| Renal transplant rejection
Thymoglobulin vs Envarsus XR
Side-by-side clinical, coverage, and cost comparison for renal transplant rejection.Deep comparison between: Thymoglobulin vs Envarsus 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 signalsEnvarsus has a higher rate of injection site reactions vs Thymoglobulin based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Envarsus but not Thymoglobulin, including UnitedHealthcare
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Category
Thymoglobulin
Envarsus
At A Glance
IV infusion
Daily
Polyclonal anti-thymocyte globulin
Oral
Once daily
Calcineurin inhibitor
Indications
- Renal transplant rejection
- Renal transplant rejection
Dosing
Renal transplant rejection (prophylaxis) 1.5 mg/kg IV daily for 4 to 7 days; first dose infused over at least 6 hours, subsequent doses over at least 4 hours; premedicate with corticosteroids, acetaminophen, and/or antihistamine 1 hour prior to each infusion.
Renal transplant rejection (treatment) 1.5 mg/kg IV daily for 7 to 14 days; first dose infused over at least 6 hours, subsequent doses over at least 4 hours; premedicate with corticosteroids, acetaminophen, and/or antihistamine 1 hour prior to each infusion.
Renal transplant rejection (de novo, with antibody induction) 0.14 mg/kg/day orally once daily on an empty stomach; target trough 6-11 ng/mL in month 1, 4-11 ng/mL thereafter.
Renal transplant rejection (conversion from tacrolimus immediate-release) 80% of the pre-conversion total daily dose of tacrolimus immediate-release orally once daily; titrate to target trough 4-11 ng/mL.
Contraindications
- History of allergy or anaphylactic reaction to rabbit proteins or to any product excipients
- Active acute or chronic infections that contraindicate additional immunosuppression
- Known hypersensitivity to tacrolimus or to any ingredient in ENVARSUS XR
Adverse Reactions
Most common (>5% higher than comparator) Urinary tract infection, abdominal pain, hypertension, nausea, dyspnea, fever, headache, anxiety, chills, hyperkalemia, leukopenia, thrombocytopenia
Serious Malignancies (including PTLD and lymphoma), anaphylactic shock, serum sickness, severe infections including sepsis
Postmarketing Hepatic dysfunction, hepatic failure, hyperbilirubinemia, febrile neutropenia, coagulopathy, disseminated intravascular coagulopathy, hemolytic anemia, thrombotic microangiopathy, anaphylaxis, cytokine release syndrome
Most common (>=10%) diarrhea, anemia, urinary tract infection, hypertension, tremor, constipation, diabetes mellitus, peripheral edema, hyperkalemia, headache, hypophosphatemia, leukopenia, nausea, insomnia, increased blood creatinine, hypomagnesemia, hypokalemia, hyperglycemia
Serious lymphoma and other malignancies, serious infections, new onset diabetes after transplant, nephrotoxicity, neurotoxicity, hyperkalemia, hypertension, QT prolongation, pure red cell aplasia, thrombotic microangiopathy including hemolytic uremic syndrome and thrombotic thrombocytopenic purpura
Postmarketing agranulocytosis, hemolytic anemia, hemolytic uremic syndrome, pancytopenia, pure red cell aplasia, thrombotic thrombocytopenic purpura, cardiac arrest, Torsades de pointes, hearing loss, blindness, gastrointestinal perforation, hepatic failure, Stevens-Johnson syndrome, toxic epidermal necrolysis, lymphoma, progressive multifocal leukoencephalopathy, posterior reversible encephalopathy syndrome, acute renal failure, rhabdomyolysis
Pharmacology
Polyclonal anti-thymocyte immunoglobulin G derived from rabbit immunization with human thymocytes; suppresses immune responses via T-cell clearance and modulation of T-cell activation, homing, and cytotoxic activities through antibodies targeting CD2, CD3, CD4, CD8, CD11a, CD18, CD25, CD44, CD45, HLA-DR, HLA Class I heavy chains, and beta2-microglobulin.
Tacrolimus is a calcineurin inhibitor that binds the intracellular protein FKBP-12, forming a complex that inhibits calcineurin phosphatase activity, thereby preventing T-lymphocyte activation and proliferation by blocking production of multiple cytokines including IL-2 and TNF-alpha.
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Most Common Insurance
Anthem BCBS
Thymoglobulin
- Covered on 5 commercial plans
- PA (5/12) · Step Therapy (0/12) · Qty limit (0/12)
Envarsus
- Covered on 5 commercial plans
- PA (6/12) · Step Therapy (0/12) · Qty limit (0/12)
UnitedHealthcare
Thymoglobulin
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Envarsus
- Covered on 4 commercial plans
- PA (2/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Thymoglobulin
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (0/3)
Envarsus
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (0/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
Cost estimate not availableHealthWell: Immunosuppressive Treatment for Solid Organ Transplant Recipients - Medicare Access
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
No savings programs available for Envarsus.
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ThymoglobulinView full Thymoglobulin profile
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.