| Leukemia, Myelocytic, Acute
Trisenox vs Onureg
Side-by-side clinical, coverage, and cost comparison for leukemia, myelocytic, acute.Deep comparison between: Trisenox vs Onureg 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 signalsOnureg has a higher rate of injection site reactions vs Trisenox based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Onureg but not Trisenox, including UnitedHealthcare
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Category
Trisenox
Onureg
At A Glance
Intravenous
Daily
Arsenical antineoplastic
Oral
Once daily, Days 1-14 of 28-day cycle
DNA methyltransferase inhibitor
Indications
- Leukemia, Myelocytic, Acute
- Leukemia, Myelocytic, Acute
Dosing
Acute Promyelocytic Leukemia (newly-diagnosed low-risk) Induction: 0.15 mg/kg/day IV daily in combination with tretinoin until bone marrow remission, not to exceed 60 days. Consolidation: 0.15 mg/kg/day IV daily for 5 days per week during weeks 1-4 of each 8-week cycle for 4 cycles in combination with tretinoin.
Acute Promyelocytic Leukemia (relapsed or refractory) Induction: 0.15 mg/kg/day IV daily until bone marrow remission, not to exceed 60 days. Consolidation: 0.15 mg/kg/day IV daily for 25 doses over a period of up to 5 weeks, beginning 3 to 6 weeks after completion of induction.
Leukemia, Myelocytic, Acute 300 mg orally once daily on Days 1 through 14 of each 28-day cycle; continue until disease progression or unacceptable toxicity.
Contraindications
- Hypersensitivity to arsenic
- Known severe hypersensitivity to azacitidine or its components
Adverse Reactions
Most common (>=30%) Nausea, cough, fatigue, pyrexia, headache, abdominal pain, vomiting, tachycardia, diarrhea, dyspnea, hypokalemia, leukocytosis, hyperglycemia, hypomagnesemia, insomnia, dermatitis, edema, QTc prolongation, rigors, sore throat, arthralgia, paresthesia, pruritus
Serious Differentiation syndrome, cardiac conduction abnormalities, QTc prolongation, encephalopathy, hepatotoxicity, hyperleukocytosis, atrial dysrhythmias, hyperglycemia
Postmarketing Ventricular tachycardia, torsade de pointes, atrioventricular block, congestive heart failure, deafness, pancytopenia, bone marrow necrosis, peripheral neuropathy, seizures, confusion, encephalopathy, Wernicke's encephalopathy, posterior reversible encephalopathy syndrome, toxic epidermal necrolysis, rhabdomyolysis, melanoma, pancreatic cancer, squamous cell carcinoma
Most common (>=10%) Nausea, vomiting, diarrhea, fatigue/asthenia, constipation, upper respiratory tract infection, pneumonia, abdominal pain, arthralgia, decreased appetite, febrile neutropenia, dizziness, skin infection, pain in extremity
Serious Pneumonia, febrile neutropenia, sepsis (including 1 fatal case)
Postmarketing Hypersensitivity reaction, interstitial lung disease, tumor lysis syndrome, Sweet's syndrome (acute febrile neutrophilic dermatosis), necrotizing fasciitis (including fatal cases), differentiation syndrome
Pharmacology
The mechanism of action is not completely understood. Arsenic trioxide causes morphological changes and DNA fragmentation characteristic of apoptosis in promyelocytic leukemia cells and causes damage or degradation of the PML-RAR-alpha fusion protein.
Azacitidine is a pyrimidine nucleoside analog of cytidine that inhibits DNA/RNA methyltransferases; incorporation into DNA reduces methylation and alters gene expression, while incorporation into RNA reduces RNA methylation and protein synthesis, inducing apoptosis in AML cells.
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Trisenox
- Covered on 5 commercial plans
- PA (9/12) · Step Therapy (0/12) · Qty limit (0/12)
Onureg
- Covered on 5 commercial plans
- PA (11/12) · Step Therapy (0/12) · Qty limit (12/12)
UnitedHealthcare
Trisenox
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Onureg
- Covered on 4 commercial plans
- PA (6/8) · Step Therapy (0/8) · Qty limit (2/8)
Humana
Trisenox
- Covered on 0 commercial plans
- PA (2/3) · Step Therapy (0/3) · Qty limit (0/3)
Onureg
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (2/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
Cost estimate not availableHealthWell: Acute Myeloid Leukemia
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
Cost estimate not availableAccessia Health: Myelodysplastic Syndromes - Private Insurance: Waitlist
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.