Vistogard

(uridine triacetate)
uridine triacetate 10000 MG Oral Granules [Vistogard]
NO BLACK BOX WARNING

Dosage & administration

Recommended Dosage

Preparation and Administration


drug label

Vistogard prescribing information

Have more Vistogard questions?

Submit MSL Request
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Need to report a Vistogard issue?

ONLINE FORM
Report adverse event
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samples

Request Vistogard samples

NOT PROVIDED BY BRAND
View Online Sample Form
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prior authorization

Vistogard Prior authorization resources

NOT PROVIDED BY BRAND
Complete Letter of Medical Necessity

NOT PROVIDED BY BRAND
Coverage Authorization Request

NOT PROVIDED BY BRAND
Coverage Authorization Appeals
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Benefits investigation

Vistogard Prescription Referral Form
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Reimbursement help (FRM)

NOT PROVIDED BY BRAND
Reimbursement help (FRM) resources
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financial assistance

Vistogard Financial assistance options

Co-pay savings program

commercial only
Enroll in Patient Savings Program
Vistogard Prescription Referral Form
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Bridge program

commercial only
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Foundation programs

under insured
no insurance
goverment insurance
65+
Patient Assistance Program
Vistogard Prescription Referral Form
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patient education

Vistogard Patient education

Getting started on Vistogard

NOT PROVIDED BY BRAND
Instructions For Use: 5-FU Toxicity

Patient toolkit

About Vistogard
ASK PATIENT TO:
Open Camera on Phone
Scan QR Code & Tap Link
Vistogard Patient Poster
ASK PATIENT TO:
Open Camera on Phone
Scan QR Code & Tap Link
Learn More

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.