| Restless Legs Syndrome

Horizant vs Neupro

Side-by-side clinical, coverage, and cost comparison for restless legs syndrome.

Deep comparison between: Horizant vs Neupro 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 signalsNeupro has a higher rate of injection site reactions vs Horizant based on FDA-approved prescribing information

Coverage gaps3 major payers require step therapy for Neupro but not Horizant, including UnitedHealthcare

Category

Horizant

Neupro

At A Glance

RouteOral

FrequencyOnce or twice daily

ClassAlpha-2-delta ligand

RouteTransdermal patch

FrequencyDaily

ClassDopamine agonist

Indications

Restless Legs Syndrome
Postherpetic neuralgia

Parkinson Disease
Restless Legs Syndrome

Dosing

Restless Legs Syndrome 600 mg orally once daily at about 5 PM; dose adjustments required based on creatinine clearance in renal impairment; not recommended for patients on hemodialysis.

Postherpetic neuralgia Initiated at 600 mg orally in the morning for 3 days, then increased to 600 mg twice daily (1,200 mg/day); dose adjustments required based on creatinine clearance in renal impairment.

Parkinson Disease Early-stage: start 2 mg/24 hours, increase by 2 mg/24 hours weekly, max 6 mg/24 hours; advanced-stage: start 4 mg/24 hours, increase by 2 mg/24 hours weekly, max 8 mg/24 hours; applied transdermally once daily.

Restless Legs Syndrome Start 1 mg/24 hours, increase by 1 mg/24 hours weekly as needed, max 3 mg/24 hours; applied transdermally once daily.

Contraindications

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Hypersensitivity to rotigotine or any component of the transdermal system

Drug Interactions

694View drug interactions

668View drug interactions

Adverse Reactions

Most common (>=5%) Somnolence/sedation, dizziness, headache, fatigue, nausea, irritability

Serious Suicidal behavior and ideation, seizures with abrupt or rapid discontinuation, respiratory depression, drug reaction with eosinophilia and systemic symptoms (DRESS)/multiorgan hypersensitivity

Postmarketing Breast enlargement, gynecomastia, elevated creatine kinase, bullous pemphigoid, life-threatening or fatal respiratory depression (with opioids or CNS depressants or underlying respiratory impairment), withdrawal symptoms including seizures, depression, anxiety, insomnia, and nausea

Most common (>=5% above placebo) Application site reactions, nausea, somnolence, dizziness, vomiting, disturbances in initiating and maintaining sleep, peripheral edema, dyskinesia, headache, hyperhidrosis, anorexia, visual disturbance

Serious Sulfite sensitivity, falling asleep during activities of daily living, hallucinations/psychosis, symptomatic hypotension, syncope, impulse control/compulsive behaviors, elevation of blood pressure and heart rate, weight gain and fluid retention, dyskinesia, augmentation and rebound in RLS, hyperpyrexia and confusion, withdrawal symptoms, fibrotic complications

Postmarketing Withdrawal symptoms, dropped head syndrome, rhabdomyolysis

Pharmacology

Gabapentin enacarbil is a prodrug of gabapentin that undergoes extensive first-pass hydrolysis after oral absorption; gabapentin binds with high affinity to the alpha-2-delta subunit of voltage-activated calcium channels, though its precise mechanism of action in RLS and PHN is unknown.

Rotigotine is a non-ergoline dopamine agonist thought to exert its therapeutic effects by stimulating dopamine receptors within the caudate-putamen in Parkinson's disease and dopamine receptors in Restless Legs Syndrome.

View Full FDA Information

View full FDA information

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Most Common Insurance

Anthem BCBS

Horizant