| Parkinson Disease
Neupro vs Rytary
Side-by-side clinical, coverage, and cost comparison for parkinson disease.Deep comparison between: Neupro vs Rytary 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 signalsRytary has a higher rate of injection site reactions vs Neupro based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Rytary but not Neupro, including UnitedHealthcare
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Category
Neupro
Rytary
At A Glance
Transdermal patch
Daily
Dopamine agonist
Oral
Three to five times daily
Dopamine precursor/decarboxylase inhibitor combination
Indications
- Parkinson Disease
- Restless Legs Syndrome
- Parkinson Disease
- Parkinson Disease, Postencephalitic
- Carbon monoxide-induced parkinsonism
- Manganese-induced parkinsonism
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, Parkinson Disease Postencephalitic, Carbon monoxide-induced parkinsonism, Manganese-induced parkinsonism (levodopa-naive) Starting dose 23.75 mg/95 mg orally three times daily for 3 days; may increase to 36.25 mg/145 mg three times daily on day 4; titrate up to a maximum of 97.5 mg/390 mg three to five times daily; maximum daily dose 612.5 mg/2,450 mg.
Converting from immediate-release carbidopa-levodopa Calculate current total daily levodopa dose; initiate RYTARY at the recommended conversion dose (855 mg to 2,340 mg total daily levodopa depending on prior dose); administer in divided doses three to five times daily; maximum daily dose 612.5 mg/2,450 mg.
Contraindications
- Hypersensitivity to rotigotine or any component of the transdermal system
- Concurrent use of nonselective MAO inhibitors (e.g., phenelzine, tranylcypromine) or use within the preceding 2 weeks
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 (>=5%) Nausea, dizziness, headache, insomnia, abnormal dreams, dry mouth, dyskinesia, anxiety, constipation, vomiting, orthostatic hypotension
Serious Falling asleep during activities of daily living, somnolence, withdrawal-emergent hyperpyrexia and confusion, cardiovascular ischemic events, hallucinations/psychosis, impulse control/compulsive behaviors, dyskinesia, vitamin B6 deficiency and seizures, peptic ulcer disease, glaucoma
Postmarketing Suicide attempt, suicidal ideation
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.
Carbidopa inhibits peripheral decarboxylation of levodopa, increasing the amount available to cross the blood-brain barrier, where levodopa is converted to dopamine to relieve the symptoms of Parkinson's disease.
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Neupro
- Covered on 5 commercial plans
- PA (5/12) · Step Therapy (0/12) · Qty limit (9/12)
Rytary
- Covered on 5 commercial plans
- PA (6/12) · Step Therapy (5/12) · Qty limit (5/12)
UnitedHealthcare
Neupro
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Rytary
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (2/8) · Qty limit (0/8)
Humana
Neupro
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (3/3) · Qty limit (2/3)
Rytary
- Covered on 0 commercial plans
- PA (0/3) · Step Therapy (2/3) · Qty limit (2/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Neupro.
No savings programs available for Rytary.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.