Prior authorization forms for prescription drugs

ABSTRAL (Fentanyl sublingal)

FV6904 (PDF, 69 ko) – General form

ACTEMRA (Tocilizumab)

FV6861 (PDF, 58 ko) – Rheumatoid Arthritis
FV7047 (PDF, 104 ko) – Giant cell arteritis
FV6904 (PDF, 69 ko) – Other indication (general form)

ADCIRCA (Tadalafil)

FV6904 (PDF, 69 ko) – General form

ADEMPAS (Riociguat)

FV6904 (PDF, 69 ko) – General form

AFINITOR (Everolimus)

FV6904 (PDF, 69 ko) – General form

AIMOVIG (Erenumab)

FV6850 (PDF, 37 ko) – Migraine

ALECENSARO (Alectinib)

FV6968 (PDF, 111 ko) – First-line treatment ALK+ locally advanced or metastatic non-small cell lung cancer (NSCLC)
FV6904 (PDF, 69 ko) – Other indication (general form)

ALUNBRIG (Brigatinib)

FV6968 (PDF, 111 ko) – First-line treatment ALK+ locally advanced or metastatic non-small cell lung cancer (NSCLC)

APTIOM (Eslicarbazepine acetate)

FV6904 (PDF, 69 ko) – General form

AUBAGIO (Teriflunomide)

FV6904 (PDF, 69 ko) – General form open ?

BANZEL (Rufinamide)

FV6904 (PDF, 69 ko) – General form

BENLYSTA (Belimumab)

FV6904 (PDF, 69 ko) – General form

BOSULIF (Bosutinib)

FV6904 (PDF, 69 ko) – General form

BOTOX (Botulinum toxin)

FV6850 (PDF, 37 ko) – Migraine
FV6904 (PDF, 69 ko) – Other indication (general form)

BRENZYS (Etanercept)

FV6861 (PDF, 58 ko) – Rheumatoid Arthritis
FV6863 (PDF, 60 ko) – Ankylosing Spondylitis
FV6904 (PDF, 69 ko) – Other indication (general form)

BRIVLERA (Brivaracetam)

FV7024 (PDF, 105 ko) – Refractory partial-onset seizure
FV6904 (PDF, 69 ko) – Other indication (general form)

CAPRELSA (Vandetanib)

FV6904 (PDF, 69 ko) – General form

CEENU (Lomustine)

FV6904 (PDF, 69 ko) – General form

CIALIS (Tadalafil)

FV6904 (PDF, 69 ko) – General form

CIMZIA (Certolizumab pegol)

FV6856 (PDF, 57 ko) – Psoriatic Arthritis
FV6861 (PDF, 58 ko) – Rheumatoid Arthritis
FV6862 (PDF, 64 ko) – Plaque psoriasis
FV6863 (PDF, 60 ko) – Ankylosing Spondylitis
FV6904 (PDF, 69 ko) – Other indication (general form)

CINQAIR (Reslizumab)

FV6857 (PDF, 54 ko) – Asthma
FV6904 (PDF, 69 ko) – Other indication (general form)

CONTRAVE (Naltrexone/Bupropion)

FV6904 (PDF, 69 ko) – General form open ?

COPAXONE (Glatiramere acetate)

FV7003 (PDF, 103 ko) – Remitting multiple sclerosis

COSENTYX (Secukinumab)

FV6856 (PDF, 57 ko) – Psoriatic Arthritis
FV6862 (PDF, 64 ko) – Plaque psoriasis
FV6863 (PDF, 60 ko) – Ankylosing Spondylitis
FV6904 (PDF, 69 ko) – Other indication (general form)

COTELLIC (Cobimetinib)

FV6943 (PDF, 150 ko) – Unresectable or metastatic melanoma
FV6904 (PDF, 69 ko) – Other indication (general form)

CRINONE (Progesterone)

FV6904 (PDF, 69 ko) – General form

CYSTADROPS (Cystéamine)

FV6904 (PDF, 69 ko) – General form

DAKLINZA (Daclatasvir)

FV6904 (PDF, 69 ko) – General form

DIACOMIT (Stiripentol)

FV6904 (PDF, 69 ko) – General form

DUODOPA (Levodopa / Carbidopa)

FV6904 (PDF, 69 ko) – General form

DUPIXENT (Dupulumab)

FV6969 (PDF, 157 ko) – Refractory atopic dermatitis
FV6904 (PDF, 69 ko) – Other indication (general form)

DYSPORT (Botulinum toxin)

FV6904 (PDF, 69 ko) – General form

EGRIFTA (Tesamorelin)

FV6904 (PDF, 69 ko) – General form

ENBREL (Etanercept)

FV7036 (PDF, 397 ko) – Juvenile idiopathic arthritis of polyarticular or systemic form
FV6856 (PDF, 57 ko) – Psoriatic Arthritis
FV6861 (PDF, 58 ko) – Rheumatoid Arthritis
FV6862 (PDF, 64 ko) – Plaque psoriasis
FV6863 (PDF, 60 ko) – Ankylosing Spondylitis
FV6904 (PDF, 69 ko) – Other indication (general form)

ENDOMETRIN (Progesterone)

FV6904 (PDF, 69 ko) – General form

ENTYVIO (Vedolizumab)

FV6851 (PDF, 66 ko) – Ulcerative colitis
FV6849 (PDF, 59 ko) – Crohn's disease
FV6904 (PDF, 69 ko) – Other indication (general form)

EPCLUSA (Sofosbuvir/Velpatasvir)

FV6904 (PDF, 69 ko) – General form

ERELZI (Etanercept)

FV6861 (PDF, 58 ko) – Rheumatoid Arthritis
FV6863 (PDF, 60 ko) – Ankylosing Spondylitis
FV6904 (PDF, 69 ko) – Other indication (general form)

ERIVEDGE (Vismodegib)

FV6996 (PDF, 105 ko) – Metastatic Basal Cell Carcinoma
FV6904 (PDF, 69 ko) – Other indication (general form)

ESBRIET (Pirfenidone)

FV6976 (PDF, 105 ko) – Idiopathic Pulmonary Fibrosis (IPF)
FV6904 (PDF, 69 ko) – Other indication (general form)

EXJADE (Deferasirox)

FV6904 (PDF, 69 ko) – General form open ?

EYLEA (Aflibercept)

FV6852 (PDF, 54 ko) – Neovascular (wet) age-related macular degeneration (AMD) (DMA)
FV6858 (PDF, 51 ko) – Diabetic Macular Edema (DME) (OMD)
FV6860 (PDF, 52 ko) – Macular edema secondary to central retinal vein occlusion (CRVO) (OVR)
FV6859 (PDF, 52 ko) – Macular edema secondary to branch retinal vein occlusion (BRVO) (OBVR)
FV6979 (PDF, 109 ko) – Visual impairment due to a choroidal neovascularization subsequent to a pathologic myopia
FV6904 (PDF, 69 ko) – Other indication (general form)

FAMPYRA (Fampridine)

FV6904 (PDF, 69 ko) – General form

FAMPYRA (Fampridine)

FV6904 (PDF, 69 ko) – General form

FASENRA (Benralizumab)

FV6857 (PDF, 54 ko) – Asthma
FV6904 (PDF, 69 ko) – Other indication (general form)

FIRAZYR (Icatibant)

FV6904 (PDF, 69 ko) – General form

FORTEO (Teriparatide)

FV6904 (PDF, 69 ko) – General form

FYCOMPA (Perampanel)

FV6904 (PDF, 69 ko) – General form

GALAFOLD (Migalast)

FV7011 (PDF, 436 ko) – Fabry Disease

GALEXOS (Simeprevir)

FV6904 (PDF, 69 ko) – General form

GENOTROPIN (Somatropin)

FV6904 (PDF, 69 ko) – General form

GILENYA (Fingolimod)

FV6904 (PDF, 69 ko) – General form

GIOTRIF (Afatinib)

FV6904 (PDF, 69 ko) – General form

GLEEVEC (Imatinib)

FV6995 (PDF, 110 ko) – Adjuvant Treatment Gastrointestinal Stromal Tumors Kit CD117 Positive After Complete Resection
FV6904 (PDF, 69 ko) – Other indication (general form)

HARVONI (Ledipasvir / Sofosbuvir )

FV6904 (PDF, 69 ko) – General form

HCG (Chorionic Gonadotropin)

FV6904 (PDF, 69 ko) – General form

HOLKIRA PAK (Ombitasvir / Paritaprevir / Ritonavir / Dasabuvir)

FV6904 (PDF, 69 ko) – General form

HUMATROPE (Somatropin)

FV6904 (PDF, 69 ko) – General form

HUMIRA (Adalimumab)

FV6856 (PDF, 57 ko) – Psoriatic Arthritis
FV6851 (PDF, 66 ko) – Ulcerative colitis
FV7057 (PDF, 409 ko) – Hidradenitis
FV6849 (PDF, 59 ko) – Crohn's disease
FV6861 (PDF, 58 ko) – Rheumatoid Arthritis
FV6863 (PDF, 60 ko) – Ankylosing Spondylitis
FV6862 (PDF, 64 ko) – Plaque psoriasis
FV6942 (PDF, 396 ko) – Non-infectious uveitis
FV6904 (PDF, 69 ko) – Other indication (general form)

IBAVYR (Ribavirin)

FV6904 (PDF, 69 ko) – General form

IBRANCE (Palbociclib)

FV6854 (PDF, 48 ko) – Breast cancer
FV6904 (PDF, 69 ko) – Other indication (general form)

ICLUSIG (Ponitinib hydrochloride)

FV6904 (PDF, 69 ko) – General form

ILARIS (Canakinumab)

FV6904 (PDF, 69 ko) – General form

IMBRUVICA (Ibrutinib)

FV6904 (PDF, 69 ko) – General form

INCIVEK (Telaprevir)

FV6904 (PDF, 69 ko) – General form

INFLECTRA (Infliximab)

FV6856 (PDF, 57 ko) – Psoriatic Arthritis
FV6851 (PDF, 66 ko) – Ulcerative colitis
FV6849 (PDF, 59 ko) – Crohn's disease
FV6861 (PDF, 58 ko) – Rheumatoid Arthritis
FV6863 (PDF, 60 ko) – Ankylosing Spondylitis
FV6862 (PDF, 64 ko) – Plaque psoriasis
FV6904 (PDF, 69 ko) – Other indication (general form)

INLYTA (Axitinib)

FV6904 (PDF, 69 ko) – General form

IRESSA (Gefitinib)

FV6904 (PDF, 69 ko) – General form

JADENU (Deferasirox)

FV6904 (PDF, 69 ko) – General form open ?

JAKAVI (Ruxolitinib)

FV6944 (PDF, 140 ko) – Polycythemia vera
FV7029 (PDF, 390 ko) – Slenomegaly associated with primary myelofibrosis
FV6904 (PDF, 69 ko) – Other indication (general form)

JETREA (Ocriplasmine)

FV6904 (PDF, 69 ko) – General form

JINARC (Tolvaptan)

FV6855 (PDF, 49 ko) – Polycystic kidney disease
FV6904 (PDF, 69 ko) – Other indication (general form)

JUXTAPID (Lomitapide)

FV6904 (PDF, 69 ko) – General form

KALYDECO (Ivacaftor)

FV6904 (PDF, 69 ko) – General form

KETALAR (Ketamine)

FV6904 (PDF, 69 ko) – General form

KEVZARA (Sarilumab)

FV6861 (PDF, 58 ko) – Rheumatoid Arthritis
FV6904 (PDF, 69 ko) – Other indication (general form)

KINERET (Anakinra)

FV6861 (PDF, 58 ko) – Rheumatoid Arthritis
FV6904 (PDF, 69 ko) – Other indication (general form)

KISQALI (Ribociclib)

FV6984 (PDF, 110 ko) – Advanced or metastasic breast cancer
FV6904 (PDF, 69 ko) – Other indication (general form)

KUVAN (Sapropterin Dihydrochloride)

FV6904 (PDF, 69 ko) – General form

LANTUS (Insulin glargine)

FV7004 (PDF, 103 ko) – Diabetes

LEMTRADA (Alemtuzumab)

FV6904 (PDF, 69 ko) – General form

LENVIMA (Lenvatinib)

FV6904 (PDF, 69 ko) – General form

LEVITRA (Vardenafil)

FV6904 (PDF, 69 ko) – General form

LEVULAN (Aminolevulinic Acid)

FV6904 (PDF, 69 ko) – General form

LOBRENA (Lorlatinib)

FV6904 (PDF, 69 ko) – General form

LONSURF (Trifluridine)

FV6970 (PDF, 111 ko) – Metastatic Colorectal Cancer
FV6904 (PDF, 69 ko) – Other indication (general form)

LUCENTIS (Ranibizumab)

FV6860 (PDF, 52 ko) – Macular edema secondary to central retinal vein occlusion (CRVO) (OVR)
FV6858 (PDF, 51 ko) – Diabetic Macular Edema (DME) (OMD)
FV6852 (PDF, 54 ko) – Neovascular (wet) age-related macular degeneration (AMD) (DMA)
FV6979 (PDF, 109 ko) – Visual impairment due to a choroidal neovascularization subsequent to a pathologic myopia
FV6904 (PDF, 69 ko) – Other indication (general form)

LYNPARZA (Olaparib)

FV6904 (PDF, 69 ko) – General form

MATULANE (Procarbazine HCL)

FV6904 (PDF, 69 ko) – General form open ?

MAVENCLAD (Cladribine)

FV6904 (PDF, 69 ko) – General form

MAVIRET (Glécaprévir/Pibrentasvir)

FV7033 (PDF, 106 ko) – Chronic hepatitis C

MEKINIST (Trametinib)

FV6904 (PDF, 69 ko) – General form

MENOPUR (Menotropins)

FV6904 (PDF, 69 ko) – General form

METVIX (Methyl Aminolevulinate)

FV6904 (PDF, 69 ko) – General form

MOVAPO (Apomorphine hydrochloride)

FV6904 (PDF, 69 ko) – General form

MYOZYME (Alglucosidase alfa)

FV6904 (PDF, 69 ko) – General form

NEUPOGEN (Filgrastim)

FV6998 (PDF, 103 ko) – Chronic or febrile neutropenia

NEXAVAR (Sorafenib)

FV6904 (PDF, 69 ko) – General form

NINLARO (Ixazomib)

FV6904 (PDF, 69 ko) – General form

NORDITROPIN (Somatropin )

FV6904 (PDF, 69 ko) – General form

NPLATE (Romiplostim)

FV6904 (PDF, 69 ko) – General form

NUCALA (Mepolizumab)

FV6857 (PDF, 70 ko) – Asthma
FV6904 (PDF, 69 ko) – Other indication (general form)

NUTROPIN (Somatropin)

FV6904 (PDF, 69 ko) – General form

OCALIVA (Obeticholic acid)

FV6904 (PDF, 392 ko) – Primary biliary cholangitis

OCREVUS (Ocrelizumab)

FV6971 (PDF, 136 ko) – Primary progressive multiple sclerosis (PPMS)
FV6972 (PDF, 136 ko) – Relapsing-Remitting Multiple Sclerosis (RRMS)
FV6904 (PDF, 69 ko) – Other indication (general form)

OFEV (Nintedanib)

FV6976 (PDF, 107 ko) – Idiopathic Pulmonary Fibrosis (IPF)
FV6904 (PDF, 69 ko) – Other indication (general form)

OMNITROPE (Somatropin)

FV6904 (PDF, 69 ko) – General form

ORENCIA (Abatacept)

FV6856 (PDF, 57 ko) – Psoriatic Arthritis
FV6861 (PDF, 58 ko) – Rheumatoid Arthritis
FV6863 (PDF, 60 ko) – Ankylosing Spondylitis
FV6904 (PDF, 69 ko) – Other indication (general form)

ORFADIN (Nitisinone)

FV6904 (PDF, 69 ko) – General form

ORKAMBI (Lumacaftor / Ivacaftor)

FV6904 (PDF, 69 ko) – General form

OTEZLA (Apremilast)

FV6856 (PDF, 57 ko) – Psoriatic Arthritis
FV6862 (PDF, 64 ko) – Plaque psoriasis
FV6904 (PDF, 69 ko) – Other indication (general form)

OZURDEX (Dexamethasone)

FV6904 (PDF, 69 ko) – General form

PEGASYS (Peginterferon alfa-2a)

FV6904 (PDF, 69 ko) – General form

PEGASYS ± RBV (Peginterferon alfa-2a ± ribavirin)

FV6904 (PDF, 69 ko) – General form

PEGETRON (Interferon alfa-2b / ribavirin)

FV6904 (PDF, 69 ko) – General form

PHEBURANE (Sodium phenylbutyrate)

FV6904 (PDF, 69 ko) – General form

POMALYST (Pomalidomide)

FV6904 (PDF, 69 ko) – General form

PRALUENT (Alirocumab)

FV6853 (PDF, 66 ko) - Hypercholesterolemia and clinically manifest atherosclerotic cardiovascular disease
FV6973 (PDF, 168 ko) - Heterozygous familial hypercholesterolemia (HeFH)
FV6904 (PDF, 69 ko) – Other indication (general form)

PREGNYL (Chorionic gonadotropin)

FV6904 (PDF, 69 ko) – General form

PREVYMIS (Letermovir)

FV6904 (PDF, 69 ko) – General form

PROCYSBI (Cysteamine)

FV6999 (PDF, 106 ko) – Treatment of nephropathic cystinosis

PULMOZYME INHALATION (Dornase Alfa)

FV6904 (PDF, 69 ko) – General form open ?

RAVICTI (Glycerol phenylbutyrate)

FV6904 (PDF, 69 ko) – General form

REMICADE (Infliximab)

FV6856 (PDF, 67 ko) – Psoriatic Arthritis
FV6851 (PDF, 66 ko) – Ulcerative colitis
FV6849 (PDF, 59 ko) – Crohn's disease
FV6861 (PDF, 58 ko) – Rheumatoid Arthritis
FV6863 (PDF, 60 ko) – Ankylosing Spondylitis
FV6862 (PDF, 64 ko) – Plaque psoriasis
FV6904 (PDF, 69 ko) – Other indication (general form)

RENFLEXIS (Infliximab)

FV6856 (PDF, 57 ko) – Psoriatic Arthritis
FV6851 (PDF, 66 ko) – Ulcerative colitis
FV6849 (PDF, 59 ko) – Crohn's disease
FV6861 (PDF, 58 ko) – Rheumatoid Arthritis
FV6863 (PDF, 60 ko) – Ankylosing Spondylitis
FV6862 (PDF, 64 ko) – Plaque psoriasis
FV6904 (PDF, 69 ko) – Other indication (general form)

REPATHA (Evolocumab)

FV6853 (PDF, 66 ko) - Hypercholesterolemia and clinically manifest atherosclerotic cardiovascular disease
FV6973 (PDF, 168 ko) - Heterozygous familial hypercholesterolemia (HeFH)
FV6974 (PDF, 144 ko) - Homozygous familial hypercholesterolemia
FV6904 (PDF, 69 ko) – Other indication (general form)

REPRONEX (Menotropins)

FV6904 (PDF, 69 ko) – General form

RETISERT (Fluocinolone acetonide)

FV6904 (PDF, 69 ko) – General form

REVATIO (Sildenafil)

FV6904 (PDF, 69 ko) – General form

REVESTIVE (Teduglutide)

FV6904 (PDF, 69 ko) – General form

REVLIMID (Lenalidomide)

FV7032 (PDF, 108 ko) – Anemia caused by a myelodysplastic syndrome (MDS) of low-risk or intermediate-1-risk according to the IPSS
FV6904 (PDF, 69 ko) – Other indication (general form)

REVOLADE (Eltrombopag)

FV6904 (PDF, 69 ko) – General form

RITUXAN (Rituximab)

FV6861 (PDF, 58 ko) – Rheumatoid Arthritis
FV6904 (PDF, 69 ko) – Other indication (general form)

RYDAPT (Midostaurine)

FV6904 (PDF, 69 ko) – General form

SAIZEN (Somatropin)

FV6904 (PDF, 69 ko) – General form

SAMSCA (Tolvaptan)

FV6904 (PDF, 69 ko) – General form

SANDOSTATIN (Octreotide)

FV6904 (PDF, 69 ko) – General form open ?

SANDOSTATIN LR (Octreotide)

FV6904 (PDF, 69 ko) – General form open ?

SATIVEX (Cannabidiol/Delta-9-tetrahydrocannabinol)

FV6904 (PDF, 69 ko) – General form

SAXENDA (Liraglutide)

FV6904 (PDF, 69 ko) – General form open ?

SEROSTIM (Somatropin)

FV6904 (PDF, 69 ko) – General form

SIGNIFOR (Pasireotide)

FV6904 (PDF, 69 ko) – General form

SIGNIFOR LAR (Pasireotide)

FV6904 (PDF, 69 ko) – General form

SILIQ (Brodulamab)

FV6862 (PDF, 64 ko) – Plaque psoriasis
FV6904 (PDF, 69 ko) – Other indication (general form)

SIMPONI (Golimumab)

FV6856 (PDF, 57 ko) – Psoriatic Arthritis
FV6851 (PDF, 66 ko) – Ulcerative colitis
FV6861 (PDF, 58 ko) – Rheumatoid Arthritis
FV6863 (PDF, 60 ko) – Ankylosing Spondylitis
FV7012 (PDF, 397 ko) – Non-Radiological Axial Spondyloarthritis
FV6904 (PDF, 69 ko) – Other indication (general form)

SOMAVERT (Pegvisomant)

FV6904 (PDF, 69 ko) – General form

SOVALDI (Sofosbuvir)

FV6904 (PDF, 69 ko) – General form

SPINRAZA (Nusinersen)

FV6904 (PDF, 69 ko) – General form

SPRYCEL (Dasatinib)

FV7060 (PDF, 391 ko) – Chronic myeloid leukemia
FV7059 (PDF, 387 ko) – Acute myeloid leukemia
FV6904 (PDF, 69 ko) – General form

STAXYN (Vardenafil)

FV6904 (PDF, 69 ko) – General form

STELARA (Ustekinumab)

FV6856 (PDF, 57 ko) – Psoriatic Arthritis
FV6849 (PDF, 59 ko) – Crohn's disease
FV6862 (PDF, 64 ko) – Plaque psoriasis
FV6904 (PDF, 69 ko) – Other indication (general form)

STIVARGA (Regorafenib)

FV6970 (PDF, 111 ko) – Metastatic Colorectal Cancer
FV7058 (PDF, 403 ko) – Hepatocellular Carcinoma
FV6904 (PDF, 69 ko) – Other indication (general form)

SUTENT (Sunitinib)

FV6904 (PDF, 69 ko) – General form

SYMDEKO (Tezacaflor/Ivacaftor)

FV6904 (PDF, 69 ko) – General form

TAFINLAR (Dabrafenib)

FV6904 (PDF, 69 ko) – General form

TAGRISSO (Osimertinib)

FV6904 (PDF, 69 ko) – General form

TALTZ (Ixekizumab)

FV6856 (PDF, 57 ko) – Psoriatic Arthritis
FV6862 (PDF, 64 ko) – Plaque psoriasis
FV6904 (PDF, 69 ko) – Other indication (general form)

TARCEVA (Erlotinib)

FV6904 (PDF, 69 ko) – General form

TASIGNA (Nilotinib)

FV6904 (PDF, 69 ko) – General form

TECFIDERA (Dimethyl Fumarate)

FV6904 (PDF, 69 ko) – General form open ?

TECHNIVIE (Ombitasvir / Paritaprevir / Ritonavir)

FV6904 (PDF, 69 ko) – General form

TEGSEDI (Inotersen)

FV6904 (PDF, 69 ko) – General form

TEMODAL (Temozolomide)

FV6904 (PDF, 69 ko) – General form

THALOMID (Thalidomide)

FV6904 (PDF, 69 ko) – General form

THYROGEN (Thyrotropin alfa)

FV6904 (PDF, 69 ko) – General form

TOCTINO (Alitretinoin)

FV6864 (PDF, 58 ko) – Chronic hand eczema
FV6904 (PDF, 69 ko) – Other indication (general form)

TRACLEER (Bosentan)

FV6904 (PDF, 69 ko) – General form open ?

TREMFYA (Guselkumab)

FV6862 (PDF, 64 ko) – Plaque psoriasis
FV6904 (PDF, 69 ko) – Other indication (general form)

TYKERB (Lapatinib)

FV6904 (PDF, 69 ko) – General form

TYSABRI (Natalizumab)

FV7034 (PDF, 396 ko) – Relapsing-Remitting Multiple Sclerosis

UPTRAVI (Selexipag)

FV6904 (PDF, 69 ko) – General form open ?

VENCLEXTA (Venetoclax)

FV6904 (PDF, 69 ko) – General form

VIAGRA (Sildenafil)

FV6904 (PDF, 69 ko) – General form

VICTRELIS (Boceprevir)

FV6904 (PDF, 69 ko) – General form

VICTRELIS TRIPLE (Boceprevir/ peginterferon alfa-2b/ RBV)

FV6904 (PDF, 69 ko) – General form

VOLIBRIS (Ambrisentan)

FV6904 (PDF, 69 ko) – General form open ?

VOSEVI (Sofosbuvir/Velpatasvir/Voxilaprevir)

FV6958 (PDF, 135 ko) – Chronic hepatitis C
FV6904 (PDF, 69 ko) – Other indication (general form)

VOTRIENT (Pazopanib)

FV6904 (PDF, 69 ko) – General form

XALKORI (Crizotinib)

FV6904 (PDF, 69 ko) – General form

XELJANZ (Critrate de tofacitinib)

FV6856 (PDF, 57 ko) – Psoriatic Arthritis
FV6851 (PDF, 70 ko) – Ulcerative Colitis
FV6861 (PDF, 58 ko) – Rheumatoid Arthritis
FV6904 (PDF, 69 ko) – Other indication (general form)

XENICAL (Orlistat)

FV6904 (PDF, 69 ko) – General form open ?

XEOMIN (IncobotulinumtoxinA)

FV6904 (PDF, 69 ko) – General form

XIAFLEX (Collagenase Clostridium Histolyticum)

FV6904 (PDF, 69 ko) – General form open ?

XOLAIR (Omalizumab)

FV6865 (PDF, 69 ko) – Asthma
FV6866 (PDF, 349 ko) – Urticaria
FV6904 (PDF, 69 ko) – Other indication (general form)

XTANDI (Enzalutamide)

FV6904 (PDF, 69 ko) – General form

XYREM (Oxybate de sodium)

FV6904 (PDF, 69 ko) – General form

ZAVESCA (Miglustat)

FV6904 (PDF, 69 ko) – General form

ZAXINE (Rifaximin)

FV6904 (PDF, 69 ko) – General form

ZELBORAF (Vemurafenib)

FV6904 (PDF, 69 ko) – General form

ZEPATIER (Elbasvir / Grazoprevir)

FV6904 (PDF, 69 ko) – General form

ZOLINZA (Vorinostat)

FV6904 (PDF, 69 ko) – General form

ZYDELIG (Idelalisib)

FV6904 (PDF, 69 ko) – General form

ZYKADIA (Ceritinib)

FV6968 (PDF, 111 ko) – First-line treatment ALK+ locally advanced or metastatic non-small cell lung cancer (NSCLC)
FV6904 (PDF, 69 ko) – Other indication (general form)

ZYTIGA (Abiraterone acetate)

FV6904 (PDF, 69 ko) – General form