Your Guide to Initiating and Continuing Patients on LUPIN-TOLVAPTAN

Meet the conditions for prescription and dispensing Lupin-Tolvaptan

Start and complete the Prescriber and Healthcare Professional Training Module, including knowledge check questions and certification

Co-sign PPAF with patient

Submit to Program

Provide prescription
and LFT orders

Follow up on Program requirements

Titrate/Adjust

dose if required

Review LFT results

and communicate to Patient Support Program

Throughout this process, the Program will:

Receive, validate and store PPAF

Contact patient to confirm enrollment and understanding of CDP

Ship supply of LUPIN-TOLVAPTAN to pharmacy for dispensing if all PPAF conditions are met

Send blood test reminders to patient (as per patient preference)

Conduct follow-up for LFT result status with prescriber, using the LFT fax-back form

CDP=Controlled Distribution Program; LFT=Liver Function Test; PPAF=Patient-Prescribe Agreement Form.