| Parkinson Disease
Northera vs Onapgo
Side-by-side clinical, coverage, and cost comparison for parkinson disease.Deep comparison between: Northera 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 Northera based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Onapgo but not Northera, including UnitedHealthcare
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Category
Northera
Onapgo
At A Glance
Oral
Three times daily
Norepinephrine prodrug
SC injection
Daily continuous infusion
Non-ergoline dopamine agonist
Indications
- Parkinson Disease
- Multiple System Atrophy
- Pure Autonomic Failure
- dopamine beta hydroxylase deficiency
- Autonomic neuropathy
- Parkinson Disease
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 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
- History of hypersensitivity to droxidopa or any of its ingredients
- 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%) 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 (>=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
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.
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.
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Northera
- Covered on 5 commercial plans
- PA (11/12) · Step Therapy (1/12) · Qty limit (11/12)
Onapgo
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (0/12) · Qty limit (9/12)
UnitedHealthcare
Northera
- Covered on 4 commercial plans
- PA (3/8) · Step Therapy (2/8) · Qty limit (3/8)
Onapgo
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Northera
- Covered on 0 commercial plans
- PA (2/3) · Step Therapy (2/3) · 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
$10/fillfill
Northera Commercial Copay Assistance ProgramCommercial or private insurance
Medicare, Medicaid, VA, TRICARE
No savings programs available for Onapgo.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.