| Parkinson Disease
Apokyn vs Nourianz
Side-by-side clinical, coverage, and cost comparison for parkinson disease.Deep comparison between: Apokyn vs Nourianz 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 signalsNourianz has a higher rate of injection site reactions vs Apokyn based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Nourianz but not Apokyn, including UnitedHealthcare
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Category
Apokyn
Nourianz
At A Glance
SC injection
As needed (PRN)
Dopamine agonist (non-ergoline)
Oral
Daily
Adenosine A2A receptor antagonist
Indications
- Parkinson Disease
- Parkinson Disease
Dosing
Parkinson Disease Starting dose 0.1 mL (1 mg) to 0.2 mL (2 mg) SC as needed for "off" episodes; titrate in 0.1 mL (1 mg) increments every few days; maximum 0.6 mL (6 mg) per dose; doses must be separated by at least 2 hours. Reduce starting dose to 0.1 mL (1 mg) in mild or moderate renal impairment.
Parkinson Disease 20 mg orally once daily; may increase to 40 mg once daily based on individual need and tolerability; may be taken with or without food; max 20 mg once daily with strong CYP3A4 inhibitors or moderate hepatic impairment; 40 mg once daily in tobacco smokers (>=20 cigarettes/day); avoid with strong CYP3A4 inducers or in severe hepatic impairment.
Contraindications
- Concomitant use of 5HT3 antagonists including antiemetics (ondansetron, granisetron, dolasetron, palonosetron) and alosetron
- Hypersensitivity or allergic reaction to apomorphine or any excipient including sodium metabisulfite
—
Adverse Reactions
Most common (>=10% above placebo) Yawning, dyskinesias, drowsiness/somnolence, nausea/vomiting, dizziness/postural hypotension, rhinorrhea, hallucination/confusion, edema/swelling of extremities
Serious Nausea and vomiting, syncope/hypotension/orthostatic hypotension, falls, hallucinations/psychotic-like behavior, dyskinesias, hemolytic anemia, impulse control/compulsive behaviors, coronary events, QTc prolongation, withdrawal-emergent hyperpyrexia and confusion, hypersensitivity, fibrotic complications, priapism
Postmarketing Hemolytic anemia
Most common (>=5%) Dyskinesia, dizziness, constipation, nausea, hallucination, insomnia
Serious Dyskinesia, hallucinations/psychotic behavior, impulse control/compulsive behaviors
Postmarketing Increased libido
Pharmacology
APOKYN is a non-ergoline dopamine agonist with high binding affinity for the dopamine D4 receptor and moderate affinity for D2, D3, D5, and adrenergic receptors; its therapeutic effect in Parkinson's disease is believed to result from stimulation of post-synaptic dopamine D2-type receptors within the caudate-putamen.
Adenosine A2A receptor antagonist; istradefylline is a xanthine derivative demonstrated in vitro and in animal studies to block adenosine A2A receptors, though the precise mechanism of therapeutic action in Parkinson's disease is unknown.
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Most Common Insurance
Anthem BCBS
Apokyn
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (0/12) · Qty limit (9/12)
Nourianz
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (0/12) · Qty limit (9/12)
UnitedHealthcare
Apokyn
- Covered on 4 commercial plans
- PA (1/8) · Step Therapy (0/8) · Qty limit (3/8)
Nourianz
- Covered on 4 commercial plans
- PA (4/8) · Step Therapy (4/8) · Qty limit (0/8)
Humana
Apokyn
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (2/3)
Nourianz
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (3/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
Cost estimate not availableApokyn Patient Assistance Program
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
$20/fillfill
Nourianz Copay Assistance ProgramCommercial or private insurance
Medicare, Medicaid, VA, TRICARE
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.