| Angioedemas, Hereditary
Orladeyo vs Ruconest
Side-by-side clinical, coverage, and cost comparison for angioedemas, hereditary.Deep comparison between: Orladeyo vs Ruconest with Prescriber.AI
AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.Safety signalsRuconest has a higher rate of injection site reactions vs Orladeyo based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Ruconest but not Orladeyo, including UnitedHealthcare
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Category
Orladeyo
Ruconest
At A Glance
Oral
Once daily
Plasma kallikrein inhibitor
IV injection
As needed (up to 2 doses/24 hours)
C1 esterase inhibitor (recombinant)
Indications
- Angioedemas, Hereditary
- Angioedemas, Hereditary
Dosing
Angioedemas, Hereditary (adults and pediatric patients >=12 years) 150 mg capsule orally once daily with food; reduce to 110 mg once daily with food for moderate or severe hepatic impairment (Child-Pugh Class B or C).
Angioedemas, Hereditary (pediatric patients 2 to <12 years) Weight-based oral pellets once daily with food: 72 mg (12 to <24 kg), 96 mg (24 to <32 kg), 108 mg (32 to <40 kg), or 132 mg (>=40 kg); avoid use in moderate or severe hepatic impairment.
Angioedemas, Hereditary 50 U/kg IV (max 4200 U) by slow intravenous injection over approximately 5 minutes; a second dose at the same level may be given if symptoms persist; no more than 2 doses within 24 hours.
Contraindications
—
- History of allergy to rabbits or rabbit-derived products
- History of life-threatening immediate hypersensitivity reactions to C1 esterase inhibitor preparations, including anaphylaxis
Adverse Reactions
Most common (>=10%) Abdominal pain, vomiting, diarrhea, back pain, gastroesophageal reflux disease
Serious QTc interval prolongation (at supratherapeutic doses), transaminase elevations
Postmarketing Nausea
Most common (>=2%) Headache, nausea, diarrhea
Serious Anaphylaxis
Postmarketing Abdominal pain, rash
Pharmacology
Plasma kallikrein inhibitor; berotralstat binds to and inhibits plasma kallikrein's proteolytic activity, thereby reducing bradykinin generation and preventing angioedema attacks in patients with HAE due to C1-inhibitor deficiency or dysfunction.
Recombinant C1 esterase inhibitor (C1INH) that regulates the complement and contact system pathways by irreversibly binding target proteases (activated C1s, kallikrein, factor XIIa, factor XIa), restoring functional C1INH activity and suppressing the bradykinin-mediated vascular permeability increases that underlie HAE attacks.
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Most Common Insurance
Anthem BCBS
Orladeyo
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (5/12) · Qty limit (9/12)
Ruconest
- Covered on 5 commercial plans
- PA (9/12) · Step Therapy (3/12) · Qty limit (9/12)
UnitedHealthcare
Orladeyo
- Covered on 4 commercial plans
- PA (1/8) · Step Therapy (0/8) · Qty limit (1/8)
Ruconest
- Covered on 4 commercial plans
- PA (5/8) · Step Therapy (0/8) · Qty limit (4/8)
Humana
Orladeyo
- Covered on 0 commercial plans
- PA (2/3) · Step Therapy (2/3) · Qty limit (2/3)
Ruconest
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (3/3) · Qty limit (2/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
Cost estimate not availableAccessia Health: Hereditary Angioedema - Private Insurance
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
Cost estimate not availableAccessia Health: Hereditary Angioedema - Private Insurance
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.