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UTAH DEPARTMENT OF HEALTH, PRIOR AUTHORIZATION REQUEST Formalin (brodalumab) and Trembley (guselkumab)
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How to fill out siliq brodalumab and tremfya
How to fill out siliq brodalumab and tremfya
01
To fill out Siliq Brodalumab:
02
Follow the instructions provided by your healthcare provider or the package insert.
03
Clean the injection site with alcohol swab and let it dry.
04
Remove the cap from the needle and attach it to the pre-filled syringe.
05
Inject the full dose of Siliq subcutaneously into the thigh or abdomen.
06
Dispose of the used syringe and needle in a puncture-resistant container.
07
08
To fill out Tremfya:
09
Follow the instructions provided by your healthcare provider or the package insert.
10
Clean the injection site with alcohol swab and let it dry.
11
Remove the cap from the needle and attach it to the pre-filled syringe.
12
Inject the full dose of Tremfya subcutaneously into the thigh or abdomen.
13
Dispose of the used syringe and needle in a puncture-resistant container.
Who needs siliq brodalumab and tremfya?
01
Siliq Brodalumab is a prescription medication approved for the treatment of moderate to severe plaque psoriasis in adult patients who are candidates for systemic therapy or phototherapy. It is used for patients who have not responded well to other treatments.
02
Tremfya is also a prescription medication approved for the treatment of moderate to severe plaque psoriasis in adult patients who are candidates for systemic therapy or phototherapy. It is used for patients who have not responded well to other treatments.
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What is siliq brodalumab and tremfya?
Siliq (brodalumab) and Tremfya are both medications used to treat psoriasis.
Who is required to file siliq brodalumab and tremfya?
Patients prescribed with Siliq brodalumab and Tremfya are required to file for them.
How to fill out siliq brodalumab and tremfya?
Patients can fill out the necessary information for Siliq brodalumab and Tremfya with the help of their healthcare provider.
What is the purpose of siliq brodalumab and tremfya?
The purpose of Siliq brodalumab and Tremfya is to help manage symptoms of psoriasis and improve skin condition.
What information must be reported on siliq brodalumab and tremfya?
Information such as dosage, frequency of use, any side effects experienced, and overall impact on psoriasis symptoms must be reported for Siliq brodalumab and Tremfya.
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