Imnovid®▼ (pomalidomide) Prescription Authorisation Form
A newly completed Prescription Authorisation Form must accompany each pomalidomide prescription to confirm that the patient has been counselled about the teratogenic risk of pomalidomide and the required contraceptive methods, continues to use effective contraception and in the case of a woman of childbearing potential, is having a pregnancy test every 4 weeks before each prescription to ensure they are not pregnant. Completion of this information is mandatory for ALL patients.