Keveyis

(dichlorphenamide)
dichlorphenamide 50 MG Oral Tablet [Keveyis]
NO BLACK BOX WARNING

Dosage & administration

Most viewed Keveyis resources

Enroll in Patient Savings Program

drug label

Keveyis prescribing information

Have more Keveyis questions?

Submit MSL Request
Learn More

Need to report a Keveyis issue?

ONLINE FORM
Report adverse event
Learn More

samples

Request Keveyis samples

NOT PROVIDED BY BRAND
View Online Sample Form
Learn More

prior authorization

Keveyis Prior authorization resources

Complete Letter of Medical Necessity

NOT PROVIDED BY BRAND
Coverage Authorization Request
Coverage Authorization Appeals
Formulary Exception Appeal Letter
Learn More

Benefits investigation

Keveyis Start Form
Learn More

Reimbursement help (FRM)

NOT PROVIDED BY BRAND
Reimbursement help (FRM) resources
Learn More

financial assistance

Keveyis Financial assistance options

Co-pay savings program

commercial only
Enroll in Patient Savings Program
Keveyis Start Form
Learn More

Bridge program

commercial only
Learn More

Foundation programs

under insured
no insurance
goverment insurance
65+
Learn More

patient education

Keveyis Patient education

Getting started on Keveyis

NOT PROVIDED BY BRAND
Instructions For Use - Primary Periodic Paralysis (PPP)

Patient toolkit

About Keveyis
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.