| Lennox-Gastaut Syndrome
Trokendi XR vs Fintepla
Side-by-side clinical, coverage, and cost comparison for lennox-gastaut syndrome.Deep comparison between: Trokendi Xr 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 Trokendi Xr based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Fintepla but not Trokendi Xr, including UnitedHealthcare
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Category
Trokendi Xr
Fintepla
At A Glance
Oral
Once daily
Anticonvulsant; carbonic anhydrase inhibitor
Oral
Twice daily
5-HT2 receptor agonist
Indications
- Lennox-Gastaut Syndrome
- Migraine Disorders
- Infantile Severe Myoclonic Epilepsy
- Lennox-Gastaut syndrome
Dosing
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).
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
- 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)
- 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, 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
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 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.
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
Trokendi Xr
- Covered on 5 commercial plans
- PA (5/12) · Step Therapy (0/12) · Qty limit (9/12)
Fintepla
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (11/12) · Qty limit (9/12)
UnitedHealthcare
Trokendi Xr
- Covered on 4 commercial plans
- PA (1/8) · 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
Trokendi Xr
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (0/3) · Qty limit (3/3)
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 Trokendi Xr.
$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.