVOKANA® can increase the risk of hypoglycemia when combined with insulin or an insulin secretagogue. A lower dose of insulin or insulin secretagogue may be required to minimize the risk of hypoglycemia when used in combination with INVOKANA®.
  • Genital Mycotic Infections: INVOKANA® increases risk of genital mycotic infections. Patients with history of these infections and uncircumcised males were more likely to develop these infections. Monitor and treat appropriately.
  • Hypersensitivity Reactions: Hypersensitivity reactions, including angioedema and anaphylaxis, were reported with INVOKANA®; these reactions generally occurred within hours to days after initiation. If reactions occur, discontinue INVOKANA®, treat per standard of care, and monitor until signs and symptoms resolve.
  • Bone Fracture: Increased risk of bone fracture, occurring as early as 12 weeks after treatment initiation, was observed in patients using INVOKANA®. Consider factors that contribute to fracture risk prior to initiating INVOKANA®.
  • Increases in Low-Density Lipoprotein (LDL-C): Dose-related increases in LDL-C can occur with INVOKANA®. Monitor LDL-C and treat per standard of care after initiating.
  • Macrovascular Outcomes: There have been no clinical studies establishing conclusive evidence of macrovascular risk reduction with INVOKANA®.

DRUG INTERACTIONS

  • UGT Enzyme Inducers: Rifampin: Co-administration of INVOKANA® with rifampin decreased INVOKANA® area under the curve (AUC) by 51% and therefore may decrease efficacy. If an inducer of UGT enzymes must be co-administered with INVOKANA®, consider increasing the dose to 300 mg once daily if patients are currently tolerating INVOKANA® 100 mg once daily, have an eGFR ≥60 mL/min/1.73 m2 , and require additional glycemic control. Consider other antihyperglycemic therapy in patients with an eGFR <60 mL/min/1.73 m2  who require additional glycemic control.
  • Digoxin: There was an increase in the AUC and mean peak drug concentration of digoxin (20% and 36%, respectively) when co-administered with INVOKANA® 300 mg. Monitor appropriately.
  • Positive Urine Glucose Test: Monitoring glycemic control with urine glucose tests is not recommended in patients taking SGLT2 inhibitors as SGLT2 inhibitors increase urinary glucose excretion and will lead to positive urine glucose test results. Use alternative methods to monitor glycemic control.
  • Interference With 1,5-Anhydroglucitol (1,5-AG) Assay: Monitoring glycemic control with 1,5-AG assay is not recommended as measurements of 1,5-AG are unreliable in assessing glycemic control in patients taking SGLT2 inhibitors. Use alternative methods to monitor glycemic control.

USE IN SPECIFIC POPULATIONS

  • Pregnancy: Based on animal data showing adverse renal effects, INVOKANA® is not recommended during the second and third trimesters of pregnancy. Limited data with INVOKANA® in pregnant women are not sufficient to determine a drug-associated risk for major birth defects or miscarriage. There are risks to mother and fetus associated with poorly controlled diabetes in pregnancy.
  • Nursing Mothers: There is no information regarding the presence of INVOKANA® in human milk, the effects on the breastfed infant, or the effects on milk production. Because of the potential for serious adverse reactions in a breastfed infant, advise women that use of INVOKANA® is not recommended while breastfeeding.
  • Pediatric Use: Safety and effectiveness in patients <18 years of age have not been established.
  • Geriatric Use: 2034 patients ≥65 years and 345 patients ≥75 years were exposed to INVOKANA® in 9 clinical studies. Patients ≥65 years had a higher incidence of adverse reactions related to reduced intravascular volume (eg, hypotension, postural dizziness, orthostatic hypotension, syncope, and dehydration), particularly with the 300-mg dose, compared to younger patients; more prominent increase in the incidence was seen in patients who were ≥75 years. Smaller reductions in HbA1c relative to placebo were seen in patients ≥65 years (-0.61% with INVOKANA® 100 mg and -0.74% with INVOKANA® 300 mg) compared to younger patients (-0.72% with INVOKANA® 100 mg and -0.87% with INVOKANA® 300 mg).
  • Renal Impairment: Efficacy and safety were evaluated in a study that included patients with moderate renal impairment (eGFR 30 to <50 mL/min/1.73 m2). These patients had less overall glycemic efficacy and a higher occurrence of adverse reactions related to reduced intravascular volume, renal-related adverse reactions, and decreases in eGFR compared to patients with mild renal impairment or normal renal function (eGFR ≥60 mL/min/1.73 m2 ); patients treated with 300 mg were more likely to experience increases in potassium. INVOKANA® is not recommended in patients with severe renal impairment (eGFR <30 mL/min/1.73 m2 ), with end-stage renal disease, or receiving dialysis.
  • Hepatic Impairment: INVOKANA® has not been studied in patients with severe hepatic impairment and is not recommended in this population.

OVERDOSAGE

  • In the event of an overdose, contact the Poison Control Center and employ the usual supportive measures, eg, remove unabsorbed material from the gastrointestinal tract, employ clinical monitoring, and institute supportive treatment as needed.

ADVERSE REACTIONS

  • The most common adverse reactions associated with INVOKANA® (5% or greater incidence) were female genital mycotic infections, urinary tract infections, and increased urination.

Please see full Prescribing Information and Medication Guide.

066709-170206