| Hormone refractory prostate cancer
Nubeqa vs Xtandi
Side-by-side clinical, coverage, and cost comparison for hormone refractory prostate cancer.Deep comparison between: Nubeqa vs Xtandi 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 signalsXtandi has a higher rate of injection site reactions vs Nubeqa based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Xtandi but not Nubeqa, including UnitedHealthcare
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Category
Nubeqa
Xtandi
At A Glance
Oral
Twice daily
Androgen receptor inhibitor
Oral
Once daily
Androgen receptor inhibitor
Indications
- Hormone refractory prostate cancer
- Metastatic Castration-Sensitive Prostate Carcinoma
- Hormone refractory prostate cancer
- Metastatic Castration-Sensitive Prostate Carcinoma
- Nonmetastatic Castration-Sensitive Prostate Carcinoma
Dosing
Hormone refractory prostate cancer 600 mg (two 300 mg tablets) orally twice daily with food; continue until disease progression or unacceptable toxicity.
Metastatic Castration-Sensitive Prostate Carcinoma 600 mg (two 300 mg tablets) orally twice daily with food; when used with docetaxel for mCSPC, administer first of 6 cycles of docetaxel within 6 weeks of starting NUBEQA; continue NUBEQA until disease progression or unacceptable toxicity.
Hormone refractory prostate cancer, Metastatic Castration-Sensitive Prostate Carcinoma 160 mg orally once daily until disease progression or unacceptable toxicity; concurrent GnRH analog or prior bilateral orchiectomy required.
Nonmetastatic Castration-Sensitive Prostate Carcinoma 160 mg orally once daily until disease progression or unacceptable toxicity; GnRH analog may be given with or without XTANDI.
Contraindications
—
—
Adverse Reactions
Most common (>=10%) Increased AST, decreased neutrophil count, increased bilirubin, fatigue, increased ALT (nmCRPC and mCSPC); constipation, rash, decreased appetite, hemorrhage, increased weight, hypertension (mCSPC with docetaxel).
Serious Febrile neutropenia (6%), decreased neutrophil count (2.8%), musculoskeletal pain (2.6%), pneumonia (2.6%), urinary retention, hematuria, arrhythmias, spinal cord compression, ischemic heart disease, heart failure.
Postmarketing COVID-19/COVID-19 pneumonia, myocardial infarction, sudden death, seizures, drug-induced liver injury.
Most common (>=10%) Musculoskeletal pain, fatigue, hot flush, constipation, decreased appetite, diarrhea, hypertension, hemorrhage, fall, fracture, headache
Serious Seizure, posterior reversible encephalopathy syndrome, hypersensitivity, ischemic heart disease, falls and fractures
Postmarketing Vomiting, dysphagia, hypersensitivity (edema of face, tongue, lip, or pharynx), posterior reversible encephalopathy syndrome, dysgeusia, rash, severe cutaneous adverse reactions (Stevens-Johnson syndrome, erythema multiforme, toxic epidermal necrolysis, DRESS, acute generalized exanthematous pustulosis)
Pharmacology
Darolutamide is an androgen receptor (AR) inhibitor that competitively inhibits androgen binding, AR nuclear translocation, and AR-mediated transcription. The major metabolite ketodarolutamide exhibits similar in vitro activity and decreased prostate cancer cell proliferation in vitro and tumor volume in xenograft models.
Enzalutamide is an androgen receptor inhibitor that competitively inhibits androgen binding to androgen receptors and consequently inhibits nuclear translocation of androgen receptors and their interaction with DNA; its major metabolite, N-desmethyl enzalutamide, exhibits similar in vitro activity.
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Nubeqa
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (0/12) · Qty limit (11/12)
Xtandi
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (0/12) · Qty limit (12/12)
UnitedHealthcare
Nubeqa
- Covered on 4 commercial plans
- PA (8/8) · Step Therapy (0/8) · Qty limit (7/8)
Xtandi
- Covered on 4 commercial plans
- PA (6/8) · Step Therapy (0/8) · Qty limit (5/8)
Humana
Nubeqa
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (2/3)
Xtandi
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (2/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
Cost estimate not availableAssistance Fund: Prostate Cancer
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
Cost estimate not availableAssistance Fund: Prostate Cancer
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.