| Parkinson Disease
Neupro vs Onapgo
Side-by-side clinical, coverage, and cost comparison for parkinson disease.Deep comparison between: Neupro 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 Neupro based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Onapgo but not Neupro, including UnitedHealthcare
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Category
Neupro
Onapgo
At A Glance
Transdermal patch
Daily
Dopamine agonist
SC injection
Daily continuous infusion
Non-ergoline dopamine agonist
Indications
- Parkinson Disease
- Restless Legs Syndrome
- Parkinson Disease
Dosing
Parkinson Disease Early-stage: start 2 mg/24 hours, increase by 2 mg/24 hours weekly, max 6 mg/24 hours; advanced-stage: start 4 mg/24 hours, increase by 2 mg/24 hours weekly, max 8 mg/24 hours; applied transdermally once daily.
Restless Legs Syndrome Start 1 mg/24 hours, increase by 1 mg/24 hours weekly as needed, max 3 mg/24 hours; applied transdermally once daily.
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
- Hypersensitivity to rotigotine or any component of the transdermal system
- 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 (>=5% above placebo) Application site reactions, nausea, somnolence, dizziness, vomiting, disturbances in initiating and maintaining sleep, peripheral edema, dyskinesia, headache, hyperhidrosis, anorexia, visual disturbance
Serious Sulfite sensitivity, falling asleep during activities of daily living, hallucinations/psychosis, symptomatic hypotension, syncope, impulse control/compulsive behaviors, elevation of blood pressure and heart rate, weight gain and fluid retention, dyskinesia, augmentation and rebound in RLS, hyperpyrexia and confusion, withdrawal symptoms, fibrotic complications
Postmarketing Withdrawal symptoms, dropped head syndrome, rhabdomyolysis
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
Rotigotine is a non-ergoline dopamine agonist thought to exert its therapeutic effects by stimulating dopamine receptors within the caudate-putamen in Parkinson's disease and dopamine receptors in Restless Legs Syndrome.
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
Neupro
- Covered on 5 commercial plans
- PA (5/12) · 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
Neupro
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Onapgo
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Neupro
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (3/3) · 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
No savings programs available for Neupro.
No savings programs available for Onapgo.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.