| Lennox-Gastaut Syndrome
Epidiolex vs Trokendi XR
Side-by-side clinical, coverage, and cost comparison for lennox-gastaut syndrome.Deep comparison between: Epidiolex vs Trokendi Xr 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 signalsTrokendi Xr has a higher rate of injection site reactions vs Epidiolex based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Trokendi Xr but not Epidiolex, including UnitedHealthcare
Sign up to reveal the full AI analysis
Category
Epidiolex
Trokendi Xr
At A Glance
Oral
Twice daily
Cannabinoid antiepileptic
Oral
Once daily
Anticonvulsant; carbonic anhydrase inhibitor
Indications
- Lennox-Gastaut syndrome
- Infantile Severe Myoclonic Epilepsy
- Tuberous Sclerosis
- Lennox-Gastaut Syndrome
- Migraine Disorders
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 Adjunctive therapy: adults (>=17 years) 200-400 mg orally once daily, initiated at 25-50 mg once daily and titrated in 25-50 mg/week increments; pediatric patients 6-16 years approximately 5-9 mg/kg/day orally once daily, initiated at 25 mg/day and titrated at 1-3 mg/kg/day every 1-2 weeks, not to exceed 400 mg/day.
Migraine Disorders Preventive treatment for patients 12 years and older: 100 mg orally once daily, titrated over 4 weeks starting at 25 mg/day (Week 1: 25 mg, Week 2: 50 mg, Week 3: 75 mg, Week 4: 100 mg).
Contraindications
- History of hypersensitivity to cannabidiol or any excipient in EPIDIOLEX
- Recent alcohol use within 6 hours prior to or 6 hours after TROKENDI XR administration
- History of hypersensitivity reaction to topiramate, TROKENDI XR, or any inactive ingredient (anaphylaxis and angioedema have occurred)
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 (>=10%) Paresthesia, weight loss, anorexia, dizziness, somnolence, nervousness, psychomotor slowing, speech disorders, vision abnormal
Serious Acute myopia and secondary angle closure glaucoma, metabolic acidosis, oligohydrosis and hyperthermia, suicidal behavior and ideation, fetal toxicity, DRESS/multiorgan hypersensitivity, serious skin reactions, anaphylaxis and angioedema, hyperammonemia and encephalopathy, decrease of bone mineral density, kidney stones
Postmarketing Hepatic failure, hepatitis, pancreatitis, Stevens-Johnson syndrome, toxic epidermal necrolysis, pemphigus, nephrocalcinosis, maculopathy, decreased INR with vitamin K antagonists
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.
Topiramate is a sulfamate-substituted monosaccharide anticonvulsant whose precise mechanism is unknown but is believed to involve blockade of voltage-dependent sodium channels, augmentation of GABA-A receptor activity, antagonism of AMPA/kainate glutamate receptors, and inhibition of carbonic anhydrase isozymes II and IV.
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Epidiolex
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (12/12) · Qty limit (0/12)
Trokendi Xr
- Covered on 5 commercial plans
- PA (5/12) · Step Therapy (0/12) · Qty limit (9/12)
UnitedHealthcare
Epidiolex
- Covered on 4 commercial plans
- PA (7/8) · Step Therapy (6/8) · Qty limit (0/8)
Trokendi Xr
- Covered on 4 commercial plans
- PA (1/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Epidiolex
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (0/3)
Trokendi Xr
- 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 availableAssistance Fund: Epilepsy (Seizures): Waitlist
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
No savings programs available for Trokendi Xr.
Compare Other Drugs
Let us handle your prior authsJust enter your patient's info and we'll:
- Verify eligibility with the payer.
- Pull the right PA forms directly from the payer.
- Submit, track & send live updates to your dashboard.
Free to start · HIPAA compliant
Next Steps for Your Patient
EpidiolexView full Epidiolex profile
Trokendi XrView full Trokendi Xr profile
Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.