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ELASTIC/GRAZOPREVIR FOR CHRONIC HEPATITIS C SPECIAL AUTHORIZATION REQUEST FORM Patients may or may not meet eligibility requirements as established by Alberta government sponsored drug programs. Please
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How to fill out elbasvirgrazoprevir for treatment of
How to fill out elbasvirgrazoprevir for treatment of
01
Consult with a healthcare provider for a prescription for elbasvir/grazoprevir.
02
Read the medication guide provided by your pharmacist before starting treatment.
03
Take elbasvir/grazoprevir exactly as prescribed by your healthcare provider.
04
Take the medication with food to improve absorption.
05
Do not stop taking elbasvir/grazoprevir without consulting your healthcare provider.
Who needs elbasvirgrazoprevir for treatment of?
01
Patients with chronic hepatitis C virus (HCV) infection.
02
Patients who have not been previously treated for HCV.
03
Patients with specific genotypes of HCV that are susceptible to elbasvir/grazoprevir.
04
Patients who are able to tolerate the potential side effects of the medication.
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What is elbasvirgrazoprevir for treatment of?
Elbasvirgrazoprevir is used for the treatment of chronic hepatitis C virus (HCV) infection.
Who is required to file elbasvirgrazoprevir for treatment of?
Healthcare providers and clinicians are required to prescribe and administer elbasvirgrazoprevir for the treatment of patients with chronic HCV infection.
How to fill out elbasvirgrazoprevir for treatment of?
Elbasvirgrazoprevir is typically taken orally once daily with or without food. It is important to follow the instructions provided by the healthcare provider.
What is the purpose of elbasvirgrazoprevir for treatment of?
The purpose of elbasvirgrazoprevir is to help cure or control chronic HCV infection and reduce the risk of liver damage, cirrhosis, and liver cancer.
What information must be reported on elbasvirgrazoprevir for treatment of?
Information such as patient demographics, medical history, current medications, liver function tests, and HCV genotype must be reported when prescribing elbasvirgrazoprevir.
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