| Seizures, Focal
Afinitor vs Xcopri
Side-by-side clinical, coverage, and cost comparison for seizures, focal.Deep comparison between: Afinitor vs Xcopri 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 signalsXcopri has a higher rate of injection site reactions vs Afinitor based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Xcopri but not Afinitor, including UnitedHealthcare
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Category
Afinitor
Xcopri
At A Glance
Oral
Daily
mTOR inhibitor
Oral
Once daily
Sodium channel inhibitor / GABA-A modulator
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 Initiate at 12.5 mg once daily and titrate every 2 weeks to recommended maintenance dose of 200 mg once daily (oral); maximum 400 mg once daily; for mild to moderate hepatic impairment, maximum 200 mg once daily.
Contraindications
- Clinically significant hypersensitivity to everolimus or other rapamycin derivatives
- Hypersensitivity to cenobamate or any of the inactive ingredients in XCOPRI
- Familial Short QT syndrome
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 (>=10%) Somnolence, dizziness, fatigue, diplopia, headache
Serious DRESS/multiorgan hypersensitivity, QT shortening, suicidal behavior and ideation, liver injury, neurological adverse reactions
Postmarketing Psychosis (hallucinations, delusions/paranoia), hostility, aggression, hepatic failure
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.
Cenobamate reduces repetitive neuronal firing by inhibiting voltage-gated sodium currents and is also a positive allosteric modulator of the GABA-A ion channel; the precise mechanism by which these effects translate to seizure reduction in patients with partial-onset seizures is unknown.
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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)
Xcopri
- Covered on 5 commercial plans
- PA (8/12) · Step Therapy (2/12) · Qty limit (11/12)
UnitedHealthcare
Afinitor
- Covered on 4 commercial plans
- PA (8/8) · Step Therapy (0/8) · Qty limit (6/8)
Xcopri
- Covered on 4 commercial plans
- PA (5/8) · Step Therapy (3/8) · Qty limit (2/8)
Humana
Afinitor
- Covered on 0 commercial plans
- PA (2/3) · Step Therapy (0/3) · Qty limit (2/3)
Xcopri
- 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.
$20/momo
Xcopri Coupon 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.