| Seizures, Focal
Fycompa vs Vimpat
Side-by-side clinical, coverage, and cost comparison for seizures, focal.Deep comparison between: Fycompa vs Vimpat 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 signalsVimpat has a higher rate of injection site reactions vs Fycompa based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Vimpat but not Fycompa, including UnitedHealthcare
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Category
Fycompa
Vimpat
At A Glance
Oral
Once daily
AMPA receptor antagonist
Oral; IV infusion
Twice daily
Sodium channel modulator
Indications
- Seizures, Focal
- Tonic-Clonic Epilepsy
- Seizures, Focal
- Idiopathic generalized epilepsy
Dosing
Seizures, Focal Start at 2 mg once daily at bedtime; increase by 2 mg no more frequently than weekly; recommended maintenance 8-12 mg once daily at bedtime (monotherapy or adjunctive). With concomitant moderate or strong CYP3A4 inducers, start at 4 mg once daily.
Tonic-Clonic Epilepsy Start at 2 mg once daily at bedtime; increase by 2 mg no more frequently than weekly; recommended maintenance 8 mg once daily at bedtime (adjunctive). With concomitant moderate or strong CYP3A4 inducers, start at 4 mg once daily.
Seizures, Focal Monotherapy (adults >=17 years): initiate 100 mg twice daily, maintenance 150-200 mg twice daily (300-400 mg/day); adjunctive therapy (adults): initiate 50 mg twice daily, maintenance 100-200 mg twice daily (200-400 mg/day); pediatric patients 1 month to <17 years: weight-based dosing twice daily; max 200 mg twice daily; IV infusion available at same dose when oral temporarily not feasible.
Idiopathic generalized epilepsy Adjunctive therapy only for patients 4 years of age and older; adults: initiate 50 mg twice daily, titrate by 50 mg twice daily weekly, maintenance 100-200 mg twice daily (200-400 mg/day); pediatric patients: weight-based dosing twice daily.
Contraindications
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Adverse Reactions
Most common (>=4%) dizziness, somnolence, fatigue, irritability, falls, nausea, ataxia, balance disorder, gait disturbance, vertigo, weight gain
Serious serious psychiatric and behavioral reactions, suicidal behavior and ideation, neurologic effects, falls, DRESS/multiorgan hypersensitivity
Postmarketing DRESS, acute psychosis, hallucinations, delusions, paranoia, delirium, confusional state, disorientation, memory impairment
Most common (>=2%) dizziness, headache, nausea, diplopia, ataxia, somnolence, vomiting, fatigue, blurred vision, vertigo, tremor, nystagmus, balance disorder
Serious suicidal behavior and ideation, dizziness and ataxia, cardiac rhythm and conduction abnormalities, syncope, DRESS/multiorgan hypersensitivity reactions
Postmarketing agranulocytosis, aggression, agitation, hallucination, insomnia, psychotic disorder, angioedema, rash, urticaria, Stevens-Johnson syndrome, toxic epidermal necrolysis, dyskinesia, new or worsening seizures
Pharmacology
Perampanel is a non-competitive antagonist of the ionotropic AMPA glutamate receptor on post-synaptic neurons, reducing neuronal over-excitation caused by glutamate, the primary excitatory neurotransmitter in the CNS; the precise mechanism by which it exerts antiepileptic effects in humans is unknown.
Lacosamide selectively enhances slow inactivation of voltage-gated sodium channels, resulting in stabilization of hyperexcitable neuronal membranes and inhibition of repetitive neuronal firing; it is a functionalized amino acid antiepileptic agent.
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Most Common Insurance
Anthem BCBS
Fycompa
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (1/12) · Qty limit (9/12)
Vimpat
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (1/12) · Qty limit (9/12)
UnitedHealthcare
Fycompa
- Covered on 4 commercial plans
- PA (4/8) · Step Therapy (0/8) · Qty limit (2/8)
Vimpat
- Covered on 4 commercial plans
- PA (4/8) · Step Therapy (4/8) · Qty limit (1/8)
Humana
Fycompa
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (3/3)
Vimpat
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (3/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
$5/momo
Fycompa Instant Savings Card - Covered benefitCommercial or private insurance
Medicare, Medicaid, VA, TRICARE
Final cost depends on formulary coverage
No savings programs available for Vimpat.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.