Actor portrayal of a patient with Pseudobulbar Affect or PBA without symptoms

Cost Savings and Insurance Coverage for NUEDEXTA

Considerable cost savings and insurance coverage available for many commercial patients1,2

  • 83% of commercially insured patients pay ≤ $30 for a NUEDEXTA prescription1
  • NUEDEXTA has preferred brand coverage for more than 100 million commercial lives2

Extensive nationwide Medicare coverage3

  • 78% of Medicare Part D patients pay ≤ $15 for a NUEDEXTA prescription4,a
  • NUEDEXTA is covered by >99% of all Medicare plans nationwide, including:3
    • Medicare Prescription Drug Plans (PDP)
    • Medicare Advantage Plans (MA)
    • Special Needs Plans (SN)

aJanuary 2018 - December 2020.

Data Sources: 1. IQVIA, LAAD Dataset; January, 2018 - December, 2020; Commercially Insured; N=249k total claims. 2. Decision Resources Group. NUEDEXTA Preferred Commercial Coverage. January 14, 2019. 3. Decision Resources Group. NUEDEXTA Medicare Coverage. January 14, 2019. 4. IQVIA, LAAD Dataset; January, 2018 - December, 2020; Medicare Insured; N=628k total claims.


NUEDEXTA Co-Pay Savings Card

You can help reduce the cost of NUEDEXTA for many of your commercially insured patients by sharing this card with them.

Example image of NUEDEXTA savings card


Visit or call 1-855-468-3339


Your commercially insured patients may pay as little as $0* for their NUEDEXTA 90-day prescription

  • Applies to both new prescription and refills
  • Patients who are eligible for any state or federally funded prescription programs, including Medicare, Medicaid, Medigap, VA, DOD, or TriCare, are not eligible for this program

Print the Co-Pay Card Now

*Restrictions apply. Most commercially insured patients pay as little as $0 for a 90-day supply or $20 for a 30-day supply.

NUEDEXTA Sample Request Form

NUEDEXTA sample bottle for Pseudobulbar Affect or PBA patients

Request a sample to start your patients on NUEDEXTA. Eligible healthcare providers can request a free 10-day sample of NUEDEXTA for appropriate patients.

Note: Most patients see best results after 12 weeks.5,6

NUEDEXTA Prior Authorization

Some insurance providers and Medicare Part D plans may require prior authorization (PA) for the patients or residents for whom you prescribe NUEDEXTA. Each health plan will determine the PA criteria for its formulary. There are 4 common pieces of documentation generally requested by plans as part of their PA process to ensure that NUEDEXTA is being used safely and appropriately. These are:

  • Documentation of primary diagnosis of PBA: ICD-10-CM diagnosis code: F48.2*
  • Documentation of underlying conditions in which PBA may occur
  • Documentation that NUEDEXTA is not contraindicated for the patient; please refer to Important Safety Information
  • Medical or clinical history document
  • For reauthorization: Usually at the start of the year, documentation of symptom improvement and/or improvement to the CNS-LS scores maybe required

*For your reference only. ICD-10-CM codes submitted to health plans/payers must be determined by provider and accurately describe the diagnosis of the patient.

The resources below can help support you and your patients through the prior authorization process.

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NUEDEXTA Sample Letters of Medical Necessity

The Sample Letters of Medical Necessity are templates of letters that can be used to provide a payer with additional information about the need for a patient to use NUEDEXTA. Choose the appropriate template to use based upon the payer request.

Download Basic Letter Download Comprehensive Letter

NUEDEXTA Connect: Tailored support to help your patients throughout their treatment journey


NUEDEXTA Connect partners with CoverMyMedsb to streamline prior authorizations for providers and pharmacists and provide many other patient support services — to help remove access barriers to therapy.

  • Benefits verification
  • Prior authorization and formulary exception support
  • Support from Case Managers
  • Easy-to-initiate co-pay assistance and information on financial support*
  • Free product for uninsured and underinsured patients
  • Referrals to independent foundations
  • Helpful information about taking NUEDEXTA

*Restrictions apply. Most commercially insured patients pay as little as $0 for a 90-day supply or $20 for a 30-day supply. Patients who are eligible for any state or federally funded prescription programs, including Medicare, Medicaid, Medigap, VA, DOD, or TriCare, are not eligible for this program.

Restrictions apply.

For information on additional support, visit our Patient Assistance page.

Actor portrayal of a resident without Pseudobulbar Affect or PBA symptoms
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Call 1-855-4NUEDEX

Monday through Friday | 8 AM – 8 PM ET

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Create a free account or log in to your existing account at You can start a NUEDEXTA Connect enrollment or seamlessly submit, track, and manage prior authorization requests.

bCoverMyMeds is a registered trademark of CoverMyMeds LLC. All rights reserved.
CoverMyMeds is an independent third-party entity contracted with Otsuka America Pharmaceutical, Inc. to provide prior authorization and patient access services.

Co-Pay Card & Sample Requests

References: 1. IQVIA, LAAD Dataset; January, 2018 - December, 2020; Commercially Insured; N=249k total claims.  2. Decision Resources Group. NUEDEXTA Preferred Commercial Coverage. January 14, 2019.  3. Decision Resources Group. NUEDEXTA Medicare Coverage. January 14, 2019.  4. IQVIA, LAAD Dataset; January, 2018 - December, 2020; Medicare Insured; N=628k total claims. 5. Pioro EP, Brooks BR, Cummings J, et al. Dextromethorphan plus ultra-low quinidine reduces pseudobulbar affect. Ann Neurol. 2010;68(5):693-702.  6. Hammond FM, Alexander DN, Cutler AJ, et al. PRISM II: an open-label study to assess effectiveness of dextromethorphan/quinidine for pseudobulbar affect in patients with dementia, stroke or traumatic brain injury. BMC Neurol. 2016;16:89. 

INDICATION and IMPORTANT SAFETY INFORMATION for NUEDEXTA® (dextromethorphan HBr and quinidine sulfate)


NUEDEXTA is indicated for the treatment of pseudobulbar affect (PBA).

PBA occurs secondary to a variety of otherwise unrelated neurologic conditions, and is characterized by involuntary, sudden, and frequent episodes of laughing and/or crying. PBA episodes typically occur out of proportion or incongruent to the underlying emotional state. PBA is a specific condition, distinct from other types of emotional lability that may occur in patients with neurologic disease or injury.



  • Quinidine and Related Drugs: NUEDEXTA contains quinidine and should not be used concomitantly with other drugs containing quinidine, quinine, or mefloquine.
  • Hypersensitivity: NUEDEXTA is contraindicated in patients with a history of NUEDEXTA-, quinine-, mefloquine-, or quinidine-induced thrombocytopenia, hepatitis, bone-marrow depression, lupus-like syndrome, or known hypersensitivity to dextromethorphan (e.g., rash, hives).
  • MAOIs: NUEDEXTA is contraindicated in patients taking monoamine oxidase inhibitors (MAOIs), or in patients who have taken MAOIs within the preceding 14 days, due to the risk of serious and possibly fatal drug interactions, including serotonin syndrome. Allow at least 14 days after stopping NUEDEXTA before starting an MAOI.
  • Cardiovascular: NUEDEXTA is contraindicated in patients with a prolonged QT interval, congenital long QT syndrome, history suggestive of torsades de pointes, heart failure, patients receiving drugs that both prolong QT interval and are metabolized by CYP2D6 (e.g., thioridazine and pimozide), patients with complete atrioventricular (AV) block without implanted pacemaker, or at high risk of complete AV block.

Thrombocytopenia and Other Hypersensitivity Reactions: Quinidine can cause immune-mediated thrombocytopenia that can be severe or fatal. Non-specific symptoms, such as lightheadedness, chills, fever, nausea, and vomiting, can precede or occur with thrombocytopenia. NUEDEXTA should be discontinued immediately if thrombocytopenia occurs.

Hepatotoxicity: Hepatitis, including granulomatous hepatitis, has been reported in patients receiving quinidine, generally during the first few weeks of therapy. Discontinue immediately if this occurs.

Cardiac Effects: NUEDEXTA causes dose-dependent QTc prolongation. QT prolongation can cause torsades de pointes–type ventricular tachycardia, with the risk increasing as the degree of prolongation increases. When initiating NUEDEXTA in patients at risk for QT prolongation and torsades de pointes, electrocardiographic (ECG) evaluation of QT interval should be conducted at baseline and 3 to 4 hours after the first dose. Some risk factors include use with CYP3A4 inhibitors or drugs that prolong QT interval, electrolyte abnormalities, bradycardia, or left ventricular hypertrophy or dysfunction. If patients taking NUEDEXTA experience symptoms that could indicate the occurrence of cardiac arrhythmias (e.g., syncope or palpitations), NUEDEXTA should be discontinued, and the patient further evaluated.

Concomitant Use of CYP2D6 Substrates: NUEDEXTA inhibits CYP2D6 and may interact with other drugs metabolized by CYP2D6. Adjust dose of CYP2D6 substrates as needed.

Dizziness: NUEDEXTA may cause dizziness. Take precautions to reduce the risk of falls.

Serotonin Syndrome: Use of NUEDEXTA with selective serotonin reuptake inhibitors (SSRIs) or tricyclic antidepressants increases the risk of “serotonin syndrome.”

Anticholinergic Effects of Quinidine: Monitor for worsening in myasthenia gravis.

Adverse Reactions: The most common adverse reactions (incidence of ≥3% and two-fold greater than placebo) in patients taking NUEDEXTA are diarrhea, dizziness, cough, vomiting, asthenia, peripheral edema, urinary tract infection, influenza, increased gamma-glutamyltransferase, and flatulence.

These are not all the risks for use of NUEDEXTA.

To report SUSPECTED ADVERSE REACTIONS, contact Otsuka America Pharmaceutical, Inc. at 1-800-438-9927 or FDA at 1-800-FDA-1088 (