Dalvance

(dalbavancin)
Dalvance 500 MG Injection
NO BOXED WARNING

Dosage & administration

Dosage in Adult Patients ( 2.1, 2.3):
Estimated Creatinine Clearance (CLcr)Single Dose
Regimen
Two-Dose Regimen
30 mL/min and above or on regular hemodialysis1500 mg1000 mg followed one week later by 500 mg
Less than 30 mL/min and not on regular hemodialysis1125 mg750 mg followed one week later by 375 mg
Dosage in Pediatric Patients with CLcr 30 mL/min/1.73m2 
and above ( 2.2)
Age RangeDosage (Single Dose Regimen)
Birth to less than 6 years22.5 mg/kg (maximum of 1500 mg)
6 to less than 18 years18 mg/kg (maximum of 1500 mg)

drug label

Dalvance prescribing information

prior authorization

Dalvance prior authorization resources

Most recent Dalvance prior authorization forms

View By Payer
Verified: Feb 07, 2024Kaiser Foundation Health Plan - Chronic High-Dose Opioid Therapy Prior Authorization Form Washington
Verified: Mar 02, 2024Highmark BCBS Northeastern NY - Medicare Prescription Drug Medication Request Form
Verified: Mar 02, 2024Highmark BCBS Northeastern NY - Short Acting Opioid Prior Authorization Form
Verified: Mar 02, 2024Highmark BCBS Western NY - Specialty Drug Prior Authorization Form
Verified: Mar 02, 2024Highmark BCBS Western NY - Non-Formulary Drug Coverage Prior Authorization Form

Most recent state uniform prior authorization forms

Verified: Feb 27, 2024Arizona - Uniform Prior Authorization Form
Verified: Feb 27, 2024Colorado - Uniform Prior Authorization Form
Verified: Feb 27, 2024Hawaii - Uniform Prior Authorization Form
Verified: Feb 27, 2024Illinois - Uniform Prior Authorization Form
Verified: Feb 27, 2024Indiana - Uniform Prior Authorization Form
Verified: Feb 27, 2024Louisiana - Uniform Prior Authorization Form
Verified: Feb 27, 2024Michigan - Uniform Prior Authorization Form
Verified: Feb 27, 2024Minnesota - Uniform Prior Authorization Form
Verified: Feb 27, 2024New Hampshire - Uniform Prior Authorization Form
Verified: Feb 27, 2024New Mexico - Uniform Prior Authorization Form
Verified: Feb 27, 2024Oregon - Uniform Prior Authorization Form
Verified: Feb 27, 2024Texas - Uniform Prior Authorization Form
Complete Letter of Medical Necessity
Coverage Authorization Appeal
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Benefits investigation

Dalvance Connect Enrollment Form
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Reimbursement help (FRM)

Receive Assistance from an FRM Regarding Reimbursement Information
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financial assistance

Dalvance financial assistance options

Co-pay savings program

commercial only
Dalvance Connect Enrollment Form
Enroll in Patient Savings Program
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PubMed™ | Dalvance

Dalvance PubMed™ News

patient education

Dalvance patient education

To share resource; ask patient to:
1.Pull out phone
2.Open camera
3.Scan QR code with camera
4.Tap link

people also ask

Dalvance FAQs

How is the dosage of Dalvance?Dalvance is available in 1 dosages, including 500 mg Injection
What does Dalvance treat?Dalvance treats Infectious Skin Diseases, Staphylococcal Infections and Streptococcal Infections
What is Dalvance made of?Dalvance contains dalbavancin which is a Lipoglycopeptide Antibacterial
How Is Dalvance Administered?Dalvance is administered as a Injectable
FAQ Data Source