| Metastatic Castration-Sensitive Prostate Carcinoma
Zytiga vs Xtandi
Side-by-side clinical, coverage, and cost comparison for metastatic castration-sensitive prostate carcinoma.Deep comparison between: Zytiga vs Xtandi 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 signalsXtandi has a higher rate of injection site reactions vs Zytiga based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Xtandi but not Zytiga, including UnitedHealthcare
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Category
Zytiga
Xtandi
At A Glance
Oral
Daily
CYP17 inhibitor
Oral
Once daily
Androgen receptor inhibitor
Indications
- Metastatic castration-resistant prostate cancer
- Metastatic Castration-Sensitive Prostate Carcinoma
- Hormone refractory prostate cancer
- Metastatic Castration-Sensitive Prostate Carcinoma
- Nonmetastatic Castration-Sensitive Prostate Carcinoma
Dosing
Metastatic castration-resistant prostate cancer 1,000 mg orally once daily with prednisone 5 mg orally twice daily; take on an empty stomach (no food 2 hours before or 1 hour after).
Metastatic Castration-Sensitive Prostate Carcinoma 1,000 mg orally once daily with prednisone 5 mg orally once daily; take on an empty stomach (no food 2 hours before or 1 hour after).
Hormone refractory prostate cancer, Metastatic Castration-Sensitive Prostate Carcinoma 160 mg orally once daily until disease progression or unacceptable toxicity; concurrent GnRH analog or prior bilateral orchiectomy required.
Nonmetastatic Castration-Sensitive Prostate Carcinoma 160 mg orally once daily until disease progression or unacceptable toxicity; GnRH analog may be given with or without XTANDI.
Contraindications
—
—
Adverse Reactions
Most common (>=10%) Fatigue, arthralgia, hypertension, nausea, edema, hypokalemia, hot flush, diarrhea, vomiting, upper respiratory infection, cough, headache
Serious Cardiac failure, hepatotoxicity, hypokalemia (Grade 3-4), arrhythmia, cardiorespiratory arrest
Postmarketing Non-infectious pneumonitis, myopathy including rhabdomyolysis, fulminant hepatitis including acute hepatic failure and death, QT prolongation and Torsades de Pointes, anaphylactic reactions
Most common (>=10%) Musculoskeletal pain, fatigue, hot flush, constipation, decreased appetite, diarrhea, hypertension, hemorrhage, fall, fracture, headache
Serious Seizure, posterior reversible encephalopathy syndrome, hypersensitivity, ischemic heart disease, falls and fractures
Postmarketing Vomiting, dysphagia, hypersensitivity (edema of face, tongue, lip, or pharynx), posterior reversible encephalopathy syndrome, dysgeusia, rash, severe cutaneous adverse reactions (Stevens-Johnson syndrome, erythema multiforme, toxic epidermal necrolysis, DRESS, acute generalized exanthematous pustulosis)
Pharmacology
Abiraterone acetate is converted in vivo to abiraterone, a selective inhibitor of CYP17 (17alpha-hydroxylase/C17,20-lyase) that blocks androgen biosynthesis in testicular, adrenal, and prostatic tumor tissues, thereby reducing serum testosterone and other androgens in patients with prostate cancer.
Enzalutamide is an androgen receptor inhibitor that competitively inhibits androgen binding to androgen receptors and consequently inhibits nuclear translocation of androgen receptors and their interaction with DNA; its major metabolite, N-desmethyl enzalutamide, exhibits similar in vitro activity.
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Most Common Insurance
Anthem BCBS
Zytiga
- Covered on 5 commercial plans
- PA (9/12) · Step Therapy (4/12) · Qty limit (9/12)
Xtandi
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (0/12) · Qty limit (12/12)
UnitedHealthcare
Zytiga
- Covered on 4 commercial plans
- PA (1/8) · Step Therapy (1/8) · Qty limit (0/8)
Xtandi
- Covered on 4 commercial plans
- PA (6/8) · Step Therapy (0/8) · Qty limit (5/8)
Humana
Zytiga
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (2/3)
Xtandi
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (2/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
$10/momo
Janssen CarePath Savings Program: ZytigaCommercial or private insurance
Medicare, Medicaid, VA, TRICARE
Cost estimate not availableAssistance Fund: Prostate Cancer
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.