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HEALTH PARTNERS PLANS PRIOR AUTHORIZATION REQUEST FORMTecfidera Phone: 2159914300Fax back to: 8662403712Health Partners Plans manages the pharmacy drug benefit for your patient. Certain requests for
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How to fill out dimethyl fumarate delayed-release capsules

01
Wash your hands before handling the capsules.
02
Take the prescribed dose as directed by your doctor.
03
Swallow the capsules whole with a glass of water. Do not crush, chew, or open the capsules.
04
You can take the capsules with or without food.
05
If you have difficulty swallowing, you may sprinkle the contents of the capsule onto a spoonful of applesauce and swallow it immediately. Do not store the mixture for later use.
06
Do not take more or less than the prescribed dose.
07
If you miss a dose, take it as soon as you remember. If it is close to the next scheduled dose, skip the missed dose and continue with your regular dosing schedule.
08
Store the capsules at room temperature, away from moisture and heat.
09
Follow all instructions provided by your doctor or pharmacist while taking dimethyl fumarate delayed-release capsules.

Who needs dimethyl fumarate delayed-release capsules?

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Dimethyl fumarate delayed-release capsules are typically prescribed for patients with relapsing forms of multiple sclerosis (MS).
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It may be prescribed for individuals who have experienced a relapse or have active lesions on their brain or spinal cord as seen on imaging scans.
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It is important to consult with a healthcare professional to determine if dimethyl fumarate delayed-release capsules are suitable for your specific condition.
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Dimethyl fumarate delayed-release capsules are a medication used to treat multiple sclerosis. They work by modulating the immune system and reducing inflammation.
Healthcare providers and pharmaceutical companies that produce or distribute dimethyl fumarate delayed-release capsules are typically required to file documentation with regulatory authorities.
To fill out a prescription for dimethyl fumarate delayed-release capsules, a healthcare provider must provide the patient's information, dosage instructions, and the number of capsules to be dispensed on a prescription form.
The purpose of dimethyl fumarate delayed-release capsules is to reduce the frequency of relapses in individuals with relapsing forms of multiple sclerosis and to slow the progression of the disease.
The information that must be reported includes the active ingredient, dosage form, expiration date, batch number, and any potential side effects or warnings related to the use of the medication.
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