Valchlor(mechlorethamine)
NO BOXED WARNING

Dosage & Administration

Get Your Patient on Valchlor

See your patient's specific prior authorization requirements including coverage restrictions and step therapies
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Valchlor Prescribing Information

Valchlor Prior Authorization Resources

Most recent state uniform prior authorization forms

Verified: Oct 24, 2024Arizona - Uniform Prior Authorization Form
Verified: Oct 24, 2024Colorado - Uniform Prior Authorization Form
Verified: Oct 24, 2024Hawaii - Uniform Prior Authorization Form
Verified: Oct 24, 2024Illinois - Uniform Prior Authorization Form
Verified: Oct 24, 2024Indiana - Uniform Prior Authorization Form
Verified: Oct 24, 2024Louisiana - Uniform Prior Authorization Form
Verified: Oct 24, 2024Minnesota - Uniform Prior Authorization Form
Verified: Oct 24, 2024New Hampshire - Uniform Prior Authorization Form
Verified: Oct 24, 2024New Mexico - Uniform Prior Authorization Form
Verified: Oct 24, 2024Oregon - Uniform Prior Authorization Form
Verified: Oct 24, 2024Texas - Uniform Prior Authorization Form
Verified: Nov 04, 2024Washington - Uniform Prior Authorization Form
Verified: Nov 04, 2024Wisconsin - Uniform Prior Authorization Form

Benefits investigation

Valchlor Patient Intake and Prescription Form

Valchlor Financial Assistance Options

Copay savings program

Valchlor Patient Intake and Prescription Form
Enroll in Patient Savings Program
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Valchlor PubMed™ News

    Valchlor Patient Education

    Getting started on Valchlor

    Instructions For Use: Mycosis Fungoides-type Cutaneous T-cell Lymphoma (MF-CTCL)
    ASK PATIENT TO:
    Open Camera on Phone
    Scan QR Code & Tap Link
    To share resource; ask patient to:
    1.Pull out phone
    2.Open camera
    3.Scan QR code with camera
    4.Tap link

    Patient toolkit

    Patient Brochure
    ASK PATIENT TO:
    Open Camera on Phone
    Scan QR Code & Tap Link
    How To Store Valchlor
    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

    Valchlor FAQs