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  • Uptravi Enrollment Form

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UPTRAVI (selexipag) Prescription and Patient Enrollment FormFAX COVER SHEET Date: To:Fax number: 18662790669From: Facility name: Facility contact:Completed UPTRAVI Prescription and Patient Enrollment.

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You should not stop taking Uptravi without your doctor's advice. Stopping suddenly may make your condition worse. Store tablets at room temperature away from moisture and heat.

This may cause people to feel tired, dizzy, short of breath, or experience other symptoms. UPTRAVI widens the pulmonary arteries and reduces their hardening. This makes it easier for the heart to pump blood through the pulmonary arteries.

Uptravi Prices, Coupons and Patient Assistance Programs. Uptravi (selexipag) is a member of the agents for pulmonary hypertension drug class and is commonly used for Pulmonary Hypertension. The cost for Uptravi oral tablet 200 mcg is around $15,030 for a supply of 60 tablets, depending on the pharmacy you visit.

People with severely decreased liver function should not use this medication. Low blood pressure: Selexipag can cause low blood pressure to become worse.

Headache, nausea, vomiting, diarrhea, loss of appetite, flushing, jaw pain, joint/muscle pain, or pain in your arms or legs may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

Your healthcare provider orders UPTRAVI ® from a specialty pharmacy. They will also determine if you need additional support services from a nurse to get started. Before your prescription is filled, you'll get a call from a specialty pharmacy to discuss coverage and shipping information.

27% of patients treated with UPTRAVI ® experienced a PAH disease progression event vs 41.6% of patients not taking UPTRAVI ®. UPTRAVI ® reduced the risk of PAH-related hospitalizations. This benefit was demonstrated in a clinical trial comparing patients taking UPTRAVI ® to those not taking UPTRAVI ®.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232