| Human immunodeficiency virus I infection
Norvir vs Sunlenca
Side-by-side clinical, coverage, and cost comparison for human immunodeficiency virus i infection.Deep comparison between: Norvir vs Sunlenca 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 signalsSunlenca has a higher rate of injection site reactions vs Norvir based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Sunlenca but not Norvir, including UnitedHealthcare
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Category
Norvir
Sunlenca
At A Glance
Oral
Twice daily
HIV protease inhibitor
SC injection
Every 6 months
HIV-1 capsid inhibitor
Indications
- Human immunodeficiency virus I infection
- Human immunodeficiency virus I infection
Dosing
Human immunodeficiency virus I infection (Adults) 600 mg twice daily by mouth with meals; initiate at 300 mg twice daily and increase by 100 mg q2-3 days to minimize adverse events.
Human immunodeficiency virus I infection (Pediatrics >1 month) 350-400 mg/m2 twice daily by mouth with meals, not to exceed 600 mg twice daily; initiate at 250 mg/m2 twice daily and increase by 50 mg/m2 q2-3 days.
Human immunodeficiency virus I infection (Initiation Option 1) Day 1: 927 mg SC injection (2 x 1.5 mL) plus 600 mg oral (2 x 300 mg tablets); Day 2: 600 mg oral (2 x 300 mg tablets); then 927 mg SC every 6 months (26 weeks) for maintenance.
Human immunodeficiency virus I infection (Initiation Option 2) Days 1 and 2: 600 mg oral (2 x 300 mg tablets); Day 8: 300 mg oral (1 x 300 mg tablet); Day 15: 927 mg SC injection (2 x 1.5 mL); then 927 mg SC every 6 months (26 weeks) for maintenance.
Contraindications
- Known hypersensitivity (e.g., TEN or Stevens-Johnson syndrome) to ritonavir or any excipient
- Co-administration with drugs highly dependent on CYP3A for clearance with potential for serious or life-threatening reactions: alfuzosin, ranolazine, amiodarone, dronedarone, flecainide, propafenone, quinidine, voriconazole, colchicine (renal/hepatic impairment), lurasidone, pimozide, dihydroergotamine, ergotamine, methylergonovine, cisapride, lovastatin, simvastatin, lomitapide, sildenafil (Revatio for PAH), triazolam, oral midazolam
- Co-administration with potent CYP3A inducers associated with potential loss of virologic response: apalutamide, St. John's Wort (hypericum perforatum)
- Concomitant use of strong CYP3A inducers
Adverse Reactions
Most common (>=1%) Diarrhea, nausea, vomiting, abdominal pain, paresthesia (including oral), rash, fatigue/asthenia, dysgeusia, coughing, arthralgia, back pain, dizziness, pruritus, myalgia, flushing, hypertriglyceridemia, peripheral neuropathy, oropharyngeal pain
Serious Hepatotoxicity, pancreatitis, allergic reactions/hypersensitivity
Postmarketing Dehydration, AV block (first-, second-, third-degree), right bundle branch block, Cushing's syndrome, adrenal suppression, seizure, nephrolithiasis, toxic epidermal necrolysis
Most common (>=3%) Injection site reactions, nausea
Serious Grade 3 injection site reactions (erythema, pain, swelling)
Postmarketing Injection site necrosis
Pharmacology
Ritonavir is a peptidomimetic inhibitor of the HIV-1 protease that renders the enzyme incapable of processing the Gag-Pol polyprotein precursor, leading to production of non-infectious immature HIV particles; it also potently inhibits CYP3A and, to a lesser extent, CYP2D6, significantly affecting plasma concentrations of many co-administered drugs.
Lenacapavir is a multistage, selective HIV-1 capsid inhibitor that directly binds to capsid protein (p24) subunits in hexamers, inhibiting multiple essential steps of the viral lifecycle including capsid-mediated nuclear uptake of proviral DNA, virus assembly and release, and capsid core formation.
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Most Common Insurance
Anthem BCBS
Norvir
- Covered on 5 commercial plans
- PA (9/12) · Step Therapy (0/12) · Qty limit (9/12)
Sunlenca
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (9/12) · Qty limit (11/12)
UnitedHealthcare
Norvir
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (1/8)
Sunlenca
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Norvir
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (1/3) · Qty limit (2/3)
Sunlenca
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (0/3) · Qty limit (3/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
Cost estimate not availableGood Days: HIV, AIDS Treatment & Prevention
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
$0/fillfill
Gilead Advancing Access Co-Pay Program: SunlencaCommercial or private insurance
Medicare, Medicaid, VA, TRICARE
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.