Formularios y Documentos
Descargue el formulario que necesita para inscribirse en Genentech
Access Solutions.
Iniciar la Inscripción con el Formulario de Inicio para
OCREVUS
Para poder comenzar, su médico y usted deben cumplimentar este formulario.
Usted solamente tiene que rellenar la Sección 1. El resto del
formulario debe rellenarlo su médico.
Al firmar la Sección 1, permite que OCREVUS Access Solutions comunique información sobre su salud al médico y a su plan de seguro médico.
También puede entregar la sección del formulario por internet.
Important Safety Information & Indication
What it Treats
What is OCREVUS?
OCREVUS is a prescription medicine used to treat adults with relapsing or primary progressive forms of multiple sclerosis.
It is not known if OCREVUS is safe or effective in children.
Who should not receive OCREVUS?
Do not receive OCREVUS if you have an active hepatitis B virus (HBV) infection.
Do not receive OCREVUS if you have had a life threatening allergic reaction to OCREVUS. Tell your healthcare provider if you have had an allergic reaction to OCREVUS or any of its ingredients in the past.
Important Safety Information
What is the most important information I should know about OCREVUS?
OCREVUS can cause serious side effects, including:
- Infusion reactions: OCREVUS can cause infusion reactions that can be serious and require you to be hospitalized. You will be monitored during your infusion and for at least 1 hour after each infusion of OCREVUS for signs and symptoms of an infusion reaction.
- Infection: OCREVUS increases your risk of getting upper respiratory tract infections, lower respiratory tract infections, skin infections, and herpes infections. If you have an active infection, your healthcare provider should delay your treatment with OCREVUS until your infection is gone.
What are the possible side effects of OCREVUS?
OCREVUS may cause serious side effects, including:
- Risk of cancers (malignancies) including breast cancer. Follow your healthcare provider’s instructions about standard screening guidelines for breast cancer.
Most common side effects include infusion reactions and infections.
These are not all the possible side effects of OCREVUS.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
For more information, go to www.OCREVUS.com or call 1-844-627-3887
For additional safety information, please see the full Prescribing Information and Medication Guide.