| Parkinson Disease

Apokyn vs Xadago

Side-by-side clinical, coverage, and cost comparison for parkinson disease.
Deep comparison between: Apokyn vs Xadago with Prescriber.AI
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Safety signalsXadago has a higher rate of injection site reactions vs Apokyn based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Xadago but not Apokyn, including UnitedHealthcare
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Apokyn
Xadago
At A Glance
SC injection
As needed (PRN)
Dopamine agonist (non-ergoline)
Oral
Daily
MAO-B inhibitor
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 Start with 50 mg orally once daily; after two weeks, may increase to 100 mg once daily based on individual need and tolerability; maximum 50 mg once daily in moderate hepatic impairment (Child-Pugh B); contraindicated in severe hepatic impairment (Child-Pugh C).
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 other MAOIs or potent monoamine oxidase inhibitors, including linezolid
  • Concomitant use of opioid drugs (meperidine and its derivatives, methadone, propoxyphene, or tramadol), SNRIs, tricyclic/tetracyclic/triazolopyridine antidepressants, cyclobenzaprine, methylphenidate, amphetamine and their derivatives, or St John's wort
  • Concomitant use of dextromethorphan
  • History of hypersensitivity to safinamide
  • Severe hepatic impairment (Child-Pugh C: 10-15)
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 (>=2%) Dyskinesia, fall, nausea, insomnia, orthostatic hypotension, anxiety, cough, dyspepsia
Serious Hypertension, serotonin syndrome, falling asleep during activities of daily living, dyskinesia, hallucinations/psychotic behavior, impulse control/compulsive behaviors, withdrawal-emergent hyperpyrexia and confusion, retinal pathology
Postmarketing Hypersensitivity (swelling of tongue and gingiva, dyspnea, skin rash), headache
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.
MAO-B inhibitor; safinamide selectively inhibits MAO-B with more than 1000-fold selectivity over MAO-A, blocking catabolism of dopamine and thereby increasing dopamine levels and dopaminergic activity 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)
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Xadago
  • Covered on 5 commercial plans
  • PA (10/12) · Step Therapy (10/12) · Qty limit (9/12)
View full coverage details ›
UnitedHealthcare
Apokyn
  • Covered on 4 commercial plans
  • PA (1/8) · Step Therapy (0/8) · Qty limit (3/8)
View full coverage details ›
Xadago
  • Covered on 4 commercial plans
  • PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
View full coverage details ›
Humana
Apokyn
  • Covered on 0 commercial plans
  • PA (3/3) · Step Therapy (0/3) · Qty limit (2/3)
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Xadago
  • Covered on 0 commercial plans
  • PA (3/3) · Step Therapy (3/3) · Qty limit (3/3)
View full coverage details ›
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 Xadago.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.