| Huntington Disease
Austedo XR vs Xenazine
Side-by-side clinical, coverage, and cost comparison for huntington disease.Deep comparison between: Austedo vs Xenazine 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 signalsXenazine has a higher rate of injection site reactions vs Austedo based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Xenazine but not Austedo, including UnitedHealthcare
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Category
Austedo
Xenazine
At A Glance
Oral
Once or twice daily
VMAT2 inhibitor
Oral
Up to 3 times daily
VMAT2 inhibitor
Indications
- Huntington Disease
- Tardive Dyskinesia
- Huntington Disease
Dosing
Huntington Disease, Tardive Dyskinesia Starting dose 12 mg/day (AUSTEDO XR: 12 mg once daily; AUSTEDO: 6 mg twice daily); titrate weekly in 6 mg/day increments to a maximum of 48 mg/day; do not exceed 36 mg/day with strong CYP2D6 inhibitors or in poor CYP2D6 metabolizers.
Huntington Disease Start at 12.5 mg/day once in the morning; increase to 25 mg/day (12.5 mg twice daily) after 1 week, then titrate by 12.5 mg/day at weekly intervals; doses of 37.5-50 mg/day given in a three times daily regimen (max single dose 25 mg); doses above 50 mg/day require CYP2D6 genotyping -- EMs/IMs may titrate to max 100 mg/day (max single dose 37.5 mg), PMs must not exceed 50 mg/day (max single dose 25 mg); oral, without regard to food.
Contraindications
- Huntington's disease with suicidality, or untreated or inadequately treated depression
- Hepatic impairment
- Concomitant reserpine; at least 20 days must elapse after stopping reserpine before initiating AUSTEDO XR or AUSTEDO
- Concomitant MAOI use, or within 14 days of discontinuing an MAOI
- Concomitant tetrabenazine or valbenazine use
- Active suicidality or untreated/inadequately treated depression
- Hepatic impairment
- Concurrent use of MAOIs or use within 14 days of MAOI discontinuation
- Concurrent use of reserpine (at least 20 days must elapse after stopping reserpine before starting XENAZINE)
- Concurrent use of deutetrabenazine or valbenazine
Adverse Reactions
Most common in Huntington Disease (>8%) somnolence, diarrhea, dry mouth, fatigue
Most common in Tardive Dyskinesia (>3%) nasopharyngitis, insomnia
Serious depression and suicidality in HD patients, QTc prolongation, neuroleptic malignant syndrome, akathisia/agitation/restlessness, parkinsonism, sedation and somnolence, hyperprolactinemia
Most common (>=10%) Sedation/somnolence, fatigue, insomnia, depression, akathisia, anxiety, nausea
Serious Depression and suicidality, neuroleptic malignant syndrome, akathisia/restlessness/agitation, parkinsonism, sedation and somnolence, QTc prolongation, hypotension and orthostatic hypotension, hyperprolactinemia
Postmarketing Tremor, confusion, worsening aggression, pneumonia, hyperhidrosis, skin rash
Pharmacology
Deutetrabenazine is a reversible vesicular monoamine transporter 2 (VMAT2) inhibitor; its active metabolites (alpha-HTBZ and beta-HTBZ) deplete monoamine stores by inhibiting uptake of dopamine, serotonin, norepinephrine, and histamine into synaptic vesicles, with the precise mechanism in treating tardive dyskinesia and Huntington's chorea believed related to this monoamine-depleting effect.
VMAT2 inhibitor; tetrabenazine reversibly inhibits human vesicular monoamine transporter type 2 (VMAT2; Ki approximately 100 nM), depleting monoamines (dopamine, serotonin, norepinephrine, histamine) from nerve terminals, which is believed to underlie its anti-chorea effect in Huntington's disease.
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Most Common Insurance
Anthem BCBS
Austedo
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (0/12) · Qty limit (11/12)
Xenazine
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (9/12) · Qty limit (9/12)
UnitedHealthcare
Austedo
- Covered on 4 commercial plans
- PA (5/8) · Step Therapy (0/8) · Qty limit (5/8)
Xenazine
- Covered on 4 commercial plans
- PA (2/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Austedo
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (1/3) · Qty limit (3/3)
Xenazine
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (2/3) · Qty limit (2/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
Cost estimate not availableHealthWell: Huntington's Disease - Medicare Access
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
$10/momo
Xenazine Copay Assistance ProgramCommercial or private insurance
Medicare, Medicaid, VA, TRICARE
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AustedoView full Austedo profile
XenazineView full Xenazine profile
Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.