| Migraine Disorders
Depakote vs Qudexy XR
Side-by-side clinical, coverage, and cost comparison for migraine disorders.Deep comparison between: Depakote vs Qudexy 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 signalsQudexy has a higher rate of injection site reactions vs Depakote based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Qudexy but not Depakote, including UnitedHealthcare
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Category
Depakote
Qudexy
At A Glance
Oral
Daily in divided doses
Valproate anticonvulsant
Oral
Once daily
Broad-spectrum anticonvulsant
Indications
- Bipolar Disorder
- Complex partial seizures
- Absence Epilepsy
- Migraine Disorders
- Seizures, Focal
- Generalized seizures
- Lennox-Gastaut syndrome
- Migraine Disorders
Dosing
Bipolar Disorder 750 mg/day initially in divided doses, titrated rapidly to clinical response; max 60 mg/kg/day; oral.
Complex partial seizures 10-15 mg/kg/day initially, increased by 5-10 mg/kg/week to optimal response; max 60 mg/kg/day; divide doses if total daily dose exceeds 250 mg; oral.
Absence Epilepsy 15 mg/kg/day initially, increased at one-week intervals by 5-10 mg/kg/day until seizures are controlled; max 60 mg/kg/day; divide doses if total daily dose exceeds 250 mg; oral.
Migraine Disorders 250 mg twice daily; some patients may benefit from doses up to 1,000 mg/day; oral.
Seizures, Focal, Generalized seizures, Lennox-Gastaut syndrome Monotherapy (adults and peds >=10 years): 400 mg orally once daily, titrated over 6 weeks from 50 mg/day; peds 2-9 years: weight-based 150-400 mg/day once daily. Adjunctive (adults): 200 to 400 mg once daily; adjunctive (peds 2-16 years): approximately 5 to 9 mg/kg once daily, not to exceed 400 mg/day.
Migraine Disorders 100 mg orally once daily for patients 12 years of age and older, titrated over 4 weeks from 25 mg/day.
Contraindications
- Hepatic disease or significant hepatic dysfunction
- Mitochondrial disorders caused by mutations in mitochondrial DNA polymerase gamma (POLG; e.g., Alpers-Huttenlocher Syndrome) and children under two years of age suspected of having a POLG-related disorder
- Known hypersensitivity to divalproex sodium, sodium valproate, or valproic acid
- Known urea cycle disorders
- Migraine prophylaxis in pregnant women or in women of childbearing potential not using effective contraception
- History of hypersensitivity reaction to topiramate, QUDEXY XR, or any inactive ingredient
Adverse Reactions
Most common (>=5%) Nausea, vomiting, somnolence, dizziness, tremor, asthenia, alopecia, headache, abdominal pain, dyspepsia, diarrhea, weight gain
Serious Hepatic failure, birth defects, pancreatitis, hyperammonemic encephalopathy, suicidal behavior and ideation, bleeding and hematopoietic disorders, hypothermia, DRESS/multiorgan hypersensitivity, serious dermatologic reactions, angioedema
Postmarketing Toxic epidermal necrolysis, Stevens-Johnson syndrome, erythema multiforme, parkinsonism, aplastic anemia, pancytopenia, fractures, decreased bone mineral density, polycystic ovary disease, male infertility, angioedema
Most common (>=10%) Paresthesia, somnolence, dizziness, weight loss, anorexia, speech disorders/related speech problems, psychomotor slowing, nervousness, vision abnormal
Serious Acute myopia and secondary angle closure glaucoma, visual field defects, oligohydrosis and hyperthermia, metabolic acidosis, suicidal behavior and ideation, cognitive/neuropsychiatric adverse reactions, decrease in bone mineral density, negative effects on growth, DRESS/multiorgan hypersensitivity, serious skin reactions, anaphylaxis and angioedema, hyperammonemia and encephalopathy, kidney stones, hypothermia with concomitant valproic acid
Postmarketing Hepatic failure, hepatitis, pancreatitis, bullous skin reactions (Stevens-Johnson syndrome, toxic epidermal necrolysis), pemphigus, maculopathy, nephrocalcinosis
Pharmacology
Divalproex sodium dissociates to the valproate ion in the gastrointestinal tract; its therapeutic mechanisms have not been fully established, but its anticonvulsant activity is thought to relate to increased brain concentrations of gamma-aminobutyric acid (GABA).
Topiramate blocks voltage-dependent sodium channels, augments GABA-A receptor activity, antagonizes the AMPA/kainate subtype of the glutamate receptor, and inhibits carbonic anhydrase isozymes II and IV; the precise mechanisms underlying its anticonvulsant and preventive migraine effects are unknown.
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Depakote
- Covered on 5 commercial plans
- PA (0/12) · Step Therapy (0/12) · Qty limit (9/12)
Qudexy
- Covered on 5 commercial plans
- PA (7/12) · Step Therapy (0/12) · Qty limit (0/12)
UnitedHealthcare
Depakote
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Qudexy
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Depakote
- Covered on 0 commercial plans
- PA (0/3) · Step Therapy (0/3) · Qty limit (0/3)
Qudexy
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (0/3) · Qty limit (0/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Depakote.
No savings programs available for Qudexy.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.