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Click ‘Get Form’ to open the Aimovig Ally Service Request Form in the editor.
Begin by filling out the Patient Information section. Ensure all fields are completed, including the patient's name, date of birth, and contact information.
Next, move to the Prescription Insurance Information section. Input details such as Rx Group # and Rx BIN # accurately to avoid processing delays.
In the Prescriber & Prescription Information section, ensure that you attach a separate prescription if required by your state laws. Sign where indicated to validate the form.
Review all entries for accuracy. Once confirmed, submit electronically through our platform or fax it to 833-873-1499 for processing.

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How is Qulipta different from Aimovig?

Aimovig is administered as a monthly subcutaneous injection, which may be preferred by patients seeking less frequent dosing schedules. Qulipta, on the other hand, is taken orally, which might be more suitable for patients who are averse to injections.

What is the FDA warning for Aimovig?

Development of hypertension and worsening of pre-existing hypertension have been reported following the use of AIMOVIG in the postmarketing setting. Many of the patients had pre-existing hypertension or risk factors for hypertension.

Is Aimovig being discontinued?

Aimovig was discontinued in most reported cases. Constipation was one of the most common (up to 3%) adverse reactions reported in clinical studies. Monitor patients treated with Aimovig for severe constipation and manage as clinically appropriate.

Is Aimovig safe long term?

But since Aimovig has been available for use, people have reported some side effects that could cause long-term complications. These include severe constipation and high blood pressure.