| Psoriasis
Otrexup vs Purified Cortrophin Gel
Side-by-side clinical, coverage, and cost comparison for psoriasis.Deep comparison between: Otrexup vs Purified Cortrophin Gel 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 signalsPurified Cortrophin Gel has a higher rate of injection site reactions vs Otrexup based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Purified Cortrophin Gel but not Otrexup, including UnitedHealthcare
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Category
Otrexup
Purified Cortrophin Gel
At A Glance
SC injection
Once weekly
Folate analog metabolic inhibitor
SC/IM injection
Corticotropin (ACTH)
Indications
- Rheumatoid Arthritis
- Juvenile polyarthritis
- Psoriasis
- Arthritis, Psoriatic
- Rheumatoid Arthritis
- Ankylosing spondylitis
- Primary gout
- Lupus Erythematosus, Systemic
- Polymyositis
- Stevens-Johnson Syndrome
- Psoriasis
- Dermatitis, Atopic
- Serum Sickness
- Allergic Conjunctivitis
- Keratitis
- Iritis
- Iridocyclitis
- Uveitis
- Optic Neuritis
- Chorioretinitis
- Sarcoidosis
- Nephrotic Syndrome
- Multiple Sclerosis
Dosing
Rheumatoid Arthritis 7.5 mg SC once weekly; adjust dose gradually; doses greater than 20 mg/week associated with significant increase in serious toxic reactions in adults.
Juvenile polyarthritis 10 mg/m2 SC once weekly; adjust dose gradually.
Psoriasis 10 to 25 mg SC once weekly; do not exceed 30 mg/week; reduce to lowest effective dose once optimal response is achieved.
Arthritis, Psoriatic, Rheumatoid Arthritis, Ankylosing spondylitis, Primary gout, Lupus Erythematosus, Systemic, Polymyositis, Stevens-Johnson Syndrome, Psoriasis, Dermatitis, Atopic, Serum Sickness, Allergic Conjunctivitis, Keratitis, Iritis, Iridocyclitis, Uveitis, Optic Neuritis, Chorioretinitis, Sarcoidosis, Nephrotic Syndrome Dose individualized based on disease severity, plasma and urine corticosteroid levels, and patient response; administer SC or IM; verify adrenal responsiveness prior to treatment (up to 80 units as a single injection); chronic doses above 40 units daily associated with uncontrollable adverse effects.
Multiple Sclerosis 80-120 units daily SC or IM for 2-3 weeks for acute exacerbations.
Contraindications
- Pregnancy
- Alcoholism, alcoholic liver disease, or other chronic liver disease
- Overt or laboratory evidence of immunodeficiency syndromes
- Preexisting blood dyscrasias, such as bone marrow hypoplasia, leukopenia, thrombocytopenia, or significant anemia
- Known hypersensitivity to methotrexate
- Intravenous administration
- Scleroderma
- Osteoporosis
- Systemic fungal infections
- Ocular herpes simplex
- Recent surgery
- History of or presence of a peptic ulcer
- Congestive heart failure
- Hypertension
- Sensitivity to proteins derived from porcine sources
- Primary adrenocortical insufficiency
- Adrenocortical hyperfunction
Adverse Reactions
Most common (>=10%) Elevated liver function tests, nausea/vomiting, ulcerative stomatitis, leukopenia, abdominal distress
Serious Bone marrow suppression, hepatotoxicity, interstitial pneumonitis, opportunistic infections, embryo-fetal toxicity, renal failure, pulmonary fibrosis
Postmarketing Toxic epidermal necrolysis, Stevens-Johnson syndrome, anaphylactoid reactions, reversible lymphoma, skin necrosis
Fluid and Electrolyte Sodium retention, hypokalemic alkalosis, fluid retention, calcium loss, potassium loss
Musculoskeletal Muscle weakness, loss of muscle mass, steroid myopathy, osteoporosis, vertebral compression fractures, aseptic necrosis of femoral and humeral heads, pathologic fracture of long bones
Gastrointestinal Peptic ulcer with possible perforation and hemorrhage, abdominal distention, ulcerative esophagitis, pancreatitis
Dermatologic Injection site reactions, impaired wound healing, increased sweating, thin fragile skin, suppression of skin test reactions, petechiae and ecchymoses, acne, hyperpigmentation, facial erythema
Cardiovascular Hypertension, congestive heart failure, necrotizing angiitis
Neurological Convulsions, increased intracranial pressure with papilledema, headache, vertigo
Endocrine Menstrual irregularities, Cushingoid state, suppression of growth in children, secondary adrenocortical and pituitary insufficiency, decreased carbohydrate tolerance, manifestations of latent diabetes mellitus, increased requirements for insulin or oral hypoglycemic agents, hirsutism
Ophthalmic Posterior subcapsular cataracts, increased intraocular pressure, glaucoma with possible damage to optic nerve, exophthalmos
Metabolic Negative nitrogen balance due to protein catabolism
Allergic Dizziness, nausea and vomiting, skin reactions, anaphylaxis (anaphylactic shock, urticaria, respiratory compromise, edema)
Miscellaneous Weight gain, abscess, development of antibodies and loss of stimulatory effect
Pharmacology
Methotrexate inhibits dihydrofolic acid reductase, preventing reduction of dihydrofolates to tetrahydrofolates and thereby interfering with DNA synthesis, repair, and cellular replication; in RA the mechanism is unknown but may affect immune function, and in psoriasis it exploits the markedly increased rate of epithelial cell proliferation.
Purified Cortrophin Gel is an anterior pituitary hormone (corticotropin/ACTH) that stimulates the functioning adrenal cortex to produce and secrete adrenocortical hormones; it is formulated as a porcine-derived purified ACTH in a sterile gelatin solution for prolonged activity.
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Otrexup
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (10/12) · Qty limit (0/12)
Purified Cortrophin Gel
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (1/12) · Qty limit (0/12)
UnitedHealthcare
Otrexup
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Purified Cortrophin Gel
- Covered on 4 commercial plans
- PA (5/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Otrexup
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (1/3) · Qty limit (0/3)
Purified Cortrophin Gel
- 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 Otrexup.
No savings programs available for Purified Cortrophin Gel.
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OtrexupView full Otrexup profile
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.