Lonsurf Prescribing & Dosing Schedule | PrescriberPoint

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

Lonsurf(tipiracil / trifluridine)

Lonsurf 15 MG / 6.14 MG Oral Tablet

NO BOXED WARNING

Dosage & Administration

Dosage & Administration

* Recommended Dosage: 35 mg/m2/dose orally twice daily with food on Days 1 through 5 and Days 8 through 12 of each 28-day cycle.

drug label

Lonsurf Prescribing Information

Contact Medical Science Liaison

Report Adverse Event

prior authorization

Lonsurf 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

Benefits investigation

Lonsurf Enrollment Form

Lonsurf Enrollment Form - Spanish

financial assistance

Lonsurf Financial Assistance Options

Copay savings program

Enroll in Patient Savings Progam

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

Foundation programs

Lonsurf Enrollment Form

Lonsurf Enrollment Form - Spanish

Patient Assistance Program

Overview

Charitable 501(c)(3) organizations provide direct cost-sharing and other support (e.g., travel, counseling) through disease-state funds to indigent patients on first-come first-served basis
These organizations may receive financial contributions from drug manaufacturers for particular disease-state funds that cannot provide funds directly to patients - the foundation must be independent/unaligned

Patient benefit

Patients apply for grants that cover a portion (or all) of their out-of-pocket costs (deductibles and copays) until the grant is exhausted

Patient eligibility

Patients must apply and meet eligibility criteria including income level (typically a multiple of federal poverty line), specific diagnosis, insurance status, etc.

How to sign up

Patients submit proof of out-of-pocket drug costs to charities for reimbursement

patient education

Lonsurf 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

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

View How to Take Lonsurf

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

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

Patient Resources

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

Patient & Caregiver Brochure

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

Patient & Caregiver Brochure - Spanish

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

Doctor Discussion Guide

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

people also ask

Lonsurf FAQs

How is the dosage of Lonsurf?Lonsurf is available in 2 dosages, including 6.14-15 mg Tab and 8.19-20 mg Tab

What does Lonsurf treat?Lonsurf treats Infectious Keratoconjunctivitis, Colorectal Neoplasms and Herpetic Keratitis

What is Lonsurf made of?Lonsurf contains tipiracil / trifluridine which is a Nucleoside Analog Antiviral

How Is Lonsurf Administered?Lonsurf is administered as a Oral Pill

What Are The Lonsurf Mechanism Of Action?Lonsurf mechanism of action is Nucleic Acid Synthesis Inhibitors or Thymidine Phosphorylase Inhibitors

FAQ Data Source