| Parkinson Disease
Nourianz vs Onapgo
Side-by-side clinical, coverage, and cost comparison for parkinson disease.Deep comparison between: Nourianz 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 Nourianz based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Onapgo but not Nourianz, including UnitedHealthcare
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Category
Nourianz
Onapgo
At A Glance
Oral
Daily
Adenosine A2A receptor antagonist
SC injection
Daily continuous infusion
Non-ergoline dopamine agonist
Indications
- Parkinson Disease
- Parkinson Disease
Dosing
Parkinson Disease 20 mg orally once daily; may increase to 40 mg once daily based on individual need and tolerability; may be taken with or without food; max 20 mg once daily with strong CYP3A4 inhibitors or moderate hepatic impairment; 40 mg once daily in tobacco smokers (>=20 cigarettes/day); avoid with strong CYP3A4 inducers or in severe hepatic impairment.
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
—
- 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%) Dyskinesia, dizziness, constipation, nausea, hallucination, insomnia
Serious Dyskinesia, hallucinations/psychotic behavior, impulse control/compulsive behaviors
Postmarketing Increased libido
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
Adenosine A2A receptor antagonist; istradefylline is a xanthine derivative demonstrated in vitro and in animal studies to block adenosine A2A receptors, though the precise mechanism of therapeutic action in Parkinson's disease is unknown.
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.
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Most Common Insurance
Anthem BCBS
Nourianz
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (0/12) · Qty limit (9/12)
Onapgo
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (0/12) · Qty limit (9/12)
UnitedHealthcare
Nourianz
- Covered on 4 commercial plans
- PA (4/8) · Step Therapy (4/8) · Qty limit (0/8)
Onapgo
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Nourianz
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (3/3)
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
$20/fillfill
Nourianz 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.