| Lennox-Gastaut Syndrome
Qudexy XR vs Onfi
Side-by-side clinical, coverage, and cost comparison for lennox-gastaut syndrome.Deep comparison between: Qudexy 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 Qudexy based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Onfi but not Qudexy, including UnitedHealthcare
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Category
Qudexy
Onfi
At A Glance
Oral
Once daily
Broad-spectrum anticonvulsant
Oral
Once or twice daily
Benzodiazepine
Indications
- Seizures, Focal
- Generalized seizures
- Lennox-Gastaut syndrome
- Migraine Disorders
- 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.
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 reaction to topiramate, QUDEXY XR, or any inactive ingredient
- History of hypersensitivity to clobazam or any of its ingredients
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 (>=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
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.
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
Qudexy
- Covered on 5 commercial plans
- PA (7/12) · Step Therapy (0/12) · Qty limit (0/12)
Onfi
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (1/12) · Qty limit (9/12)
UnitedHealthcare
Qudexy
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Onfi
- Covered on 4 commercial plans
- PA (5/8) · Step Therapy (4/8) · Qty limit (1/8)
Humana
Qudexy
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (0/3) · 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
No savings programs available for Qudexy.
$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.