Myfembree

(estradiol / norethindrone / relugolix)
estradiol 1 MG / norethindrone acetate 0.5 MG / relugolix 40 MG Oral Tablet [Myfembree]

Dosage & administration

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drug label

Myfembree prescribing information

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Need to report a Myfembree issue?

ONLINE FORM
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samples

Request Myfembree samples

Online Sample Form
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prior authorization

Myfembree Prior authorization resources

Complete Letter of Medical Necessity

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Coverage Authorization Request
Coverage Authorization Appeals
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Benefits investigation

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Reimbursement help (FRM)

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Reimbursement help (FRM) resources
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financial assistance

Myfembree Financial assistance options

Co-pay savings program

commercial only
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Bridge program

commercial only
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Foundation programs

under insured
no insurance
goverment insurance
65+
Myfembree Support Enrollment Form
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patient education

Myfembree Patient education

Getting started on Myfembree

NOT PROVIDED BY BRAND
Instructions For Use - Control Heavy Menstrual Bleeding due to Uterine Fibroids in Premenopausal Women

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Instructions For Use - Pain Associated with Endometriosis in Premenopausal Women

Patient toolkit

About Myfembree
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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.