| Seizures, Focal
Xcopri vs Vimpat
Side-by-side clinical, coverage, and cost comparison for seizures, focal.Deep comparison between: Xcopri 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 Xcopri based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Vimpat but not Xcopri, including UnitedHealthcare
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Category
Xcopri
Vimpat
At A Glance
Oral
Once daily
Sodium channel inhibitor / GABA-A modulator
Oral; IV infusion
Twice daily
Sodium channel modulator
Indications
- Seizures, Focal
- Seizures, Focal
- Idiopathic generalized epilepsy
Dosing
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.
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
- Hypersensitivity to cenobamate or any of the inactive ingredients in XCOPRI
- Familial Short QT syndrome
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Adverse Reactions
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
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
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.
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
Xcopri
- Covered on 5 commercial plans
- PA (8/12) · Step Therapy (2/12) · Qty limit (11/12)
Vimpat
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (1/12) · Qty limit (9/12)
UnitedHealthcare
Xcopri
- Covered on 4 commercial plans
- PA (5/8) · Step Therapy (3/8) · Qty limit (2/8)
Vimpat
- Covered on 4 commercial plans
- PA (4/8) · Step Therapy (4/8) · Qty limit (1/8)
Humana
Xcopri
- 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
$20/momo
Xcopri Coupon CardCommercial or private insurance
Medicare, Medicaid, VA, TRICARE
No savings programs available for Vimpat.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.