| Parkinson Disease
Onapgo vs Rytary
Side-by-side clinical, coverage, and cost comparison for parkinson disease.Deep comparison between: Onapgo 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 Onapgo based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Rytary but not Onapgo, including UnitedHealthcare
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Category
Onapgo
Rytary
At A Glance
SC injection
Daily continuous infusion
Non-ergoline dopamine agonist
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 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.
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
- 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)
- Concurrent use of nonselective MAO inhibitors (e.g., phenelzine, tranylcypromine) or use within the preceding 2 weeks
Adverse Reactions
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
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
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.
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
Onapgo
- 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
Onapgo
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Rytary
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (2/8) · Qty limit (0/8)
Humana
Onapgo
- Covered on 0 commercial plans
- PA (2/3) · Step Therapy (2/3) · 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
No savings programs available for Onapgo.
No savings programs available for Rytary.
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OnapgoView full Onapgo profile
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.