| Chemotherapy-induced nausea and vomiting
Syndros vs Varubi
Side-by-side clinical, coverage, and cost comparison for chemotherapy-induced nausea and vomiting.Deep comparison between: Syndros vs Varubi 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 signalsVarubi has a higher rate of injection site reactions vs Syndros based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Varubi but not Syndros, including UnitedHealthcare
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Category
Syndros
Varubi
At A Glance
Oral
Cannabinoid
Oral
Once per chemotherapy cycle
NK1 receptor antagonist
Indications
- Anorexia
- Chemotherapy-induced nausea and vomiting
- Chemotherapy-induced nausea and vomiting
Dosing
Anorexia 2.1 mg orally twice daily, one hour before lunch and one hour before dinner; may titrate up to 4.2 mg before lunch and 4.2 mg before dinner; maximum 8.4 mg twice daily.
Chemotherapy-induced nausea and vomiting 4.2 mg/m2 orally 1 to 3 hours prior to chemotherapy, then every 2 to 4 hours after chemotherapy for 4 to 6 doses per day; may titrate in increments of 2.1 mg/m2; maximum 12.6 mg/m2 per dose.
Chemotherapy-induced nausea and vomiting 180 mg as a single oral dose within 2 hours prior to initiation of chemotherapy, in combination with a 5-HT3 receptor antagonist and dexamethasone; administer at no less than 2-week intervals per chemotherapy cycle.
Contraindications
- History of hypersensitivity reaction to dronabinol
- History of hypersensitivity reaction to alcohol
- Concurrent or recent use of disulfiram- or metronidazole-containing products within 14 days
- Concomitant use with CYP2D6 substrates with a narrow therapeutic index such as thioridazine and pimozide, due to risk of QT prolongation and Torsades de Pointes
- Pediatric patients less than 2 years of age due to risk of irreversible impairment of sexual development and fertility
Adverse Reactions
Most common (>=3%) abdominal pain, dizziness, euphoria, nausea, paranoid reaction, somnolence, thinking abnormal, vomiting
Serious neuropsychiatric adverse reactions, hemodynamic instability, seizures, paradoxical nausea/vomiting/abdominal pain, toxicity in preterm neonates
Postmarketing fatigue, hypersensitivity reactions (lip swelling, hives, rash), fall, seizures, disorientation, movement disorder, loss of consciousness, delirium, insomnia, panic attack, syncope
Most common (>=3%) Neutropenia, decreased appetite, dizziness, hiccups, dyspepsia, urinary tract infection, stomatitis, abdominal pain, anemia
Pharmacology
Dronabinol is an orally active cannabinoid that exerts complex effects on the CNS, including central sympathomimetic activity, mediated through cannabinoid receptors in neural tissues.
Rolapitant is a selective and competitive antagonist of human substance P/NK1 receptors; it does not have significant affinity for NK2 or NK3 receptors or other receptors, transporters, enzymes, or ion channels, and is active in animal models of chemotherapy-induced emesis.
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Most Common Insurance
Anthem BCBS
Syndros
- Covered on 5 commercial plans
- PA (5/12) · Step Therapy (6/12) · Qty limit (9/12)
Varubi
- Covered on 5 commercial plans
- PA (5/12) · Step Therapy (2/12) · Qty limit (9/12)
UnitedHealthcare
Syndros
- Covered on 4 commercial plans
- PA (4/8) · Step Therapy (0/8) · Qty limit (0/8)
Varubi
- Covered on 4 commercial plans
- PA (1/8) · Step Therapy (0/8) · Qty limit (2/8)
Humana
Syndros
- Covered on 0 commercial plans
- PA (0/3) · Step Therapy (0/3) · Qty limit (0/3)
Varubi
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (0/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
Cost estimate not availableHealthWell: Chemotherapy Induced Nausea or Vomiting - Medicare Access
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
No savings programs available for Varubi.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.