Compare Actos vs. Invokana

Head-to-head comparisons of medication uses, side effects, ratings, and more.

Actos
(pioglitazone)

Invokana
(canagliflozin)

Lowers blood sugar. Actos (pioglitazone) can improve blood sugar control but is not a top choice since it has a lot of side effects.Lowers blood sugar. Invokana (canagliflozin) can be used together with other diabetes medicines to help lower your blood sugar, but it can be expensive because it's brand name.
Reviews & ratings
Filter group. All currently selected
Filter group. All currently selected
4.11Actos
Reviews for Actos
42%
of people (All ages) say Actos is worth it
30%
say it works well
21%
say it's a big hassle
175 reviews
Have you used Actos (pioglitazone)?
Worth itNot sureNot worth it
Reviews for Invokana
67%
-25% worse vs. Actos
56%
-26% worse vs. Actos
19%
-2% worse vs. Actos
Have you used Invokana (canagliflozin)?
Worth itNot sureNot worth it
Side effects
ActosInvokana
  • Swelling 11%
  • Low blood sugar 8%
  • Colds and flu 4%
  • Headache 2%
  • Heart failure 2%
  • Sinus infection 1%
  • Back pain 1%
  • Muscle pain 2%
More Actos side effects »
  • Yeast infection in women 8%
  • Urinary tract infections 2%
  • Increased urination 4%
  • Yeast infection in men 3%
  • Thirst 3%
  • Vaginal itching 2%
  • Constipation 1%
  • Abdominal pain 1%
More Invokana side effects »
How it works
ActosInvokana
Actos (pioglitazone) is a thiazolidinedione that improves your body's ability to use insulin to lower your blood sugar.Invokana (canagliflozin) is an anti-diabetes medication. It lowers blood sugar by causing your body to get rid of sugar in your urine.
Type of medication
ActosInvokana
Prescription onlyPrescription only
Available as
ActosInvokana
  • Pill
  • Pill
Used for
ActosInvokana
Risk factors for serious side effects
ActosInvokana
  • Heart failure
  • Current liver problems
  • History of bladder cancer
  • Women
Detailed Actos (pioglitazone) risks & warnings »
  • History of amputations 
  • Peripheral vascular disease (narrowed blood vessels)
  • Nerve problems
  • Diabetic foot ulcers 
  • History of kidney damage
Detailed Invokana (canagliflozin) risks & warnings »
Pregnancy

Research studies with animals found harmful effects on unborn babies. It hasn’t been properly studied in humans. The benefits might outweigh the risks even if you’re pregnant. Talk with your doctor.

Alcohol
ActosInvokana
No alcohol related info.
  • Avoid if you are a heavy drinker of alcohol.
Food
ActosInvokana
  • Take once a day with or without food.
  • Take once daily before your first meal of the day.
  • You only have to take Invokana (canagliflozin) once a day before meals.
Kidneys and liver
ActosInvokana
  • If you've had liver problems or damage in the past, talk to your doctor before starting Actos (pioglitazone), since there's a small chance that it can hurt your liver. Tell your doctor about any stomach pain that don't go away, dark urine, or yellowing of eyes/skin. Your doctor will check your liver regularly.
  • Not for people with severe kidney problems.
Pain
ActosInvokana
No pain related info.
  • Rarely, Invokana (canagliflozin) can hurt the kidneys. This is more likely to happen if you already have kidney damage, heart failure, or take certain medicines for blood pressure or anti-inflammatories (NSAIDs). Invokana (canagliflozin) can also lower your blood pressure since it makes you urinate more. Your doctor will check your kidneys by blood tests regularly, and might ask you to change how you take Invokana (canagliflozin). Make sure to stay hydrated to prevent low blood pressure and kidney problems.
Weight
ActosInvokana
  • Can cause weight gain, headache, and swelling from fluid build-up.
  • Can cause weight gain.
No weight related info.
Upsides and benefits
ActosInvokana
  • Improves sugar control and lowers A1c levels by around 1%.
  • Easily taken by mouth as a once a day pill.
  • Prevents the harmful effects of high sugar levels on your organs.
  • Rarely causes low blood sugar.
  • Lower the risk of heart attack or stroke.
  • Lowers A1C (blood sugar) levels by 1%.
  • You only have to take Invokana (canagliflozin) once a day before meals.
  • Less likely to cause low blood sugar than other diabetes medicines.
  • Also available as a combination drug with metformin (Invokamet).
Downsides and risks
ActosInvokana
  • May take several weeks to lower blood sugar.
  • Can cause weight gain.
  • People with heart failure or history of bladder cancer shouldn't use this medicine.
  • Some people might get fluid accumulation (edema), from minor ankle swelling to fluid in lungs that makes it hard to breathe.
  • Raises the risk of bone fractures, especially for people who already have a risk for fractures.
  • You're more likely to have broken bones, yeast infections and urinary tract infections with Invokana (canagliflozin).
  • There's a rare but serious risk of leg and foot amputations with Invokana (canagliflozin). Talk to your doctor if you develop new pain or infections in your feet.
  • Not for people with severe kidney problems.
  • Can raise your cholesterol.
  • Avoid if you are a heavy drinker of alcohol.
Tips from our pharmacists for people taking the medication
ActosInvokana
  • Take once a day with or without food.
  • May need several weeks to see full effect on blood sugar control.
  • Can cause weight gain, headache, and swelling from fluid build-up.
  • Tell your doctor about any shortness of breath, heart troubles, or unusual swelling.
  • Not recommended for patients with a history of heart failure or bladder cancer.
  • Check your blood sugar regularly.
  • Take once daily before your first meal of the day.
  • Invokana (canagliflozin) can cause you to urinate more, so be sure to stay hydrated.
  • Can cause genital yeast infections in females and males.
  • Can cause urinary tract infections (UTI).
  • Can cause low blood sugar, so make sure to check your blood sugar if you don't feel well.
  • You should continue to exercise regularly, eat a healthy diet, and take your other diabetes medicines along with Invokana (canagliflozin).
Learn more
More about ActosSide effectsReviews & ratingsAlternativesFDA package insert
Have you used Actos (pioglitazone)?
Worth itNot sureNot worth it
More about InvokanaSide effectsReviews & ratingsAlternativesFDA package insert
Have you used Invokana (canagliflozin)?
Worth itNot sureNot worth it