Eligard

(leuprolide)
0.25 ML leuprolide acetate 30 MG/ML Prefilled Syringe [Eligard]0.375 ML leuprolide acetate 120 MG/ML Prefilled Syringe [Eligard]
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NO BLACK BOX WARNING

Dosage & administration

drug label

Eligard prescribing information

Have more Eligard questions?

Submit MSL Request
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Need to report an Eligard issue?

ONLINE FORM
Report adverse event
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samples

Request Eligard samples

NOT PROVIDED BY BRAND
View Online Sample Form
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prior authorization

Eligard Prior authorization resources

NOT PROVIDED BY BRAND
Complete Letter of Medical Necessity

NOT PROVIDED BY BRAND
Coverage Authorization Request

NOT PROVIDED BY BRAND
Coverage Authorization Appeals
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Benefits investigation

Tolmar Patient Services Form
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Reimbursement help (FRM)

NOT PROVIDED BY BRAND
Reimbursement help (FRM) resources
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financial assistance

Eligard Financial assistance options

Co-pay savings program

commercial only

NOT PROVIDED BY BRAND
Enroll in Patient Savings Program
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Bridge program

commercial only
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Foundation programs

under insured
no insurance
goverment insurance
65+
Tolmar Patient Services Form
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patient education

Eligard Patient education

Getting started on Eligard

NOT PROVIDED BY BRAND
Not Provided By Brand

Patient toolkit

About Eligard
ASK PATIENT TO:
Open Camera on Phone
Scan QR Code & Tap Link
Patient Resources
ASK PATIENT TO:
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Scan QR Code & Tap Link
Doctor Discussion Guide
ASK PATIENT TO:
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Scan QR Code & Tap Link
Prostate Cancer & You Guide
ASK PATIENT TO:
Open Camera on Phone
Scan QR Code & Tap Link
Patient Brochure
ASK PATIENT TO:
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Scan QR Code & Tap Link
Patient Brochure - Spanish
ASK PATIENT TO:
Open Camera on Phone
Scan QR Code & Tap Link
Managing Side Effects
ASK PATIENT TO:
Open Camera on Phone
Scan QR Code & Tap Link
Learn More

Can't find what you're looking for?

Our trained staff can help you:
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.
  • Samples are provided at the discretion of the brand.
  • We are unable to collect Protected Health Information (PHI), fill out forms, or submit them on your behalf.