| Migraine Disorders
Qudexy XR vs Tosymra
Side-by-side clinical, coverage, and cost comparison for migraine disorders.Deep comparison between: Qudexy vs Tosymra 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 signalsTosymra has a higher rate of injection site reactions vs Qudexy based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Tosymra but not Qudexy, including UnitedHealthcare
Sign up to reveal the full AI analysis
Category
Qudexy
Tosymra
At A Glance
Oral
Once daily
Broad-spectrum anticonvulsant
Nasal spray
Per migraine attack
5-HT1B/1D receptor agonist
Indications
- Seizures, Focal
- Generalized seizures
- Lennox-Gastaut syndrome
- Migraine Disorders
- Migraine Disorders
Dosing
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.
Migraine Disorders 10 mg as a single spray in one nostril; max 30 mg in 24 hours with doses separated by at least 1 hour.
Contraindications
- History of hypersensitivity reaction to topiramate, QUDEXY XR, or any inactive ingredient
- Ischemic coronary artery disease (angina pectoris, history of myocardial infarction, or documented silent ischemia) or coronary artery vasospasm, including Prinzmetal's angina
- Wolff-Parkinson-White syndrome or arrhythmias associated with other cardiac accessory conduction pathway disorders
- History of stroke or transient ischemic attack (TIA) or history of hemiplegic or basilar migraine
- Peripheral vascular disease
- Ischemic bowel disease
- Uncontrolled hypertension
- Recent use (within 24 hours) of ergotamine-containing or ergot-type medication, or another 5-HT1 agonist
- Concurrent administration or recent use (within 2 weeks) of an MAO-A inhibitor
- Hypersensitivity to sumatriptan
- Severe hepatic impairment
Adverse Reactions
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
Most common (>=2%) Atypical sensations, tingling, dizziness/vertigo, warm/hot sensation, burning sensation, feeling of heaviness, flushing, weakness, neck pain/stiffness, chest discomfort, drowsiness/sedation
Serious Myocardial ischemia/infarction, arrhythmias, cerebrovascular events, vasospasm reactions, serotonin syndrome, increase in blood pressure, hypersensitivity reactions, seizures
Postmarketing Hypotension, palpitations, dystonia, tremor
Pharmacology
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.
Sumatriptan is a selective 5-HT1B/1D receptor agonist that exerts its therapeutic effects through agonist activity at 5-HT1B/1D receptors on intracranial blood vessels and sensory nerves of the trigeminal system, resulting in cranial vessel constriction and inhibition of pro-inflammatory neuropeptide release.
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Qudexy
- Covered on 5 commercial plans
- PA (7/12) · Step Therapy (0/12) · Qty limit (0/12)
Tosymra
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (10/12) · Qty limit (10/12)
UnitedHealthcare
Qudexy
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Tosymra
- Covered on 4 commercial plans
- PA (3/8) · Step Therapy (0/8) · Qty limit (1/8)
Humana
Qudexy
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (0/3) · Qty limit (0/3)
Tosymra
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (3/3) · Qty limit (3/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Qudexy.
No savings programs available for Tosymra.
Compare Other Drugs
Let us handle your prior authsJust enter your patient's info and we'll:
- Verify eligibility with the payer.
- Pull the right PA forms directly from the payer.
- Submit, track & send live updates to your dashboard.
Free to start · HIPAA compliant
Next Steps for Your Patient
QudexyView full Qudexy profile
TosymraView full Tosymra profile
Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.