| Parkinson Disease
Nourianz vs Rytary
Side-by-side clinical, coverage, and cost comparison for parkinson disease.Deep comparison between: Nourianz 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 Nourianz based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Rytary but not Nourianz, including UnitedHealthcare
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Category
Nourianz
Rytary
At A Glance
Oral
Daily
Adenosine A2A receptor antagonist
Oral
Three to five times daily
Dopamine precursor/decarboxylase inhibitor combination
Indications
- Parkinson Disease
- Parkinson Disease
- Parkinson Disease, Postencephalitic
- Carbon monoxide-induced parkinsonism
- Manganese-induced parkinsonism
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, 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
—
- Concurrent use of nonselective MAO inhibitors (e.g., phenelzine, tranylcypromine) or use within the preceding 2 weeks
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 (>=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
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.
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.
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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)
Rytary
- Covered on 5 commercial plans
- PA (6/12) · Step Therapy (5/12) · Qty limit (5/12)
UnitedHealthcare
Nourianz
- Covered on 4 commercial plans
- PA (4/8) · Step Therapy (4/8) · Qty limit (0/8)
Rytary
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (2/8) · Qty limit (0/8)
Humana
Nourianz
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (3/3)
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
$20/fillfill
Nourianz 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.