Folotyn

(pralatrexate)
1 ML pralatrexate 20 MG/ML Injection [Folotyn]2 ML pralatrexate 20 MG/ML Injection [Folotyn]
NO BLACK BOX WARNING

Dosage & administration

Most viewed Folotyn resources

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drug label

Folotyn prescribing information

Have more Folotyn questions?

Submit MSL Request
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Need to report a Folotyn issue?

ONLINE FORM
Report adverse event
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prior authorization

Folotyn 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

STAR Patient Enrollment Form
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Reimbursement help (FRM)

Receive Assistance from an FRM Regarding Reimbursement Information
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financial assistance

Folotyn Financial assistance options

Co-pay savings program

commercial only
STAR Patient Enrollment Form
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+
STAR Patient Enrollment Form
Patient Assistance Program
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patient education

Folotyn Patient education

Getting started on Folotyn

NOT PROVIDED BY BRAND
Instructions For Use: Relapsed or Refractory PTCL

Patient toolkit

About Folotyn
ASK PATIENT TO:
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Receiving Folotyn
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Side Effects
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Patient Resources
ASK PATIENT TO:
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Scan QR Code & Tap Link
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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.