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

How you take it

One shot under the skin once a month, on the same day each month. You or a caregiver can give it with the autoinjector pen after training. The label also advises a daily vitamin A supplement at the recommended amount, and no more.

Before your first dose

• Your neurologist's office faxes an enrollment form to AstraZeneca Access 360, the drugmaker's program. It checks your insurance and then follows the approval with your plan.
• Your insurance plan has to approve the medicine before the pharmacy ships it. If the approval is delayed, your doctor can ask for a free limited supply for eligible patients.
• Find out if you were prescribed the autoinjector pen or the prefilled syringe. Only a nurse, doctor or other healthcare provider may give the syringe.
• A specialty pharmacy calls to set up delivery of the autoinjector, which arrives in a cooler. AstraZeneca says a healthcare provider gives the syringe at an office or an injection center.
• Your healthcare provider shows you or your caregiver how to use the autoinjector the first time.
• Ask your neurologist which vitamin A supplement to take, how much, and when to start. The label says not to take more than the recommended amount.
• Tell your healthcare provider about every medicine, vitamin and supplement you take, especially vitamin A or beta-carotene.
• Tell your healthcare provider if you are pregnant, plan to become pregnant, or are breastfeeding.
• Make room in the refrigerator, where Wainua is kept in its carton. It can stay at room temperature, no warmer than 86 degrees Fahrenheit, for up to 6 weeks if needed. The label says never to freeze it or expose it to heat.
• Questions about insurance or cost go to 1-844-292-4682, Monday through Friday, 8 AM to 6 PM ET.

The first 90 days

1. About 2 weeks beforeEnrollment form faxed, then the insurance approval
2. After the formBenefits check and prior authorization
3. Week beforeThe specialty pharmacy calls to set up delivery
4. Days beforeThe carton arrives cold
5. Day 1Dose 1, one 45mg injection
6. OngoingDaily vitamin A, at the recommended amount
7. Days afterThe injection site
8. Before each monthly dose, then every 30 daysYour next carton, which holds one dose
9. 1 month after dose 1, then every 30 daysSecond shot, 1 month after the first, then once a month