| Migraine Disorders
Relpax vs Trokendi XR
Side-by-side clinical, coverage, and cost comparison for migraine disorders.Deep comparison between: Relpax 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 Relpax based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Trokendi Xr but not Relpax, including UnitedHealthcare
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Category
Relpax
Trokendi Xr
At A Glance
Oral
As needed
5-HT1B/1D agonist (triptan)
Oral
Once daily
Anticonvulsant; carbonic anhydrase inhibitor
Indications
- Migraine Disorders
- Lennox-Gastaut Syndrome
- Migraine Disorders
Dosing
Migraine Disorders 20 mg or 40 mg orally for acute treatment; a second dose may be taken at least 2 hours after the first if migraine has not resolved or returns; maximum 80 mg/day.
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
- 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, transient ischemic attack (TIA), or history or current evidence of hemiplegic or basilar migraine
- Peripheral vascular disease
- Ischemic bowel disease
- Uncontrolled hypertension
- Recent use (within 24 hours) of another 5-HT1 agonist, ergotamine-containing medication, or ergot-type medication such as dihydroergotamine (DHE) or methysergide
- Hypersensitivity to eletriptan or any excipient (angioedema and anaphylaxis seen)
- Recent use (within at least 72 hours) of potent CYP3A4 inhibitors: ketoconazole, itraconazole, nefazodone, troleandomycin, clarithromycin, ritonavir, or nelfinavir
- 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 (>=2%) Asthenia, nausea, dizziness, somnolence, headache, paresthesia, flushing/feeling of warmth, chest tightness/pain/pressure, abdominal pain/discomfort, dry mouth, dyspepsia, dysphagia
Serious Myocardial ischemia and myocardial infarction, Prinzmetal's angina, arrhythmias, chest/throat/neck/jaw pain/tightness/pressure, cerebrovascular events, vasospasm reactions, medication overuse headache, serotonin syndrome, increase in blood pressure, hypersensitivity reactions
Postmarketing Seizure, vomiting
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
Eletriptan is a selective 5-HT1B/1D receptor agonist (triptan) that acts on intracranial blood vessel receptors and trigeminal sensory nerves to produce cranial vessel constriction and inhibit pro-inflammatory neuropeptide release.
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.
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Relpax
- Covered on 5 commercial plans
- PA (3/12) · Step Therapy (0/12) · Qty limit (9/12)
Trokendi Xr
- Covered on 5 commercial plans
- PA (5/12) · Step Therapy (0/12) · Qty limit (9/12)
UnitedHealthcare
Relpax
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (2/8) · Qty limit (7/8)
Trokendi Xr
- Covered on 4 commercial plans
- PA (1/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Relpax
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (0/3) · 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
No savings programs available for Relpax.
No savings programs available for Trokendi Xr.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.