Pharmacy

Per FDA requirements, to order and dispense Tikosyn and its authorized generic, retail pharmacies are required to secure a one-time certification. Even if you have been certified prior to 2011, you are required to secure a one-time recertification. You must enroll in the Tikosyn and Authorized Generic REMS program to prescribe or dispense Tikosyn® or its authorized generic.

To become (re)certified you must review and follow the TIKOSYN and Authorized Generic REMS Program certification procedures below and (re)enroll in the REMS Program:

  • Review the Prescribing Information, including the Medication Guide and Treatment Guidelines
  • Complete the Tikosyn and Authorized Generic REMS Pharmacy Certification Form
  • Sign and fax the form to 1-800-788-2637
  • After 1 to 2 business days, confirm your certification by calling 1-866-249-7261 or visit www.tikosynlist.com. You will need to enter your pharmacy DEA number
  • Your signature on the REMS certification form acknowledges that the appropriate staff members in your pharmacy are aware of the procedures for dispensing Tikosyn and its authorized generic
  • The Tikosyn and Authorized Generic In Pharmacy Systems (T.I.P.S™) Program Brochure describing the steps needed for retail pharmacies to enroll, order and dispense Tikosyn and its Authorized Generic are available here. Please post the T.I.P.S. program procedures, and dofetilide contraindications in your pharmacy.

 

Corporate Pharmacy Enrollment (certifying multiple pharmacies)

  • For corporate pharmacy enrollment you must print out a copy of the blank Tikosyn and Authorized Generic Pharmacy Certification Form and complete the required fields.
  • A list of pharmacy sites that have been trained should be included as a separate attachment: this list must include the same required Pharmacy Information detailed on the enrollment form for EACH pharmacy.
  • Both the completed form and the attached list of pharmacy site information should be emailed to TIKOSYNREMS@UBC.com

 

Through pharmacy certification the pharmacy acknowledges that:

  • The pharmacist will verify that a prescriber has participated in the Tikosyn and Authorized Generic REMS Program and is confirmed in the National Tikosyn and Authorized Generic Database before dispensing.
  • The pharmacist will dispense a Medication Guide with each prescription.

Contact us

Should you have any questions regarding the certification program, please call 1-866-249-7261.