| Parkinson Disease
Rytary vs Duopa
Side-by-side clinical, coverage, and cost comparison for parkinson disease.Deep comparison between: Rytary vs Duopa 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 signalsDuopa has a higher rate of injection site reactions vs Rytary based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Duopa but not Rytary, including UnitedHealthcare
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Category
Rytary
Duopa
At A Glance
Oral
Three to five times daily
Dopamine precursor/decarboxylase inhibitor combination
Intrajejunal infusion
Daily 16-hour infusion
Carbidopa-levodopa combination
Indications
- Parkinson Disease
- Parkinson Disease, Postencephalitic
- Carbon monoxide-induced parkinsonism
- Manganese-induced parkinsonism
- Parkinson Disease
Dosing
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.
Parkinson Disease Administer via continuous 16-hour intrajejunal infusion through a PEG-J tube using the CADD-Legacy 1400 pump; dose individualized as a morning dose, continuous dose, and extra doses; maximum 2000 mg levodopa (one cassette) per day.
Contraindications
- Concurrent use of nonselective MAO inhibitors (e.g., phenelzine, tranylcypromine) or use within the preceding 2 weeks
- Concurrent or recent (within 2 weeks) use of nonselective MAO inhibitors (e.g., phenelzine, tranylcypromine)
Adverse Reactions
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
Most common (>=7% greater than oral immediate-release carbidopa-levodopa) Complication of device insertion, nausea, depression, peripheral edema, hypertension, upper respiratory tract infection, oropharyngeal pain, atelectasis, incision site erythema
Serious Gastrointestinal and procedure-related risks, falling asleep during activities of daily living and somnolence, orthostatic hypotension, hallucinations/psychosis/confusion, impulse control/compulsive behaviors, depression and suicidality, withdrawal-emergent hyperpyrexia and confusion, dyskinesia, vitamin B6 deficiency and seizures, neuropathy, cardiovascular ischemic events, glaucoma
Pharmacology
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.
Carbidopa inhibits peripheral decarboxylation of levodopa, increasing levodopa availability in the brain; levodopa crosses the blood-brain barrier and is converted to dopamine, which is thought to treat the motor symptoms of Parkinson's disease.
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Most Common Insurance
Anthem BCBS
Rytary
- Covered on 5 commercial plans
- PA (6/12) · Step Therapy (5/12) · Qty limit (5/12)
Duopa
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (10/12) · Qty limit (0/12)
UnitedHealthcare
Rytary
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (2/8) · Qty limit (0/8)
Duopa
- Covered on 4 commercial plans
- PA (6/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Rytary
- Covered on 0 commercial plans
- PA (0/3) · Step Therapy (2/3) · Qty limit (2/3)
Duopa
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (2/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Rytary.
Cost estimate not availableAssistance Fund: Parkinson's Disease
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.