| Major Depressive Disorder
Aplenzin vs Trintellix
Side-by-side clinical, coverage, and cost comparison for major depressive disorder.Deep comparison between: Aplenzin vs Trintellix 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 signalsTrintellix has a higher rate of injection site reactions vs Aplenzin based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Trintellix but not Aplenzin, including UnitedHealthcare
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Category
Aplenzin
Trintellix
At A Glance
Oral
Once daily
Norepinephrine-dopamine reuptake inhibitor
Oral
Once daily
Antidepressant
Indications
- Major Depressive Disorder
- Seasonal Affective Disorder
- Major Depressive Disorder
Dosing
Major Depressive Disorder Starting dose 174 mg once daily in the morning; after 4 days, increase to target dose of 348 mg once daily.
Seasonal Affective Disorder Starting dose 174 mg once daily; after 7 days, increase to target dose of 348 mg once daily in the morning; initiate in autumn, continue through winter, taper and discontinue in early spring.
Hepatic Impairment Moderate to severe (Child-Pugh 7-15): maximum 174 mg every other day; mild (Child-Pugh 5-6): consider reducing dose and/or frequency.
Renal Impairment Consider reducing dose and/or frequency in patients with GFR less than 90 mL/min.
Major Depressive Disorder Starting dose 10 mg once daily without regard to meals; increase to 20 mg/day as tolerated. May decrease to 5 mg/day for patients who do not tolerate higher doses. Maximum 20 mg/day (10 mg/day in CYP2D6 poor metabolizers). Taper from 15-20 mg/day to 10 mg/day for one week before discontinuation if possible.
Contraindications
- Seizure disorder
- Current or prior diagnosis of bulimia or anorexia nervosa
- Abrupt discontinuation of alcohol, benzodiazepines, barbiturates, or antiepileptic drugs
- Concomitant use or use within 14 days of an MAOI intended to treat psychiatric disorders
- Starting APLENZIN in a patient being treated with reversible MAOIs such as linezolid or intravenous methylene blue
- Known hypersensitivity to bupropion or any ingredient of APLENZIN
- Hypersensitivity to vortioxetine or any component of the formulation
- Use of MAOIs intended to treat psychiatric disorders concurrently or within 21 days of stopping TRINTELLIX
- Use within 14 days of stopping an MAOI intended to treat psychiatric disorders
- Initiation in patients being treated with linezolid or intravenous methylene blue
Adverse Reactions
Most common (>=5%) Anorexia, dry mouth, rash, sweating, tinnitus, tremor at 300 mg/day bupropion HCl SR equivalent; insomnia, headache, nausea, dizziness, constipation, anxiety also reported.
Serious Suicidal thoughts and behaviors, seizure, hypertension, activation of mania or hypomania, psychosis and other neuropsychiatric events, angle-closure glaucoma, hypersensitivity reactions including anaphylaxis and Stevens-Johnson Syndrome.
Postmarketing Stroke, complete atrioventricular block, myocardial infarction, Brugada pattern/syndrome, angioedema, DRESS, acute generalized exanthematous pustulosis, rhabdomyolysis, hepatitis, pancreatitis, aseptic meningitis.
Most common (>=5% and twice placebo) Nausea (21-32%), constipation (3-6%), vomiting (3-6%), diarrhea (7-10%), dry mouth (6-8%), dizziness (6-9%)
Serious Serotonin syndrome, increased bleeding risk, activation of mania/hypomania, angle closure glaucoma, hyponatremia, hypersensitivity reactions including anaphylaxis and angioedema
Postmarketing Hyperprolactinemia, acute pancreatitis, seizure, aggression, agitation, anger, hostility, irritability, anosmia, hyposmia, weight gain, rash, generalized rash, hyperhidrosis
Pharmacology
Bupropion is an aminoketone antidepressant whose action is presumed to be mediated by noradrenergic and/or dopaminergic mechanisms; it is a relatively weak inhibitor of neuronal norepinephrine and dopamine reuptake and does not inhibit MAO or serotonin reuptake.
Vortioxetine's antidepressant effect is thought to be related to enhancement of serotonergic activity in the CNS through inhibition of serotonin reuptake, along with 5-HT3 receptor antagonism and 5-HT1A receptor agonism.
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Aplenzin
- Covered on 5 commercial plans
- PA (4/12) · Step Therapy (10/12) · Qty limit (9/12)
Trintellix
- Covered on 5 commercial plans
- PA (3/12) · Step Therapy (3/12) · Qty limit (11/12)
UnitedHealthcare
Aplenzin
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Trintellix
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (4/8) · Qty limit (5/8)
Humana
Aplenzin
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (3/3) · Qty limit (2/3)
Trintellix
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (3/3) · Qty limit (2/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
$100/momo
Aplenzin Copay Savings Program - Non-covered benefitCommercial or private insurance
Medicare, Medicaid, VA, TRICARE
$10/fillfill
Trintellix Savings CardCommercial or private insurance
Medicare, Medicaid, VA, TRICARE
Final cost depends on formulary coverage
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.