Varithena

(polidocanol)
polidocanol 10 MG/ML Injectable Foam [Varithena]
NO BLACK BOX WARNING

Dosage & administration

Incompetent great saphenous or accessory saphenous veins: Use Varithena 1% (CEAP Class 2-6 Disease). .
For intravenous use which should be performed under ultrasound guidance when treating the GSV.

Use up to 5 mL per injection and 15 mL per treatment session.
Separate treatment sessions by a minimum of 5 days.

drug label

Varithena prescribing information

Need to report a Varithena issue?

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samples

Request Varithena samples

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View Online Sample Form
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prior authorization

Varithena Prior authorization resources

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Complete Letter of Medical Necessity

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Coverage Authorization Request

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Complete Coverage Authorization appeals

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Coverage Authorization Appeal
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Benefits investigation

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Benefits investigation resources
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Reimbursement help (FRM)

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Reimbursement help (FRM) resources
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financial assistance

Varithena Financial assistance options

Co-pay savings program

commercial only

NOT PROVIDED BY BRAND
Enroll in Patient Savings Program
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Bridge program

commercial only
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Foundation programs

under insured
no insurance
goverment insurance
65+
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patient education

Varithena Patient education

Getting started on Varithena

NOT PROVIDED BY BRAND
Instructions For Use: Varicose Veins

NOT PROVIDED BY BRAND
Instructions For Use: Leg Ulcers

Patient toolkit

About Varithena
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Scan QR Code & Tap Link
Before & After
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Patient Brochure
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Can't find what you're looking for?

Our trained staff can help you:
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.