| Narcolepsy
Sunosi vs Wakix
Side-by-side clinical, coverage, and cost comparison for narcolepsy.Deep comparison between: Sunosi vs Wakix 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 signalsWakix has a higher rate of injection site reactions vs Sunosi based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Wakix but not Sunosi, including UnitedHealthcare
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Category
Sunosi
Wakix
At A Glance
Oral
Once daily
DNRI
Oral
Daily
H3 receptor antagonist/inverse agonist
Indications
- Narcolepsy
- Sleep Apnea, Obstructive
- Narcolepsy
- Cataplexy
Dosing
Narcolepsy 75 mg orally once daily upon awakening; may double every 3 days based on efficacy and tolerability; maximum 150 mg once daily.
Sleep Apnea, Obstructive 37.5 mg orally once daily upon awakening; may double every 3 days based on efficacy and tolerability; maximum 150 mg once daily.
Renal Impairment Moderate (eGFR 30-59 mL/min/1.73 m2): start 37.5 mg once daily, may increase to max 75 mg after at least 7 days. Severe (eGFR 15-29 mL/min/1.73 m2): 37.5 mg once daily; maximum 37.5 mg. ESRD: not recommended.
Narcolepsy, Cataplexy (Adults) Initiate 8.9 mg orally once daily in the morning; increase to 17.8 mg at week 2; may increase to maximum 35.6 mg once daily at week 3.
Narcolepsy, Cataplexy (Pediatric, 6 years and older) Initiate 4.45 mg orally once daily in the morning; increase to 8.9 mg at week 2, 17.8 mg at week 3 (maximum for <40 kg); patients >=40 kg may increase to maximum 35.6 mg once daily at week 4.
Contraindications
- Concomitant use with MAO inhibitors or within 14 days after discontinuing MAOI treatment due to risk of hypertensive reaction
- Known hypersensitivity to pitolisant or any component of the formulation
- Severe hepatic impairment
Adverse Reactions
Most common (>=5%) headache, nausea, decreased appetite, anxiety, insomnia
Serious blood pressure and heart rate increases, psychiatric symptoms
Postmarketing hypersensitivity reactions (rash erythematous, rash, urticaria)
Most common (>=5%) Insomnia, nausea, anxiety (adults); headache, insomnia (pediatric)
Serious QT interval prolongation
Postmarketing Fatigue, anaphylaxis, weight increased, dizziness, epilepsy, abnormal behavior, depression, suicidal ideation, suicide attempt, pruritus
Pharmacology
Solriamfetol is a dopamine and norepinephrine reuptake inhibitor (DNRI) that inhibits reuptake of dopamine and norepinephrine with no appreciable binding to serotonin transporters or to dopamine, serotonin, norepinephrine, GABA, adenosine, histamine, orexin, or acetylcholine receptors.
Pitolisant acts as an antagonist/inverse agonist at histamine-3 (H3) receptors (Ki = 1 nM) with no appreciable binding to H1, H2, or H4 receptors; its precise mechanism in narcolepsy-associated EDS or cataplexy is unclear but is thought to be mediated through H3 receptor blockade.
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Most Common Insurance
Anthem BCBS
Sunosi
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (10/12) · Qty limit (1/12)
Wakix
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (10/12) · Qty limit (1/12)
UnitedHealthcare
Sunosi
- Covered on 4 commercial plans
- PA (7/8) · Step Therapy (6/8) · Qty limit (7/8)
Wakix
- Covered on 4 commercial plans
- PA (5/8) · Step Therapy (4/8) · Qty limit (5/8)
Humana
Sunosi
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (2/3) · Qty limit (3/3)
Wakix
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (2/3) · Qty limit (3/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
Cost estimate not availableAssistance Fund: Narcolepsy
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
Cost estimate not availableAssistance Fund: Narcolepsy
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.