| Parkinson Disease
Apokyn vs Onapgo
Side-by-side clinical, coverage, and cost comparison for parkinson disease.Deep comparison between: Apokyn vs Onapgo 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 signalsOnapgo has a higher rate of injection site reactions vs Apokyn based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Onapgo but not Apokyn, including UnitedHealthcare
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Category
Apokyn
Onapgo
At A Glance
SC injection
As needed (PRN)
Dopamine agonist (non-ergoline)
SC injection
Daily continuous infusion
Non-ergoline dopamine agonist
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 Initial continuous dosage 1 mg/hr SC infusion over the waking day (up to 16 hours), titrated in 0.5-1 mg/hr increments up to 6 mg/hr; extra doses of 0.5-2 mg up to 3 times/day as needed; maximum total daily dosage 98 mg.
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
- Concomitant use of 5HT3 antagonists, including antiemetics (e.g., ondansetron, granisetron, dolasetron, palonosetron) and alosetron
- Hypersensitivity or allergic reaction to apomorphine or any excipient of ONAPGO, including sulfite (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 (>=10%) Infusion site nodule, nausea, somnolence, infusion site erythema, dyskinesia, headache, insomnia
Serious Syncope, hypotension, orthostatic hypotension, falls, hallucinations, psychotic-like behavior, hemolytic anemia, impulse control disorders, cardiac events, QTc prolongation, hypersensitivity, fibrotic complications, priapism
Postmarketing Hemolytic anemia
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.
Non-ergoline dopamine agonist with high binding affinity for the dopamine D4 receptor and moderate affinity for D2, D3, D5, and adrenergic receptors; believed to act via stimulation of post-synaptic dopamine D2-type receptors within the caudate-putamen in the brain.
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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)
Onapgo
- 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)
Onapgo
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Apokyn
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (2/3)
Onapgo
- Covered on 0 commercial plans
- PA (2/3) · Step Therapy (2/3) · 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
No savings programs available for Onapgo.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.