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

Revlimid(lenalidomide)

Revlimid 2.5 MG Oral Capsule

Dosage & Administration

* MM combination therapy: 25 mg once daily orally on Days 1-21 of repeated 28-day cycles. .
* MM maintenance therapy following auto-HSCT: 10 mg once daily continuously on Days 1-28 of repeated 28-day cycles .
* MDS: 10 mg once daily .
* MCL: 25 mg once daily orally on Days 1-21 of repeated 28-day cycles .
* FL or MZL: 20 mg once daily orally on Days 1-21 of repeated 28-day cycles for up to 12 cycles .
* Renal impairment: Adjust starting dose based on the creatinine clearance value .
* For concomitant therapy doses, see Full Prescribing Information .

drug label

Revlimid Prescribing Information

Contact Medical Science Liaison

Report Adverse Event

prior authorization

Revlimid 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

Revlimid Enrollment Form

Revlimid Enrollment Form - Spanish

Reimbursement help (FRM)

Receive Assistance from an FRM Regarding Reimbursement Information

pharmacy

Revlimid Preferred Pharmacy

Pharmacy List

Financial Assistance

Financial Assistance Programs

Revlimid retails for $878 per dose without insurance or financial assistance.Depending on your patient's insurance situation and other eligibility criteria, they may be able to get Revlimid 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

Revlimid Enrollment Form

Revlimid Enrollment Form - Spanish

patient education

Revlimid Patient Education

To share resource; ask patient to:

1.Pull out phone

2.Open camera

3.Scan QR code with camera

4.Tap link