| Parkinson Disease
Duopa vs Xadago
Side-by-side clinical, coverage, and cost comparison for parkinson disease.Deep comparison between: Duopa vs Xadago 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 signalsXadago has a higher rate of injection site reactions vs Duopa based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Xadago but not Duopa, including UnitedHealthcare
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Category
Duopa
Xadago
At A Glance
Intrajejunal infusion
Daily 16-hour infusion
Carbidopa-levodopa combination
Oral
Daily
MAO-B inhibitor
Indications
- Parkinson Disease
- Parkinson Disease
Dosing
Parkinson Disease Administer via continuous 16-hour intrajejunal infusion through a PEG-J tube using the CADD-Legacy 1400 pump; dose individualized as a morning dose, continuous dose, and extra doses; maximum 2000 mg levodopa (one cassette) per day.
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
- Concurrent or recent (within 2 weeks) use of nonselective MAO inhibitors (e.g., phenelzine, tranylcypromine)
- 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 (>=7% greater than oral immediate-release carbidopa-levodopa) Complication of device insertion, nausea, depression, peripheral edema, hypertension, upper respiratory tract infection, oropharyngeal pain, atelectasis, incision site erythema
Serious Gastrointestinal and procedure-related risks, falling asleep during activities of daily living and somnolence, orthostatic hypotension, hallucinations/psychosis/confusion, impulse control/compulsive behaviors, depression and suicidality, withdrawal-emergent hyperpyrexia and confusion, dyskinesia, vitamin B6 deficiency and seizures, neuropathy, cardiovascular ischemic events, glaucoma
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
Carbidopa inhibits peripheral decarboxylation of levodopa, increasing levodopa availability in the brain; levodopa crosses the blood-brain barrier and is converted to dopamine, which is thought to treat the motor symptoms of Parkinson's disease.
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.
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Duopa
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (10/12) · Qty limit (0/12)
Xadago
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (10/12) · Qty limit (9/12)
UnitedHealthcare
Duopa
- Covered on 4 commercial plans
- PA (6/8) · Step Therapy (0/8) · Qty limit (0/8)
Xadago
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Duopa
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (2/3)
Xadago
- 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 availableAssistance Fund: Parkinson's Disease
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.