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

Empliciti(elotuzumab)

Empliciti 300 MG Injection

NO BOXED WARNING

Dosage & Administration

* With lenalidomide and dexamethasone: 10 mg/kg administered intravenously every week for the first two cycles and every 2 weeks thereafter until disease progression or unacceptable toxicity. (2.1)
* With pomalidomide and dexamethasone: 10 mg/kg administered intravenously every week for the first two cycles and 20 mg/kg every 4 weeks thereafter until disease progression or unacceptable toxicity. (2.2)
* Premedicate with dexamethasone, diphenhydramine, ranitidine and acetaminophen. (2.3)

drug label

Empliciti Prescribing Information

Contact Medical Science Liaison

Report Adverse Event

prior authorization

Empliciti 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 Appeals

Commercial Claim Denial Appeal/Redetermination Letter

Medically Unlikely Edit (MUE) Appeal Letter

Benefits investigation

Empliciti Enrollment Form

Empliciti Enrollment Form - Spanish

Reimbursement help (FRM)

Receive Assistance from an FRM Regarding Reimbursement Information

Financial Assistance

Financial Assistance Programs

Empliciti retails for $2,313 per dose without insurance or financial assistance.Depending on your patient's insurance situation and other eligibility criteria, they may be able to get Empliciti for significantly less. Review the program information below to determine what program can offer your patient the most benefits.

Copay Card Program$0 Copay

Available for

commercial

Program Details

Program Expires Calendar Year

Forms

Empliciti Enrollment Form

Empliciti Enrollment Form - Spanish

Enroll in Patient Savings Program

patient education

Empliciti Patient Education

To share resource; ask patient to:

1.Pull out phone

2.Open camera

3.Scan QR code with camera

4.Tap link

Patient toolkit

About Empliciti

ASK PATIENT TO:
Open Camera on Phone
Scan QR Code & Tap Link

Empliciti FAQs

How is the dosage of Empliciti?Empliciti is available in 2 dosages, including 300 mg Injection and 400 mg Injection

What does Empliciti treat?Empliciti treats Multiple Myeloma

What is Empliciti made of?Empliciti contains elotuzumab which is a SLAMF7-directed Immunostimulatory Antibody

How Is Empliciti Administered?Empliciti is administered as a Injectable

What Are The Empliciti Mechanism Of Action?Empliciti mechanism of action is SLAMF7-directed Antibody Interactions

FAQ Data Source

Dosage & Administration

Dosage & Administration

drug label

Empliciti Prescribing Information

prior authorization

Empliciti Prior Authorization Resources

Most recent state uniform prior authorization forms

Benefits investigation

Reimbursement help (FRM)

Financial Assistance

Financial Assistance Programs

patient education

Empliciti Patient Education

Patient toolkit

people also ask

Empliciti FAQs