| Migraine Disorders
Nurtec ODT vs Trokendi XR
Side-by-side clinical, coverage, and cost comparison for migraine disorders.Deep comparison between: Nurtec Odt vs Trokendi Xr 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 signalsTrokendi Xr has a higher rate of injection site reactions vs Nurtec Odt based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Trokendi Xr but not Nurtec Odt, including UnitedHealthcare
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Category
Nurtec Odt
Trokendi Xr
At A Glance
Oral
As needed or every other day
CGRP receptor antagonist
Oral
Once daily
Anticonvulsant; carbonic anhydrase inhibitor
Indications
- Migraine Disorders
- Episodic migraine
- Lennox-Gastaut Syndrome
- Migraine Disorders
Dosing
Migraine Disorders 75 mg orally as needed; maximum 75 mg per 24-hour period; safety of more than 18 doses in a 30-day period has not been established; may be taken with or without food.
Episodic migraine 75 mg orally every other day, with or without food.
Lennox-Gastaut Syndrome Adjunctive therapy: adults (>=17 years) 200-400 mg orally once daily, initiated at 25-50 mg once daily and titrated in 25-50 mg/week increments; pediatric patients 6-16 years approximately 5-9 mg/kg/day orally once daily, initiated at 25 mg/day and titrated at 1-3 mg/kg/day every 1-2 weeks, not to exceed 400 mg/day.
Migraine Disorders Preventive treatment for patients 12 years and older: 100 mg orally once daily, titrated over 4 weeks starting at 25 mg/day (Week 1: 25 mg, Week 2: 50 mg, Week 3: 75 mg, Week 4: 100 mg).
Contraindications
- History of hypersensitivity reaction to rimegepant, NURTEC ODT, or any of its components, including anaphylaxis and delayed serious hypersensitivity
- Recent alcohol use within 6 hours prior to or 6 hours after TROKENDI XR administration
- History of hypersensitivity reaction to topiramate, TROKENDI XR, or any inactive ingredient (anaphylaxis and angioedema have occurred)
Adverse Reactions
Most common Nausea, abdominal pain/dyspepsia
Serious Hypersensitivity including dyspnea and severe rash
Postmarketing Hypersensitivity (anaphylaxis), hypertension, Raynaud's phenomenon
Most common (>=10%) Paresthesia, weight loss, anorexia, dizziness, somnolence, nervousness, psychomotor slowing, speech disorders, vision abnormal
Serious Acute myopia and secondary angle closure glaucoma, metabolic acidosis, oligohydrosis and hyperthermia, suicidal behavior and ideation, fetal toxicity, DRESS/multiorgan hypersensitivity, serious skin reactions, anaphylaxis and angioedema, hyperammonemia and encephalopathy, decrease of bone mineral density, kidney stones
Postmarketing Hepatic failure, hepatitis, pancreatitis, Stevens-Johnson syndrome, toxic epidermal necrolysis, pemphigus, nephrocalcinosis, maculopathy, decreased INR with vitamin K antagonists
Pharmacology
Rimegepant is a calcitonin gene-related peptide (CGRP) receptor antagonist; it is an orally administered small molecule that blocks the CGRP receptor implicated in migraine pathophysiology, indicated for both acute and preventive treatment.
Topiramate is a sulfamate-substituted monosaccharide anticonvulsant whose precise mechanism is unknown but is believed to involve blockade of voltage-dependent sodium channels, augmentation of GABA-A receptor activity, antagonism of AMPA/kainate glutamate receptors, and inhibition of carbonic anhydrase isozymes II and IV.
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Most Common Insurance
Anthem BCBS
Nurtec Odt
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (12/12) · Qty limit (12/12)
Trokendi Xr
- Covered on 5 commercial plans
- PA (5/12) · Step Therapy (0/12) · Qty limit (9/12)
UnitedHealthcare
Nurtec Odt
- Covered on 4 commercial plans
- PA (6/8) · Step Therapy (6/8) · Qty limit (6/8)
Trokendi Xr
- Covered on 4 commercial plans
- PA (1/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Nurtec Odt
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (3/3)
Trokendi Xr
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (0/3) · Qty limit (3/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
Cost estimate not availableHealthWell: Migraine
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
No savings programs available for Trokendi Xr.
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Nurtec OdtView full Nurtec Odt profile
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.