| Lennox-Gastaut Syndrome
Fintepla vs Onfi
Side-by-side clinical, coverage, and cost comparison for lennox-gastaut syndrome.Deep comparison between: Fintepla 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 Fintepla based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Onfi but not Fintepla, including UnitedHealthcare
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Category
Fintepla
Onfi
At A Glance
Oral
Twice daily
5-HT2 receptor agonist
Oral
Once or twice daily
Benzodiazepine
Indications
- Infantile Severe Myoclonic Epilepsy
- Lennox-Gastaut syndrome
- Lennox-Gastaut syndrome
Dosing
Infantile Severe Myoclonic Epilepsy, Lennox-Gastaut syndrome Initial 0.1 mg/kg twice daily orally, titrated weekly; maintenance up to 0.35 mg/kg twice daily (max 26 mg/day); with concomitant stiripentol plus clobazam, maximum 0.2 mg/kg twice daily (max 17 mg/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
- Hypersensitivity to fenfluramine or any of the excipients in FINTEPLA
- Concomitant use, or within 14 days of administration, of monoamine oxidase inhibitors
- History of hypersensitivity to clobazam or any of its ingredients
Adverse Reactions
Most common (>=10%) Decreased appetite, somnolence/sedation/lethargy, diarrhea, fatigue/malaise/asthenia, abnormal echocardiogram, ataxia/balance disorder/gait disturbance, blood pressure increased, drooling/salivary hypersecretion, pyrexia, upper respiratory tract infection, vomiting, weight decreased
Serious Valvular heart disease, pulmonary arterial hypertension, decreased appetite and decreased weight, somnolence/sedation/lethargy, suicidal behavior and ideation, serotonin syndrome, increase in blood pressure, glaucoma, status epilepticus
Postmarketing Aggression
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
Fenfluramine and its metabolite norfenfluramine exhibit agonist activity at serotonin 5-HT2 receptors; the precise mechanism by which this produces antiseizure effects in Dravet syndrome and Lennox-Gastaut syndrome is unknown, though 5-HT2B receptor agonism is associated with valvular heart disease and pulmonary arterial hypertension risk.
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
Fintepla
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (11/12) · Qty limit (9/12)
Onfi
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (1/12) · Qty limit (9/12)
UnitedHealthcare
Fintepla
- Covered on 4 commercial plans
- PA (6/8) · Step Therapy (4/8) · Qty limit (2/8)
Onfi
- Covered on 4 commercial plans
- PA (5/8) · Step Therapy (4/8) · Qty limit (1/8)
Humana
Fintepla
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (2/3) · Qty limit (3/3)
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
$25
ONWARD Copay Assistance Program: FinteplaCommercial or private insurance
Medicare, Medicaid, VA, TRICARE
$10/fillfill
Onfi Copay Savings ProgramCommercial or private insurance
Medicare, Medicaid, VA, TRICARE
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.