Ampyra

(dalfampridine)
12 HR dalfampridine 10 MG Extended Release Oral Tablet [Ampyra]
NO BLACK BOX WARNING

Dosage & administration

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drug label

Ampyra prescribing information

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ONLINE FORM
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prior authorization

Ampyra Prior authorization resources

NOT PROVIDED BY BRAND
Complete Letter of Medical Necessity

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Coverage Authorization Request

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Coverage Authorization Appeals
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Benefits investigation

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Benefits investigation resources
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Reimbursement help (FRM)

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Reimbursement help (FRM) resources
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financial assistance

Ampyra Financial assistance options

Co-pay savings program

commercial only
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Bridge program

commercial only
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Foundation programs

under insured
no insurance
goverment insurance
65+
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patient education

Ampyra Patient education

Getting started on Ampyra

Patient toolkit

About Ampyra
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Patient Stories
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Ampyra FAQs

FAQ Data Source

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Please note:
  • Access to a Field Reimbursement Manager (FRM) or Medical Science Liaison (MSL) varies by brand and may require talking with your rep first.
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