Dalvance Prescribing & Dosing Schedule

Dosage & Administration Drug label Prior authorization Financial assistance Patient education People also ask

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 hemodialysis	1500 mg	1000 mg followed one week later by 500 mg
Less than 30 mL/min and not on regular hemodialysis	1125 mg	750 mg followed one week later by 375 mg

* Administer by intravenous infusion over 30 minutes ( 2.1, 2.4)

* See Full Prescribing Information for instructions on reconstitution of lyophilized powder and preparation of injection ( 2.4).

Dosage in Pediatric Patients with CLcr 30 mL/min/1.73m2 and above ( 2.2)
Age Range	Dosage (Single Dose Regimen)
Birth to less than 6 years	22.5 mg/kg (maximum of 1500 mg)
6 to less than 18 years	18 mg/kg (maximum of 1500 mg)

* Dosage adjustment in pediatric patients with CLcr less than 30 mL/min has not been studied.

drug label

Dalvance Prescribing Information

Contact Medical Science Liaison

Report Adverse Event

prior authorization

Dalvance Prior Authorization Resources

Most recent state uniform prior authorization forms

Verified: Jun 26, 2024Arizona - Uniform Prior Authorization Form

Verified: Jun 26, 2024Colorado - Uniform Prior Authorization Form

Verified: Jun 26, 2024Hawaii - Uniform Prior Authorization Form

Verified: Jul 26, 2024Illinois - Uniform Prior Authorization Form

Verified: Jun 26, 2024Indiana - Uniform Prior Authorization Form

Verified: Jun 26, 2024Louisiana - Uniform Prior Authorization Form

Verified: Jun 26, 2024Minnesota - Uniform Prior Authorization Form

Verified: Jun 26, 2024New Hampshire - Uniform Prior Authorization Form

Verified: Jun 26, 2024New Mexico - Uniform Prior Authorization Form

Verified: Jun 26, 2024Oregon - Uniform Prior Authorization Form

Verified: Jun 26, 2024Texas - Uniform Prior Authorization Form

Verified: Jul 07, 2024Washington - Uniform Prior Authorization Form

Verified: Jul 07, 2024Wisconsin - Uniform Prior Authorization Form

Complete Letter of Medical Necessity

Coverage Authorization Appeal

Benefits investigation

Dalvance Connect Enrollment Form

financial assistance

Dalvance Financial Assistance Options

Copay savings program

Dalvance Connect Enrollment Form

Enroll in Patient Savings Program

Learn More

Overview

Reduce patient OOP costs for drug (and occasionally for drug administration/infusion costs or drug-related test costs)

Patient benefit

A portion (or all) of patient OOP (deductible, copay), typically up to monthly and/or annual max

Patient eligibility

Patient must enroll or activate (may permit HCPs to enroll on patient’s behalf for HCP-administered drugs)
Generally, must have commercial insurance (rarely, may permit uninsured patients to use)
May never be used with government insurance

How to sign up

Cards may be downloadable digital cards or hard copies
Some pharmacos offer debit cards with pre-loaded copay benefit
Typically, available through multiple channels (e.g., rep to HCP to patient; pharmacy to patient; patient via website, Hub live agent, or copay vendor (live agent or IVR); patient and HCP via Hub enrollment form)
Some HCP-administered product programs permit HCPs to enroll on a patient’s behalf through via Hub form

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

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

Dosage & Administration

Dosage & Administration

drug label

Dalvance Prescribing Information

prior authorization

Dalvance Prior Authorization Resources

Most recent state uniform prior authorization forms

Benefits investigation

financial assistance

Dalvance Financial Assistance Options

Copay savings program

patient education

Dalvance Patient Education

people also ask

Dalvance FAQs