Supprelin

(histrelin)
histrelin acetate 0.00271 MG/HR Drug Implant [Supprelin]
NO BOXED WARNING

Dosage & administration

The recommended dose of SUPPRELIN LA is one implant every 12 months. The implant is inserted subcutaneously in the inner aspect of the upper arm and provides continuous release of histrelin for 12 months of hormonal therapy .

drug label

Supprelin prescribing information

prior authorization

Supprelin prior authorization resources

Most recent Supprelin prior authorization forms

View By Payer
Verified: Feb 07, 2024Kaiser Foundation Health Plan - Chronic High-Dose Opioid Therapy Prior Authorization Form Washington
Verified: Feb 01, 2024Highmark BCBS Northeastern NY - Medicare Prescription Drug Medication Request Form
Verified: Feb 01, 2024Highmark BCBS Northeastern NY - Short Acting Opioid Prior Authorization Form
Verified: Feb 01, 2024Highmark BCBS Western NY - Specialty Drug Prior Authorization Form

Most recent state uniform prior authorization forms

Verified: Feb 27, 2024Arizona - Uniform Prior Authorization Form
Verified: Feb 27, 2024Colorado - Uniform Prior Authorization Form
Verified: Feb 27, 2024Hawaii - Uniform Prior Authorization Form
Verified: Feb 27, 2024Illinois - Uniform Prior Authorization Form
Verified: Feb 27, 2024Indiana - Uniform Prior Authorization Form
Verified: Feb 27, 2024Louisiana - Uniform Prior Authorization Form
Verified: Feb 27, 2024Michigan - Uniform Prior Authorization Form
Verified: Feb 27, 2024Minnesota - Uniform Prior Authorization Form
Verified: Feb 27, 2024New Hampshire - Uniform Prior Authorization Form
Verified: Feb 27, 2024New Mexico - Uniform Prior Authorization Form
Verified: Feb 27, 2024Oregon - Uniform Prior Authorization Form
Verified: Feb 27, 2024Texas - Uniform Prior Authorization Form
Complete Letter of Medical Necessity
Coverage Authorization Appeals
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Benefits investigation

Service Request Form & Prescription Form
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financial assistance

Supprelin financial assistance options

Co-pay savings program

commercial only
Enroll in Patient Savings Program
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PubMed™ | Supprelin

Supprelin PubMed™ News

patient education

Supprelin 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

Caregiver Brochure
ASK PATIENT TO:
Open Camera on Phone
Scan QR Code & Tap Link
Caregiver Brochure - Spanish
ASK PATIENT TO:
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Scan QR Code & Tap Link
About Supprelin LA
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Side Effects
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Insertion & After Care
ASK PATIENT TO:
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Removal & Reinsertion
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Caregiver Resources
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Caregiver Resources: Videos
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people also ask

Supprelin FAQs

How is the dosage of Supprelin?Supprelin is available in 1 dosages, including 2.71 mcg/hr Drug Implant
What does Supprelin treat?Supprelin treats Precocious Puberty
What is Supprelin made of?Supprelin contains histrelin which is a Gonadotropin Releasing Hormone Receptor Agonist
How Is Supprelin Administered?Supprelin is administered as a Implant
What Are The Supprelin Mechanism Of Action?Supprelin mechanism of action is Gonadotropin Releasing Hormone Receptor Agonists
FAQ Data Source