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