Starting Onpattro (patisiran)Your first 90 days with hereditary ATTR amyloidosis with polyneuropathy: the steps, the dates and who to call

How you take it

A drip into a vein every 3 weeks, given by a nurse or doctor over about 80 minutes. The label also advises a daily vitamin A supplement at the recommended amount, and no more.

Before your first dose

• You and your nerve doctor (neurologist) sign a Start Form for Alnylam Assist, the drugmaker's support program. The form lists your weight and your dose.
• An Alnylam Case Manager contacts you within 2 business days to explain what your insurance covers.
• Your insurance has to approve the medicine before the first infusion. Plans such as Cigna ask for a genetic test and records of your nerve symptoms.
• You and your doctor settle where you get the infusion. Alnylam Assist can send a list of treatment sites that fit your insurance.
• Ask your nerve doctor which vitamin A supplement to take, how much, and when to start. The label says not to take more than the recommended amount.
• On infusion day you get 4 medicines at least 60 minutes before the drip starts. These medicines lower the chance of an infusion reaction.

The first 90 days

1. 3 weeks beforeStart Form signed and sent
2. 2 business daysA Case Manager makes contact
3. About 2 weeks beforeInsurance approval
4. Week beforeWhere the infusion is given
5. Day 1Premedicines, at least 60 minutes before
6. Day 1Infusion 1, about 80 minutes
7. OngoingDaily vitamin A, at the recommended amount
8. 3 weeks after dose 1Second infusion, 3 weeks after the first
9. Week 7Third infusion
10. Week 10Fourth infusion
11. Week 13, then every 21 daysFifth infusion, then one every 3 weeks