| Seizures, Focal
Afinitor vs Aptiom
Side-by-side clinical, coverage, and cost comparison for seizures, focal.Deep comparison between: Afinitor vs Aptiom 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 signalsAptiom has a higher rate of injection site reactions vs Afinitor based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Aptiom but not Afinitor, including UnitedHealthcare
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Category
Afinitor
Aptiom
At A Glance
Oral
Daily
mTOR inhibitor
Oral
Once daily
Sodium channel inhibitor
Indications
- Hormone receptor positive breast cancer
- Neuroendocrine tumor of pancreas
- Gastro-enteropancreatic neuroendocrine tumor
- Renal Cell Carcinoma
- Angiomyolipoma of kidney
- Subependymal Giant Cell Astrocytoma
- Seizures, Focal
- Seizures, Focal
Dosing
Hormone receptor positive breast cancer 10 mg orally once daily in combination with exemestane until disease progression or unacceptable toxicity.
Neuroendocrine tumor of pancreas, Gastro-enteropancreatic neuroendocrine tumor 10 mg orally once daily until disease progression or unacceptable toxicity.
Renal Cell Carcinoma 10 mg orally once daily until disease progression or unacceptable toxicity.
Angiomyolipoma of kidney 10 mg orally once daily until disease progression or unacceptable toxicity.
Subependymal Giant Cell Astrocytoma Starting dose 4.5 mg/m2 orally once daily (AFINITOR or AFINITOR DISPERZ); titrate to trough concentration 5-15 ng/mL.
Seizures, Focal Starting dose 5 mg/m2 orally once daily (AFINITOR DISPERZ); titrate to trough concentration 5-15 ng/mL.
Seizures, Focal (Adults) Initial 400 mg orally once daily; may initiate at 800 mg once daily if need for seizure reduction outweighs increased adverse reaction risk; increase weekly by 400-600 mg to recommended maintenance of 800-1600 mg once daily.
Seizures, Focal (Pediatric, 4-17 years) Weight-based once daily oral dosing; initial dose and titration increments per weight table; maintenance 400-1200 mg/day depending on body weight range (11-21 kg: 400-600 mg; 22-31 kg: 500-800 mg; 32-38 kg: 600-900 mg; >38 kg: 800-1200 mg).
Renal Impairment (Moderate or Severe) Reduce dosage by 50% in patients with creatinine clearance below 50 mL/min.
Contraindications
- Clinically significant hypersensitivity to everolimus or other rapamycin derivatives
- Hypersensitivity to eslicarbazepine acetate or oxcarbazepine
Adverse Reactions
Most common (>=30%) Stomatitis, infections, rash, fatigue, diarrhea, decreased appetite.
Serious Non-infectious pneumonitis, infections, severe hypersensitivity reactions, angioedema, stomatitis, renal failure, impaired wound healing, metabolic disorders (hyperglycemia, dyslipidemia), myelosuppression, radiation sensitization and recall.
Postmarketing Thrombotic microangiopathy, cardiac failure (including with pulmonary hypertension), acute pancreatitis, cholecystitis, cholelithiasis, sepsis, reflex sympathetic dystrophy, arterial thrombotic events, lymphedema, radiation sensitization and recall.
Most common (>=4%) dizziness, somnolence, nausea, headache, diplopia, vomiting, fatigue, vertigo, ataxia, blurred vision, tremor
Serious suicidal behavior and ideation, serious dermatologic reactions, DRESS/multiorgan hypersensitivity, anaphylactic reactions and angioedema, hyponatremia, drug-induced liver injury, abnormal thyroid function, pancytopenia, agranulocytosis, leukopenia
Postmarketing leukopenia, agranulocytosis, thrombocytopenia, megaloblastic anemia, pancytopenia, syndrome of inappropriate antidiuretic hormone secretion (SIADH)
Pharmacology
Everolimus is an mTOR inhibitor that binds the intracellular protein FKBP-12 to form an inhibitory complex with mTORC1, suppressing downstream effectors (S6K1, 4E-BP1) involved in protein synthesis, cell proliferation, and angiogenesis, and reducing HIF-1 and VEGF expression; mTOR pathway dysregulation occurs in several human cancers and in tuberous sclerosis complex.
APTIOM is extensively converted to its active metabolite eslicarbazepine after oral administration; eslicarbazepine exerts anticonvulsant activity thought to involve inhibition of voltage-gated sodium channels.
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Most Common Insurance
Anthem BCBS
Afinitor
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (0/12) · Qty limit (0/12)
Aptiom
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (0/12) · Qty limit (0/12)
UnitedHealthcare
Afinitor
- Covered on 4 commercial plans
- PA (8/8) · Step Therapy (0/8) · Qty limit (6/8)
Aptiom
- Covered on 4 commercial plans
- PA (6/8) · Step Therapy (0/8) · Qty limit (3/8)
Humana
Afinitor
- Covered on 0 commercial plans
- PA (2/3) · Step Therapy (0/3) · Qty limit (2/3)
Aptiom
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (3/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Afinitor.
$35/fillfill
Aptiom High-Deductible Discount CardCommercial or private insurance
Medicare, Medicaid, VA, TRICARE
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.