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Patient Assistance Information

 
 
 
Addyi Risk Evaluation and Mitigation Strategy (REMS) Program

4208 Six forks Road Suite 1010
Raleigh, NC 27609
Phone : 844-233-9415
Fax: 844-694-3373
Eligibility
> The medication must be medically necessary as determined by a doctor.
Who Can Apply
> Doctors must call.
Required
> Patients must inform the doctor that he/she is in need. Doctors must enroll in the program.
Supply
> Not specified
Ship To
> Not specified
Note
> Resources for HEALTHCARE PROFESSIONALS ONLY.
 
Includes Support for This Drug
NOTE: Linked drugs are available for Prescribers to Apply Online now.
Click drug logo or drug name to start online application.
 
Addyi tablet
 
Printable Application Forms
Applications that patients can fill out and bring to their doctor.
 
Download printable Form
Download printable Form
Download printable Form
(Requires Acrobat Reader