| Bipolar I disorder
Igalmi vs Uzedy
Side-by-side clinical, coverage, and cost comparison for bipolar i disorder.Deep comparison between: Igalmi vs Uzedy 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 signalsUzedy has a higher rate of injection site reactions vs Igalmi based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Uzedy but not Igalmi, including UnitedHealthcare
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Category
Igalmi
Uzedy
At A Glance
Sublingual or buccal film
As needed (acute use)
Alpha-2 adrenergic receptor agonist
SC injection
Every 4-8 weeks
Atypical antipsychotic
Indications
- Schizophrenia
- Bipolar I disorder
- Bipolar Disorder Type 2
- Schizophrenia
- Bipolar I disorder
Dosing
Schizophrenia, Bipolar I disorder, Bipolar Disorder Type 2 - Adults Mild or moderate agitation: 120 mcg initial dose SL or buccal; severe agitation: 180 mcg initial; up to 2 additional doses (60-90 mcg) at least 2 hours apart; maximum 240-360 mcg/day.
Mild or Moderate Hepatic Impairment Mild or moderate agitation: 90 mcg initial; severe agitation: 120 mcg initial; optional additional doses of 60 mcg at least 2 hours apart; maximum 210-240 mcg/day.
Severe Hepatic Impairment Mild or moderate agitation: 60 mcg initial; severe agitation: 90 mcg initial; optional additional doses of 60 mcg at least 2 hours apart; maximum 180-210 mcg/day.
Geriatric Patients (>=65 years) 120 mcg initial dose regardless of agitation severity; optional additional doses of 60 mcg at least 2 hours apart; maximum 240 mcg/day.
Schizophrenia Once monthly SC injection (50 mg, 75 mg, 100 mg, or 125 mg) or once every 2 months (100 mg, 150 mg, 200 mg, or 250 mg) based on equivalent daily oral risperidone dose (2-5 mg); initiate the day after last oral dose, no loading dose required.
Bipolar I disorder Once monthly SC injection (50 mg, 75 mg, or 100 mg) as monotherapy or adjunctive therapy to lithium or valproate, based on equivalent daily oral risperidone dose (2-4 mg); once every 2 months dosing is not recommended for this indication.
Contraindications
—
- Known hypersensitivity to risperidone, its metabolite paliperidone, or any of its components
Adverse Reactions
Most common (>=5%) Somnolence, oral paresthesia or oral hypoesthesia, dizziness, dry mouth, hypotension, orthostatic hypotension.
Serious Hypotension, orthostatic hypotension, bradycardia, QT interval prolongation, somnolence, withdrawal reactions, tolerance and tachyphylaxis.
Postmarketing Arrhythmia, atrial fibrillation, cardiac arrest, bradycardia, convulsion, apnea, bronchospasm, agitation, delirium, hallucination, hypertension, rash, urticaria.
Most common (>5%) Parkinsonism, akathisia, dystonia, tremor, sedation, dizziness, anxiety, blurred vision, nausea, vomiting, upper abdominal pain, stomach discomfort, dyspepsia, diarrhea, salivary hypersecretion, constipation, dry mouth, increased appetite, weight gain, fatigue, rash, nasal congestion, upper respiratory tract infection, nasopharyngitis, pharyngolaryngeal pain
Serious Increased mortality in elderly patients with dementia-related psychosis, cerebrovascular adverse events, neuroleptic malignant syndrome, tardive dyskinesia, metabolic changes, hyperprolactinemia, orthostatic hypotension and syncope, leukopenia, neutropenia, agranulocytosis, seizures, dysphagia, priapism
Postmarketing Alopecia, anaphylactic reaction, angioedema, atrial fibrillation, cardiopulmonary arrest, diabetic ketoacidosis, Stevens-Johnson syndrome and toxic epidermal necrolysis, sudden death, thrombocytopenia, injection site pain
Pharmacology
Dexmedetomidine is an alpha-2 adrenergic receptor agonist whose mechanism of action in acute agitation is thought to involve activation of presynaptic alpha-2 adrenergic receptors; it also exhibits concentration-dependent QT prolongation.
Risperidone is an atypical antipsychotic whose therapeutic activity may be mediated through combined dopamine Type 2 (D2) and serotonin Type 2 (5HT2) receptor antagonism; clinical effect results from the combined concentrations of risperidone and its major active metabolite, 9-hydroxyrisperidone (paliperidone).
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Most Common Insurance
Anthem BCBS
Igalmi
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (1/12) · Qty limit (11/12)
Uzedy
- Covered on 5 commercial plans
- PA (9/12) · Step Therapy (0/12) · Qty limit (9/12)
UnitedHealthcare
Igalmi
- Covered on 4 commercial plans
- PA (2/8) · Step Therapy (1/8) · Qty limit (0/8)
Uzedy
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Igalmi
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (1/3)
Uzedy
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (0/3) · Qty limit (3/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Igalmi.
Cost estimate not availableHealthWell: Movement Disorders - Medicare Access
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.