| Migraine Disorders
Ubrelvy vs Trokendi XR
Side-by-side clinical, coverage, and cost comparison for migraine disorders.Deep comparison between: Ubrelvy 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 Ubrelvy based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Trokendi Xr but not Ubrelvy, including UnitedHealthcare
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Category
Ubrelvy
Trokendi Xr
At A Glance
Oral
As needed
CGRP receptor antagonist
Oral
Once daily
Anticonvulsant; carbonic anhydrase inhibitor
Indications
- Migraine Disorders
- Lennox-Gastaut Syndrome
- Migraine Disorders
Dosing
Migraine Disorders 50 mg or 100 mg orally as needed; a second dose may be taken at least 2 hours after the initial dose; maximum 200 mg per 24-hour period. Dose reductions apply with moderate or weak CYP3A4 inhibitors, BCRP and/or P-gp only inhibitors, and in patients with severe hepatic or severe renal impairment (CLcr 15-29 mL/min); avoid in end-stage renal disease.
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
- Concomitant use of strong CYP3A4 inhibitors
- History of serious hypersensitivity to ubrogepant or any component of UBRELVY (reactions have included anaphylaxis, dyspnea, and facial or throat edema)
- 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%) Nausea, somnolence, dry mouth
Serious Hypersensitivity reactions, hypertension, Raynaud's phenomenon
Postmarketing Hypersensitivity (anaphylaxis, dyspnea, facial or throat edema, rash, urticaria, pruritus), 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
Ubrogepant is a calcitonin gene-related peptide (CGRP) receptor antagonist; by blocking CGRP receptor signaling it inhibits a pathway implicated in migraine pathophysiology.
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
Ubrelvy
- Covered on 5 commercial plans
- PA (6/12) · 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
Ubrelvy
- Covered on 4 commercial plans
- PA (8/8) · Step Therapy (8/8) · Qty limit (8/8)
Trokendi Xr
- Covered on 4 commercial plans
- PA (1/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Ubrelvy
- 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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UbrelvyView full Ubrelvy profile
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.