| Parkinson Disease
Northera vs Rytary
Side-by-side clinical, coverage, and cost comparison for parkinson disease.Deep comparison between: Northera 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 Northera based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Rytary but not Northera, including UnitedHealthcare
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Category
Northera
Rytary
At A Glance
Oral
Three times daily
Norepinephrine prodrug
Oral
Three to five times daily
Dopamine precursor/decarboxylase inhibitor combination
Indications
- Parkinson Disease
- Multiple System Atrophy
- Pure Autonomic Failure
- dopamine beta hydroxylase deficiency
- Autonomic neuropathy
- Parkinson Disease
- Parkinson Disease, Postencephalitic
- Carbon monoxide-induced parkinsonism
- Manganese-induced parkinsonism
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, 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
- History of hypersensitivity to droxidopa or any of its ingredients
- Concurrent use of nonselective MAO inhibitors (e.g., phenelzine, tranylcypromine) or use within the preceding 2 weeks
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%) 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
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.
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
Northera
- Covered on 5 commercial plans
- PA (11/12) · Step Therapy (1/12) · Qty limit (11/12)
Rytary
- Covered on 5 commercial plans
- PA (6/12) · Step Therapy (5/12) · Qty limit (5/12)
UnitedHealthcare
Northera
- Covered on 4 commercial plans
- PA (3/8) · Step Therapy (2/8) · Qty limit (3/8)
Rytary
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (2/8) · Qty limit (0/8)
Humana
Northera
- Covered on 0 commercial plans
- PA (2/3) · Step Therapy (2/3) · 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
$10/fillfill
Northera Commercial Copay Assistance ProgramCommercial or private insurance
Medicare, Medicaid, VA, TRICARE
No savings programs available for Rytary.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.