| Leukemia, Myelocytic, Acute
Venclexta vs Nivestym
Side-by-side clinical, coverage, and cost comparison for leukemia, myelocytic, acute.Deep comparison between: Venclexta vs Nivestym 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 signalsNivestym has a higher rate of injection site reactions vs Venclexta based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Nivestym but not Venclexta, including UnitedHealthcare
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Category
Venclexta
Nivestym
At A Glance
Oral
Once daily
BCL-2 inhibitor
SC injection or IV infusion
Daily
G-CSF analog
Indications
- Chronic Lymphocytic Leukemia
- Small Lymphocytic Lymphoma
- Leukemia, Myelocytic, Acute
- Leukemia, Myelocytic, Acute
- Severe congenital neutropenia
- Cyclic neutropenia
- Idiopathic neutropenia
Dosing
Chronic Lymphocytic Leukemia, Small Lymphocytic Lymphoma 5-week ramp-up starting at 20 mg, increasing to 400 mg orally once daily; used as monotherapy or in combination with acalabrutinib, obinutuzumab, or rituximab.
Leukemia, Myelocytic, Acute 3- or 4-day ramp-up to 400 mg orally once daily in combination with azacitidine or decitabine, or 600 mg orally once daily in combination with low-dose cytarabine, each in 28-day cycles.
Cancer receiving myelosuppressive chemotherapy, Leukemia, Myelocytic, Acute 5 mcg/kg/day SC injection, short IV infusion (15-30 min), or continuous IV infusion; administer at least 24 hours after cytotoxic chemotherapy; continue daily for up to 2 weeks or until ANC reaches 10,000/mm3 after the expected nadir.
Cancer undergoing bone marrow transplantation 10 mcg/kg/day IV infusion no longer than 24 hours; administer first dose at least 24 hours after cytotoxic chemotherapy and at least 24 hours after bone marrow infusion; titrate against neutrophil response per dosage adjustment table.
Autologous peripheral blood progenitor cell mobilization 10 mcg/kg/day SC injection; administer at least 4 days before first leukapheresis and continue until last leukapheresis; discontinue if WBC rises above 100,000/mm3.
Severe congenital neutropenia 6 mcg/kg SC injection twice daily; individualize based on clinical course and ANC with chronic daily administration.
Cyclic neutropenia, Idiopathic neutropenia 5 mcg/kg SC injection once daily; individualize based on clinical course and ANC with chronic daily administration.
Contraindications
- Concomitant use with strong CYP3A inhibitors at initiation and during the ramp-up phase in patients with Chronic Lymphocytic Leukemia or Small Lymphocytic Lymphoma due to increased risk of tumor lysis syndrome
- History of serious allergic reactions to human granulocyte colony-stimulating factors such as filgrastim products or pegfilgrastim products
Adverse Reactions
Most common (>=20%) in CLL/SLL Neutropenia, thrombocytopenia, anemia, diarrhea, nausea, upper respiratory tract infection, cough, musculoskeletal pain, fatigue, edema
Most common (>=30%) in AML Nausea, diarrhea, thrombocytopenia, constipation, neutropenia, febrile neutropenia, fatigue, vomiting, edema, pyrexia, pneumonia, dyspnea, hemorrhage, anemia, rash, abdominal pain, sepsis, musculoskeletal pain, dizziness, cough, oropharyngeal pain, hypotension
Serious Tumor lysis syndrome, febrile neutropenia, pneumonia, sepsis, hemorrhage
Most common (>=5% higher incidence vs placebo) Pyrexia, nausea, fatigue, thrombocytopenia, back pain, bone pain, rash, dizziness, dyspnea, cough, chest pain, arthralgia, pain in extremity, increased blood alkaline phosphatase, increased blood lactate dehydrogenase
Serious Splenic rupture, acute respiratory distress syndrome, serious allergic reactions, sickle cell disorders, glomerulonephritis, alveolar hemorrhage and hemoptysis, capillary leak syndrome, myelodysplastic syndrome, acute myeloid leukemia, thrombocytopenia, leukocytosis, cutaneous vasculitis, aortitis
Postmarketing Anaphylaxis, splenomegaly, Sweet's syndrome, decreased bone density and osteoporosis (pediatric chronic use), extramedullary hematopoiesis
Pharmacology
BCL-2 inhibitor; venetoclax is a selective, orally bioavailable small-molecule that restores apoptosis by binding directly to the BCL-2 protein, displacing pro-apoptotic proteins like BIM and triggering mitochondrial outer membrane permeabilization and activation of caspases.
Filgrastim-aafi is a recombinant G-CSF analog that binds to specific cell surface receptors on hematopoietic cells, stimulating neutrophil progenitor proliferation, differentiation, and end-cell functional activation; its activity is selective for the neutrophil lineage with minimal effects on other hematopoietic cell types.
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Venclexta
- Covered on 5 commercial plans
- PA (11/12) · Step Therapy (9/12) · Qty limit (11/12)
Nivestym
- Covered on 5 commercial plans
- PA (11/12) · Step Therapy (7/12) · Qty limit (0/12)
UnitedHealthcare
Venclexta
- Covered on 4 commercial plans
- PA (8/8) · Step Therapy (0/8) · Qty limit (8/8)
Nivestym
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Venclexta
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (2/3)
Nivestym
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (1/3) · Qty limit (1/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Venclexta.
Cost estimate not availableAssistance Fund: Acute Myeloid Leukemia
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.