| Major Depressive Disorder
Caplyta vs Fetzima
Side-by-side clinical, coverage, and cost comparison for major depressive disorder.Deep comparison between: Caplyta vs Fetzima 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 signalsFetzima has a higher rate of injection site reactions vs Caplyta based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Fetzima but not Caplyta, including UnitedHealthcare
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Category
Caplyta
Fetzima
At A Glance
Oral
Once daily
Atypical antipsychotic
Oral
Once daily
SNRI
Indications
- Schizophrenia
- Depression, Bipolar
- Major Depressive Disorder
- Major Depressive Disorder
Dosing
Schizophrenia, Depression, Bipolar, Major Depressive Disorder 42 mg orally once daily with or without food; no dose titration needed.
With strong CYP3A4 inhibitors Reduce to 10.5 mg once daily.
With moderate CYP3A4 inhibitors Reduce to 21 mg once daily.
Moderate or severe hepatic impairment Reduce to 21 mg once daily (Child-Pugh class B or C).
Major Depressive Disorder Initiate at 20 mg once daily for 2 days, then increase to 40 mg once daily; may increase in 40 mg increments at intervals of 2 or more days; max 120 mg once daily, oral, with or without food.
Renal Impairment Severe (CrCl 15-29 mL/min): max 40 mg once daily; moderate (CrCl 30-59 mL/min): max 80 mg once daily; ESRD: not recommended.
Contraindications
- History of hypersensitivity reaction to lumateperone or any component of CAPLYTA (including pruritus, rash, and urticaria)
- Hypersensitivity to levomilnacipran, milnacipran HCl, or any excipient in the formulation
- Concomitant use with MAOIs intended to treat psychiatric disorders, or within 7 days of stopping FETZIMA
- Use of FETZIMA within 14 days of stopping an MAOI intended to treat psychiatric disorders
- Concomitant use with linezolid or intravenous methylene blue
Adverse Reactions
Most common (>=5%) Somnolence/sedation, dizziness, nausea, dry mouth, headache, fatigue, diarrhea, vomiting
Serious Neuroleptic malignant syndrome, tardive dyskinesia, metabolic changes, leukopenia/neutropenia/agranulocytosis, orthostatic hypotension and syncope, seizures, suicidal thoughts and behaviors, cerebrovascular adverse reactions including stroke in elderly patients with dementia-related psychosis
Postmarketing Burning sensation, including skin burning sensation
Most common (>=5%) Nausea, constipation, hyperhidrosis, heart rate increased, erectile dysfunction, ejaculation disorder, tachycardia, vomiting, palpitations
Serious Suicidal thoughts and behaviors, serotonin syndrome, elevated blood pressure, elevated heart rate, increased risk of bleeding, angle closure glaucoma, urinary hesitation or retention, activation of mania/hypomania, seizure, discontinuation syndrome, hyponatremia, sexual dysfunction
Postmarketing Takotsubo cardiomyopathy, anosmia, hyposmia
Pharmacology
Lumateperone is an atypical antipsychotic whose mechanism may be mediated through antagonist activity at central serotonin 5-HT2A receptors and partial agonist activity at central dopamine D2 receptors; it also has moderate SERT inhibitory activity and moderate binding affinity for dopamine D1, D4, and adrenergic alpha-1 receptors.
Levomilnacipran is a potent and selective serotonin and norepinephrine reuptake inhibitor (SNRI) that potentiates serotonin and norepinephrine neurotransmission in the central nervous system through inhibition of reuptake at their respective transporters, with no significant affinity for other receptors, ion channels, or transporters.
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Caplyta
- Covered on 5 commercial plans
- PA (5/12) · Step Therapy (5/12) · Qty limit (2/12)
Fetzima
- Covered on 5 commercial plans
- PA (3/12) · Step Therapy (11/12) · Qty limit (12/12)
UnitedHealthcare
Caplyta
- Covered on 4 commercial plans
- PA (4/8) · Step Therapy (4/8) · Qty limit (6/8)
Fetzima
- Covered on 4 commercial plans
- PA (1/8) · Step Therapy (8/8) · Qty limit (6/8)
Humana
Caplyta
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (3/3)
Fetzima
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (2/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
Cost estimate not availableHealthWell: Schizophrenia - Medicare Access
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
No savings programs available for Fetzima.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.