| Thyroid carcinoma
Retevmo vs Synthroid
Side-by-side clinical, coverage, and cost comparison for thyroid carcinoma.Deep comparison between: Retevmo vs Synthroid 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 signalsSynthroid has a higher rate of injection site reactions vs Retevmo based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Synthroid but not Retevmo, including UnitedHealthcare
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Category
Retevmo
Synthroid
At A Glance
Oral
Twice daily
RET kinase inhibitor
Oral
Daily
Synthetic thyroid hormone (T4)
Indications
- Non-Small Cell Lung Carcinoma
- Medullary carcinoma of thyroid
- Thyroid carcinoma
- Hypothyroidism
- Thyroid carcinoma
Dosing
Non-Small Cell Lung Carcinoma, Medullary carcinoma of thyroid, Thyroid carcinoma Adults and adolescents >= 12 years: 120 mg orally twice daily (< 50 kg) or 160 mg orally twice daily (>= 50 kg); pediatric patients 2 to < 12 years: 40 mg three times daily to 160 mg twice daily orally based on body surface area; administered until disease progression or unacceptable toxicity.
Hypothyroidism Once daily oral dose on an empty stomach one-half to one hour before breakfast; full replacement starting dose is 1.6 mcg/kg/day in adults (lower starting dose for patients at cardiac risk or geriatric patients); titrate by 12.5 to 25 mcg increments every 4 to 6 weeks based on serum TSH or free-T4; pediatric dosing starts at 10 to 15 mcg/kg/day in neonates and decreases with age.
Thyroid carcinoma Once daily oral dose; dosage is based on the target level of TSH suppression for the stage and clinical status of well-differentiated thyroid cancer.
Contraindications
—
- Uncorrected adrenal insufficiency
Adverse Reactions
Most common (>=25%) edema, diarrhea, fatigue, dry mouth, hypertension, abdominal pain, constipation, rash, nausea, headache
Serious hepatotoxicity, interstitial lung disease/pneumonitis, hypertension, QT interval prolongation, hemorrhagic events, hypersensitivity, tumor lysis syndrome, impaired wound healing, hypothyroidism, slipped capital femoral epiphysis in adolescents
Postmarketing Stevens-Johnson Syndrome
Most common Fatigue, increased appetite, weight loss, heat intolerance, fever, excessive sweating, headache, hyperactivity, nervousness, anxiety, irritability, emotional lability, insomnia, tremors, muscle weakness, muscle spasm, palpitations, tachycardia, arrhythmias, increased pulse and blood pressure, dyspnea, diarrhea, vomiting, abdominal cramps, elevated liver function tests, hair loss, flushing, rash, decreased bone mineral density, menstrual irregularities, impaired fertility.
Serious Heart failure, angina, myocardial infarction, cardiac arrest, seizures (rare); in pediatric patients: pseudotumor cerebri, slipped capital femoral epiphysis, craniosynostosis in infants, and premature epiphyseal closure.
Postmarketing Hypersensitivity reactions to inactive ingredients including urticaria, pruritus, skin rash, flushing, angioedema, gastrointestinal symptoms, fever, arthralgia, serum sickness, and wheezing.
Pharmacology
Selpercatinib is a kinase inhibitor that selectively inhibits wild-type RET and multiple mutated RET isoforms (including gene fusions and activating point mutations) as well as VEGFR1 and VEGFR3, and at clinically achievable concentrations also inhibits FGFR1, 2, and 3, blocking constitutive RET signaling that acts as an oncogenic driver promoting tumor cell proliferation.
Synthetic T4 (levothyroxine) exerts the same physiologic effect as endogenous thyroxine by binding thyroid receptor proteins in the cell nucleus to activate DNA transcription and protein synthesis; approximately 80% of circulating T3, the predominantly active form, is derived from peripheral deiodination of T4.
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Most Common Insurance
Anthem BCBS
No coverage data available for Retevmo.
Synthroid
- Covered on 5 commercial plans
- PA (0/12) · Step Therapy (0/12) · Qty limit (0/12)
UnitedHealthcare
Retevmo
- Covered on 4 commercial plans
- PA (6/8) · Step Therapy (0/8) · Qty limit (6/8)
Synthroid
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Retevmo
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (2/3)
Synthroid
- Covered on 0 commercial plans
- PA (0/3) · Step Therapy (0/3) · Qty limit (0/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Retevmo.
No savings programs available for Synthroid.
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RetevmoView full Retevmo profile
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.