| Osteoarthritis, Knee
Pennsaid 2% vs Zilretta
Side-by-side clinical, coverage, and cost comparison for osteoarthritis, knee.Deep comparison between: Pennsaid vs Zilretta 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 signalsZilretta has a higher rate of injection site reactions vs Pennsaid based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Zilretta but not Pennsaid, including UnitedHealthcare
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Category
Pennsaid
Zilretta
At A Glance
Topical
Twice daily
NSAID
Intra-articular injection
Single dose
Corticosteroid
Indications
- Osteoarthritis, Knee
- Osteoarthritis, Knee
Dosing
Osteoarthritis, Knee 40 mg (2 pump actuations) applied topically to each painful knee twice daily; use the lowest effective dosage for the shortest duration.
Osteoarthritis, Knee 32 mg (5 mL) as a single intra-articular injection into the knee, prepared per the Instructions for Use using the supplied diluent.
Contraindications
- Known hypersensitivity (e.g., anaphylactic reactions and serious skin reactions) to diclofenac or any components of the drug product
- History of asthma, urticaria, or other allergic-type reactions after taking aspirin or other NSAIDs
- In the setting of coronary artery bypass graft (CABG) surgery
- Hypersensitivity to triamcinolone acetonide, corticosteroids, or any components of the product
Adverse Reactions
Most common (>1%) Application site dryness, exfoliation, erythema, pruritus, pain, induration, rash, scabbing, urinary tract infection, contusion, sinus congestion, nausea
Serious Cardiovascular thrombotic events, GI bleeding/ulceration/perforation, hepatotoxicity, hypertension, heart failure and edema, renal toxicity and hyperkalemia, anaphylactic reactions, serious skin reactions, hematologic toxicity
Postmarketing Stevens-Johnson Syndrome, toxic epidermal necrolysis, fixed drug eruption, exfoliative dermatitis, asthma, hypertension, rectal hemorrhage, lip swelling, throat swelling
Most common (>=1%) Sinusitis, cough, contusions, joint swelling
Serious Neurologic adverse reactions with epidural/intrathecal administration, hypersensitivity reactions, joint infection and damage, increased risk of infections, alterations in endocrine function, cardiovascular effects, renal effects, increased intraocular pressure, gastrointestinal perforation, alterations in bone density, behavioral and mood disturbances
Postmarketing Increased blood glucose (diabetic patients), injection site pain, hypersensitivity reactions, septic arthritis, arthralgia, joint swelling or effusion, muscle spasms, headache, postmenopausal vaginal bleeding
Pharmacology
Diclofenac is an NSAID that inhibits cyclooxygenase (COX-1 and COX-2), reducing prostaglandin synthesis in peripheral tissues to produce analgesic, anti-inflammatory, and antipyretic effects.
Triamcinolone acetonide is a corticosteroid that binds to and activates the glucocorticoid receptor, activating anti-inflammatory transcription factors such as lipocortins and inhibiting inflammatory pathways by blocking arachidonic acid release and preventing prostaglandin and leukotriene synthesis.
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Most Common Insurance
Anthem BCBS
Pennsaid
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (4/12) · Qty limit (9/12)
Zilretta
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (5/12) · Qty limit (9/12)
UnitedHealthcare
Pennsaid
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Zilretta
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Pennsaid
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (2/3)
Zilretta
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (2/3) · Qty limit (0/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Pennsaid.
No savings programs available for Zilretta.
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PennsaidView full Pennsaid profile
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.