| Parkinson Disease
Northera vs Xadago
Side-by-side clinical, coverage, and cost comparison for parkinson disease.Deep comparison between: Northera vs Xadago 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 signalsXadago has a higher rate of injection site reactions vs Northera based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Xadago but not Northera, including UnitedHealthcare
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Category
Northera
Xadago
At A Glance
Oral
Three times daily
Norepinephrine prodrug
Oral
Daily
MAO-B inhibitor
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 Start with 50 mg orally once daily; after two weeks, may increase to 100 mg once daily based on individual need and tolerability; maximum 50 mg once daily in moderate hepatic impairment (Child-Pugh B); contraindicated in severe hepatic impairment (Child-Pugh C).
Contraindications
- History of hypersensitivity to droxidopa or any of its ingredients
- Concomitant use of other MAOIs or potent monoamine oxidase inhibitors, including linezolid
- Concomitant use of opioid drugs (meperidine and its derivatives, methadone, propoxyphene, or tramadol), SNRIs, tricyclic/tetracyclic/triazolopyridine antidepressants, cyclobenzaprine, methylphenidate, amphetamine and their derivatives, or St John's wort
- Concomitant use of dextromethorphan
- History of hypersensitivity to safinamide
- Severe hepatic impairment (Child-Pugh C: 10-15)
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 (>=2%) Dyskinesia, fall, nausea, insomnia, orthostatic hypotension, anxiety, cough, dyspepsia
Serious Hypertension, serotonin syndrome, falling asleep during activities of daily living, dyskinesia, hallucinations/psychotic behavior, impulse control/compulsive behaviors, withdrawal-emergent hyperpyrexia and confusion, retinal pathology
Postmarketing Hypersensitivity (swelling of tongue and gingiva, dyspnea, skin rash), headache
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.
MAO-B inhibitor; safinamide selectively inhibits MAO-B with more than 1000-fold selectivity over MAO-A, blocking catabolism of dopamine and thereby increasing dopamine levels and dopaminergic activity in the brain.
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Most Common Insurance
Anthem BCBS
Northera
- Covered on 5 commercial plans
- PA (11/12) · Step Therapy (1/12) · Qty limit (11/12)
Xadago
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (10/12) · Qty limit (9/12)
UnitedHealthcare
Northera
- Covered on 4 commercial plans
- PA (3/8) · Step Therapy (2/8) · Qty limit (3/8)
Xadago
- 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)
Xadago
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · 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 Xadago.
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NortheraView full Northera profile
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.