| Migraine Disorders
VYEPTI vs Trokendi XR
Side-by-side clinical, coverage, and cost comparison for migraine disorders.Deep comparison between: Vyepti 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 Vyepti based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Trokendi Xr but not Vyepti, including UnitedHealthcare
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Category
Vyepti
Trokendi Xr
At A Glance
IV infusion
Every 3 months
CGRP antagonist
Oral
Once daily
Anticonvulsant; carbonic anhydrase inhibitor
Indications
- Migraine Disorders
- Lennox-Gastaut Syndrome
- Migraine Disorders
Dosing
Migraine Disorders 100 mg by IV infusion every 3 months; some patients may benefit from 300 mg by IV infusion every 3 months.
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
- Serious hypersensitivity to eptinezumab-jjmr or any excipient, including anaphylaxis and angioedema
- 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%) nasopharyngitis, hypersensitivity reactions
Postmarketing anaphylaxis, fatigue, 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
Eptinezumab-jjmr is a humanized IgG1 monoclonal antibody that binds to calcitonin gene-related peptide (CGRP) ligand and blocks its binding to the receptor, thereby preventing CGRP-mediated effects relevant to migraine.
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
Vyepti
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (10/12) · Qty limit (9/12)
Trokendi Xr
- Covered on 5 commercial plans
- PA (5/12) · Step Therapy (0/12) · Qty limit (9/12)
UnitedHealthcare
Vyepti
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Trokendi Xr
- Covered on 4 commercial plans
- PA (1/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Vyepti
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (2/3)
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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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.