Nuedexta (dextromethorphan HBr and quinidine sulfate) vs Radicava ORS (edaravone)

Nuedexta (dextromethorphan HBr and quinidine sulfate) vs Radicava ORS (edaravone)

Nuedexta and Radicava ORS (edaravone) are medications used for different medical conditions: Nuedexta is approved for the treatment of pseudobulbar affect (PBA), a condition characterized by sudden and uncontrollable episodes of crying or laughing, while Radicava ORS is an oral suspension formulation of edaravone, designed to treat amyotrophic lateral sclerosis (ALS), a neurodegenerative disorder. The active components in Nuedexta, dextromethorphan and quinidine, work by affecting signaling in the brain to help control the involuntary episodes associated with PBA, whereas edaravone in Radicava ORS is believed to act as a free radical scavenger, potentially slowing the decline in physical function in ALS patients. When deciding between these medications, it is crucial to consider the specific condition being treated, as Nuedexta is not indicated for ALS, and Radicava ORS is not indicated for PBA, thus the choice should be based on the diagnosis and a healthcare provider's recommendation.

Difference between Nuedexta and Radicava ORS

Metric Nuedexta (dextromethorphan HBr and quinidine sulfate) Radicava ORS (edaravone)
Generic name Dextromethorphan hydrobromide and quinidine sulfate Edaravone
Indications Treatment of pseudobulbar affect (PBA) Treatment of amyotrophic lateral sclerosis (ALS)
Mechanism of action Dextromethorphan acts on the central nervous system to modulate the excitatory neurotransmitter glutamate, while quinidine increases the availability of dextromethorphan by inhibiting its metabolism Free radical scavenger that is believed to relieve oxidative stress by augmenting the action of a natural antioxidant enzyme, superoxide dismutase
Brand names Nuedexta Radicava, Radicut
Administrative route Oral Oral suspension
Side effects Diarrhea, dizziness, cough, vomiting, weakness, swelling of feet or ankles Bruising (contusion), problems walking (gait disturbance), headache
Contraindications Patients taking monoamine oxidase inhibitors (MAOIs) or with a history of heart disease Patients with a history of hypersensitivity to edaravone or any of the excipients
Drug class Central nervous system agent Free radical scavenger
Manufacturer Avanir Pharmaceuticals Mitsubishi Tanabe Pharma

Efficacy

Nuedexta and ALS

Nuedexta, a combination of dextromethorphan HBr and quinidine sulfate, is primarily approved by the FDA for the treatment of pseudobulbar affect (PBA), a condition characterized by sudden and uncontrollable episodes of crying or laughing, which can occur in various neurological disorders, including amyotrophic lateral sclerosis (ALS). While Nuedexta is not specifically approved for the treatment of ALS itself, its efficacy in managing PBA symptoms in ALS patients has been recognized. The reduction in the frequency and severity of PBA episodes can significantly improve the quality of life for individuals with ALS, although it does not alter the progression of the underlying disease.

Efficacy of Nuedexta in ALS-Related PBA

The efficacy of Nuedexta in treating PBA in the context of ALS has been supported by clinical trials. These studies have demonstrated that patients with ALS who suffer from PBA experienced a reduction in the number of PBA episodes when treated with Nuedexta. The mechanism of action is thought to involve the modulation of excitatory neurotransmission in the brain, which can help stabilize the emotional lability associated with PBA. However, it is important to note that while Nuedexta can be beneficial for managing PBA in ALS patients, it does not have a direct impact on the motor neuron degeneration that is characteristic of ALS.

Radicava ORS and ALS

Radicava ORS (oral suspension of edaravone) is a medication that has been approved by the FDA for the treatment of ALS. Edaravone is an antioxidant that is believed to work by relieving oxidative stress, a factor that may contribute to the nerve cell damage seen in ALS. The efficacy of Radicava ORS in slowing the decline in physical function in ALS patients has been evaluated in clinical trials. These studies have shown that Radicava ORS can lead to a modest reduction in the rate of functional decline as measured by standardized ALS functional rating scales.

Efficacy of Radicava ORS in ALS

The clinical trials that led to the approval of Radicava ORS for ALS indicated that the medication could slow the progression of the disease. Patients treated with Radicava ORS showed a slower decline in physical function compared to those who received a placebo. It is important to note that while Radicava ORS has shown efficacy in slowing the progression of ALS, it is not a cure for the disease. The treatment may help to preserve motor function and independence for a longer period, which is a significant outcome for patients with this progressive and currently incurable disease.

Regulatory Agency Approvals

Nuedexta
  • Food and Drug Administration (FDA), USA
Radicava ORS
  • Food and Drug Administration (FDA), USA
  • Health Canada

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If Nuedexta or Radicava ORS are not approved or available in your country (e.g. due to supply issues), you can access them via Everyone.org.

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