| Parkinson Disease

Northera vs Neupro

Side-by-side clinical, coverage, and cost comparison for parkinson disease.

Deep comparison between: Northera vs Neupro 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 signalsNeupro has a higher rate of injection site reactions vs Northera based on FDA-approved prescribing information

Coverage gaps3 major payers require step therapy for Neupro but not Northera, including UnitedHealthcare

Category

Northera

Neupro

At A Glance

RouteOral

FrequencyThree times daily

ClassNorepinephrine prodrug

RouteTransdermal patch

FrequencyDaily

ClassDopamine agonist

Indications

Parkinson Disease
Multiple System Atrophy
Pure Autonomic Failure
dopamine beta hydroxylase deficiency
Autonomic neuropathy

Parkinson Disease
Restless Legs Syndrome

Dosing

Parkinson Disease, Multiple System Atrophy, Pure Autonomic Failure, dopamine beta hydroxylase deficiency, Autonomic neuropathy Starting dose 100 mg orally three times daily (upon arising, at midday, and in the late afternoon at least 3 hours before bedtime); titrate in increments of 100 mg three times daily every 24-48 hours to a maximum of 600 mg three times daily (1,800 mg/day total).

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.

Contraindications

History of hypersensitivity to droxidopa or any of its ingredients

Hypersensitivity to rotigotine or any component of the transdermal system

Drug Interactions

724View drug interactions

668View drug interactions

Adverse Reactions

Most common (>5%) Headache, dizziness, nausea, hypertension

Serious Supine hypertension, hyperpyrexia and confusion, exacerbation of ischemic heart disease, arrhythmias, congestive heart failure

Postmarketing Chest pain, blurred vision, pancreatitis, abdominal pain, vomiting, diarrhea, fatigue, cerebrovascular accident, psychosis, hallucination, delirium, agitation, memory disorder

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

Pharmacology

Droxidopa is a synthetic amino acid analog directly metabolized to norepinephrine by dopa-decarboxylase; norepinephrine increases blood pressure by inducing peripheral arterial and venous vasoconstriction.

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.

View Full FDA Information

View full FDA information

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Most Common Insurance

Anthem BCBS

Northera