| Seizures, Focal
Qudexy XR vs Fycompa
Side-by-side clinical, coverage, and cost comparison for seizures, focal.Deep comparison between: Qudexy vs Fycompa 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 signalsFycompa has a higher rate of injection site reactions vs Qudexy based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Fycompa but not Qudexy, including UnitedHealthcare
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Category
Qudexy
Fycompa
At A Glance
Oral
Once daily
Broad-spectrum anticonvulsant
Oral
Once daily
AMPA receptor antagonist
Indications
- Seizures, Focal
- Generalized seizures
- Lennox-Gastaut syndrome
- Migraine Disorders
- Seizures, Focal
- Tonic-Clonic Epilepsy
Dosing
Seizures, Focal, Generalized seizures, Lennox-Gastaut syndrome Monotherapy (adults and peds >=10 years): 400 mg orally once daily, titrated over 6 weeks from 50 mg/day; peds 2-9 years: weight-based 150-400 mg/day once daily. Adjunctive (adults): 200 to 400 mg once daily; adjunctive (peds 2-16 years): approximately 5 to 9 mg/kg once daily, not to exceed 400 mg/day.
Migraine Disorders 100 mg orally once daily for patients 12 years of age and older, titrated over 4 weeks from 25 mg/day.
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.
Contraindications
- History of hypersensitivity reaction to topiramate, QUDEXY XR, or any inactive ingredient
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Adverse Reactions
Most common (>=10%) Paresthesia, somnolence, dizziness, weight loss, anorexia, speech disorders/related speech problems, psychomotor slowing, nervousness, vision abnormal
Serious Acute myopia and secondary angle closure glaucoma, visual field defects, oligohydrosis and hyperthermia, metabolic acidosis, suicidal behavior and ideation, cognitive/neuropsychiatric adverse reactions, decrease in bone mineral density, negative effects on growth, DRESS/multiorgan hypersensitivity, serious skin reactions, anaphylaxis and angioedema, hyperammonemia and encephalopathy, kidney stones, hypothermia with concomitant valproic acid
Postmarketing Hepatic failure, hepatitis, pancreatitis, bullous skin reactions (Stevens-Johnson syndrome, toxic epidermal necrolysis), pemphigus, maculopathy, nephrocalcinosis
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
Pharmacology
Topiramate blocks voltage-dependent sodium channels, augments GABA-A receptor activity, antagonizes the AMPA/kainate subtype of the glutamate receptor, and inhibits carbonic anhydrase isozymes II and IV; the precise mechanisms underlying its anticonvulsant and preventive migraine effects are unknown.
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.
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Most Common Insurance
Anthem BCBS
Qudexy
- Covered on 5 commercial plans
- PA (7/12) · Step Therapy (0/12) · Qty limit (0/12)
Fycompa
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (1/12) · Qty limit (9/12)
UnitedHealthcare
Qudexy
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Fycompa
- Covered on 4 commercial plans
- PA (4/8) · Step Therapy (0/8) · Qty limit (2/8)
Humana
Qudexy
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (0/3) · Qty limit (0/3)
Fycompa
- 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 Qudexy.
$5/momo
Fycompa Instant Savings Card - Covered benefitCommercial or private insurance
Medicare, Medicaid, VA, TRICARE
Final cost depends on formulary coverage
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.