| Heart failure
Inpefa vs Samsca
Side-by-side clinical, coverage, and cost comparison for heart failure.Deep comparison between: Inpefa vs Samsca 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 signalsSamsca has a higher rate of injection site reactions vs Inpefa based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Samsca but not Inpefa, including UnitedHealthcare
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Category
Inpefa
Samsca
At A Glance
Oral
Daily
SGLT1/SGLT2 inhibitor
Oral
Daily
Vasopressin V2-receptor antagonist
Indications
- Heart failure
- Diabetes Mellitus, Non-Insulin-Dependent
- Chronic Kidney Diseases
- Hyponatremia
- Heart failure
- Inappropriate ADH Syndrome
Dosing
Heart failure, Diabetes Mellitus, Non-Insulin-Dependent, Chronic Kidney Diseases 200 mg orally once daily, not more than one hour before the first meal; titrate after at least 2 weeks to 400 mg once daily as tolerated; down-titrate to 200 mg as necessary.
Hyponatremia, Heart failure, Inappropriate ADH Syndrome Start at 15 mg once daily; titrate at intervals >=24 hours to 30 mg once daily, then to a maximum of 60 mg once daily as needed; initiate and re-initiate in a hospital; do not administer for more than 30 days.
Contraindications
- History of serious hypersensitivity reaction to INPEFA
- Autosomal dominant polycystic kidney disease (ADPKD) outside of FDA-approved REMS
- Unable to sense or respond to thirst
- Hypovolemic hyponatremia
- Concomitant use of strong CYP3A inhibitors
- Anuria
- Hypersensitivity to tolvaptan or any components of the product
Adverse Reactions
Most common (>=2%) Urinary tract infection, volume depletion, diarrhea, hypoglycemia, dizziness, genital mycotic infection
Serious Diabetic ketoacidosis, volume depletion, urosepsis, pyelonephritis, hypoglycemia with insulin and insulin secretagogues, necrotizing fasciitis of the perineum, genital mycotic infections
Most common (>=5%) Thirst, dry mouth, asthenia, constipation, pollakiuria or polyuria, hyperglycemia
Serious Disseminated intravascular coagulation, intracardiac thrombus, ventricular fibrillation, ischemic colitis, diabetic ketoacidosis, rhabdomyolysis, cerebrovascular accident, pulmonary embolism, respiratory failure, deep vein thrombosis
Postmarketing Osmotic demyelination syndrome, hypernatremia, hypersensitivity reactions including anaphylactic shock and generalized rash
Pharmacology
Sotagliflozin is a dual inhibitor of SGLT2 and SGLT1; SGLT2 inhibition reduces renal reabsorption of glucose and sodium (lowering cardiac pre- and afterload and downregulating sympathetic activity), while SGLT1 inhibition reduces intestinal absorption of glucose and sodium.
Tolvaptan is a selective vasopressin V2-receptor antagonist that blocks vasopressin's renal effect, promoting free water excretion (aquaresis) and raising serum sodium concentrations without significantly affecting urinary sodium or potassium excretion.
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Most Common Insurance
Anthem BCBS
Inpefa
- Covered on 5 commercial plans
- PA (9/12) · Step Therapy (9/12) · Qty limit (10/12)
Samsca
- Covered on 5 commercial plans
- PA (9/12) · Step Therapy (0/12) · Qty limit (9/12)
UnitedHealthcare
Inpefa
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Samsca
- Covered on 4 commercial plans
- PA (1/8) · Step Therapy (0/8) · Qty limit (1/8)
Humana
Inpefa
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (2/3) · Qty limit (3/3)
Samsca
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (2/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
$10/fillfill
Inpefa Savings Card ProgramCommercial or private insurance
Medicare, Medicaid, VA, TRICARE
$0
Otsuka Patient Assistance Foundation (OPAF)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.