| Lennox-Gastaut Syndrome
Epidiolex vs Onfi
Side-by-side clinical, coverage, and cost comparison for lennox-gastaut syndrome.Deep comparison between: Epidiolex vs Onfi 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 signalsOnfi has a higher rate of injection site reactions vs Epidiolex based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Onfi but not Epidiolex, including UnitedHealthcare
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Category
Epidiolex
Onfi
At A Glance
Oral
Twice daily
Cannabinoid antiepileptic
Oral
Once or twice daily
Benzodiazepine
Indications
- Lennox-Gastaut syndrome
- Infantile Severe Myoclonic Epilepsy
- Tuberous Sclerosis
- Lennox-Gastaut syndrome
Dosing
Lennox-Gastaut syndrome, Infantile Severe Myoclonic Epilepsy Starting 2.5 mg/kg orally twice daily (5 mg/kg/day); increase after 1 week to maintenance 5 mg/kg twice daily (10 mg/kg/day); may increase up to maximum 10 mg/kg twice daily (20 mg/kg/day) in weekly increments based on response and tolerability.
Tuberous Sclerosis Starting 2.5 mg/kg orally twice daily (5 mg/kg/day); increase weekly by 2.5 mg/kg twice daily (5 mg/kg/day) as tolerated to recommended maintenance 12.5 mg/kg twice daily (25 mg/kg/day).
Lennox-Gastaut syndrome Weight-based oral dosing: <=30 kg start at 5 mg/day titrated to 20 mg/day; >30 kg start at 10 mg/day titrated to 40 mg/day; doses >5 mg/day given in two divided doses twice daily; escalate no faster than weekly.
Contraindications
- History of hypersensitivity to cannabidiol or any excipient in EPIDIOLEX
- History of hypersensitivity to clobazam or any of its ingredients
Adverse Reactions
Most common (>=10%) Somnolence, decreased appetite, diarrhea, transaminase elevations, fatigue, malaise, asthenia, rash, insomnia, pyrexia, vomiting
Serious Hepatic injury, somnolence and sedation, suicidal behavior and ideation, hypersensitivity reactions
Most common (>=5%) Somnolence or sedation, pyrexia, upper respiratory tract infection, lethargy, drooling, aggression, vomiting, irritability, insomnia, fatigue, cough
Serious Serious dermatological reactions, DRESS/multiorgan hypersensitivity, respiratory depression with opioids, dependence and withdrawal reactions, suicidal behavior and ideation, neonatal sedation and withdrawal syndrome
Postmarketing Anemia, eosinophilia, leukopenia, thrombocytopenia, diplopia, blurred vision, abdominal distention, hypothermia, elevated hepatic enzymes, muscle spasms, agitation, anxiety, confusional state, depression, hallucination, urinary retention, respiratory depression, rash, urticaria, angioedema
Pharmacology
Cannabidiol is a phytocannabinoid antiepileptic; its precise mechanisms of anticonvulsant action in humans are unknown and do not appear to involve interaction with cannabinoid receptors.
Clobazam is a 1,5-benzodiazepine whose exact mechanism is not fully understood but is thought to involve potentiation of GABAergic neurotransmission through binding at the benzodiazepine site of the GABA-A receptor.
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Most Common Insurance
Anthem BCBS
Epidiolex
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (12/12) · Qty limit (0/12)
Onfi
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (1/12) · Qty limit (9/12)
UnitedHealthcare
Epidiolex
- Covered on 4 commercial plans
- PA (7/8) · Step Therapy (6/8) · Qty limit (0/8)
Onfi
- Covered on 4 commercial plans
- PA (5/8) · Step Therapy (4/8) · Qty limit (1/8)
Humana
Epidiolex
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (0/3)
Onfi
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (1/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
Cost estimate not availableAssistance Fund: Epilepsy (Seizures): Waitlist
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
$10/fillfill
Onfi Copay Savings ProgramCommercial or private insurance
Medicare, Medicaid, VA, TRICARE
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EpidiolexView full Epidiolex profile
Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.