| Migraine Disorders
Onzetra Xsail vs Qudexy XR
Side-by-side clinical, coverage, and cost comparison for migraine disorders.Deep comparison between: Onzetra Xsail 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 Onzetra Xsail based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Qudexy but not Onzetra Xsail, including UnitedHealthcare
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Category
Onzetra Xsail
Qudexy
At A Glance
Nasal powder
As needed
5-HT1B/1D agonist (triptan)
Oral
Once daily
Broad-spectrum anticonvulsant
Indications
- Migraine Disorders
- Seizures, Focal
- Generalized seizures
- Lennox-Gastaut syndrome
- Migraine Disorders
Dosing
Migraine Disorders 22 mg (one 11 mg nosepiece per nostril) intranasally as a single dose; if migraine unresolved at 2 hours or returns, a second 22 mg dose may be administered at least 2 hours after the first; maximum 44 mg per 24 hours.
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
- Ischemic coronary artery disease or coronary artery vasospasm, including Prinzmetal's angina, or other significant underlying cardiovascular disease
- Wolff-Parkinson-White Syndrome or arrhythmias associated with other cardiac accessory conduction pathway disorders
- History of stroke, transient ischemic attack (TIA), or hemiplegic or basilar migraine
- Peripheral vascular disease
- Ischemic bowel disease
- Uncontrolled hypertension
- Recent use (within 24 hours) of ergotamine-containing or ergot-type medications, or another 5-HT1 agonist
- Concurrent administration or recent use (within 2 weeks) of an MAO-A inhibitor
- Hypersensitivity to sumatriptan
- Severe hepatic impairment
- History of hypersensitivity reaction to topiramate, QUDEXY XR, or any inactive ingredient
Adverse Reactions
Most common (>=2%) Abnormal taste, nasal discomfort, rhinorrhea, rhinitis
Serious Myocardial ischemia, myocardial infarction, Prinzmetal's angina, arrhythmias, chest/throat/neck/jaw pain/tightness/pressure, cerebrovascular events, vasospasm reactions, medication overuse headache, serotonin syndrome, increased blood pressure, hypersensitivity reactions, seizures
Postmarketing Epistaxis
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
Sumatriptan is a selective 5-HT1B/1D receptor agonist that constricts intracranial blood vessels and inhibits pro-inflammatory neuropeptide release from the trigeminal system, relieving migraine headache.
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.
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Most Common Insurance
Anthem BCBS
Onzetra Xsail
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (10/12) · Qty limit (9/12)
Qudexy
- Covered on 5 commercial plans
- PA (7/12) · Step Therapy (0/12) · Qty limit (0/12)
UnitedHealthcare
Onzetra Xsail
- Covered on 4 commercial plans
- PA (3/8) · Step Therapy (0/8) · Qty limit (1/8)
Qudexy
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Onzetra Xsail
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (3/3) · Qty limit (3/3)
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 Onzetra Xsail.
No savings programs available for Qudexy.
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Onzetra XsailView full Onzetra Xsail profile
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.