| Lennox-Gastaut Syndrome
Qudexy XR vs Fintepla
Side-by-side clinical, coverage, and cost comparison for lennox-gastaut syndrome.Deep comparison between: Qudexy vs Fintepla 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 signalsFintepla has a higher rate of injection site reactions vs Qudexy based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Fintepla but not Qudexy, including UnitedHealthcare
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Category
Qudexy
Fintepla
At A Glance
Oral
Once daily
Broad-spectrum anticonvulsant
Oral
Twice daily
5-HT2 receptor agonist
Indications
- Seizures, Focal
- Generalized seizures
- Lennox-Gastaut syndrome
- Migraine Disorders
- Infantile Severe Myoclonic Epilepsy
- Lennox-Gastaut syndrome
Dosing
Seizures, Focal, Generalized seizures, Lennox-Gastaut syndrome Monotherapy (adults and peds >=10 years): 400 mg orally once daily, titrated over 6 weeks from 50 mg/day; peds 2-9 years: weight-based 150-400 mg/day once daily. Adjunctive (adults): 200 to 400 mg once daily; adjunctive (peds 2-16 years): approximately 5 to 9 mg/kg once daily, not to exceed 400 mg/day.
Migraine Disorders 100 mg orally once daily for patients 12 years of age and older, titrated over 4 weeks from 25 mg/day.
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).
Contraindications
- History of hypersensitivity reaction to topiramate, QUDEXY XR, or any inactive ingredient
- Hypersensitivity to fenfluramine or any of the excipients in FINTEPLA
- Concomitant use, or within 14 days of administration, of monoamine oxidase inhibitors
Adverse Reactions
Most common (>=10%) Paresthesia, somnolence, dizziness, weight loss, anorexia, speech disorders/related speech problems, psychomotor slowing, nervousness, vision abnormal
Serious Acute myopia and secondary angle closure glaucoma, visual field defects, oligohydrosis and hyperthermia, metabolic acidosis, suicidal behavior and ideation, cognitive/neuropsychiatric adverse reactions, decrease in bone mineral density, negative effects on growth, DRESS/multiorgan hypersensitivity, serious skin reactions, anaphylaxis and angioedema, hyperammonemia and encephalopathy, kidney stones, hypothermia with concomitant valproic acid
Postmarketing Hepatic failure, hepatitis, pancreatitis, bullous skin reactions (Stevens-Johnson syndrome, toxic epidermal necrolysis), pemphigus, maculopathy, nephrocalcinosis
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
Pharmacology
Topiramate blocks voltage-dependent sodium channels, augments GABA-A receptor activity, antagonizes the AMPA/kainate subtype of the glutamate receptor, and inhibits carbonic anhydrase isozymes II and IV; the precise mechanisms underlying its anticonvulsant and preventive migraine effects are unknown.
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.
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Most Common Insurance
Anthem BCBS
Qudexy
- Covered on 5 commercial plans
- PA (7/12) · Step Therapy (0/12) · Qty limit (0/12)
Fintepla
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (11/12) · Qty limit (9/12)
UnitedHealthcare
Qudexy
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Fintepla
- Covered on 4 commercial plans
- PA (6/8) · Step Therapy (4/8) · Qty limit (2/8)
Humana
Qudexy
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (0/3) · Qty limit (0/3)
Fintepla
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (2/3) · Qty limit (3/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Qudexy.
$25
ONWARD Copay Assistance Program: FinteplaCommercial or private insurance
Medicare, Medicaid, VA, TRICARE
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.