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Web please see full prescribing information, including medication guide, for additional important safety information and. Web sign a printed form and fax or mail it to us (or give it to your doctor's office to do so) your doctor also has to fill out a form called the. Prefilled syringe 75 mg/0.5 ml, prefilled syringe 150 mg/ml, vial 150 mg for reconstitution drug class:. Once completed, fax to the number indicated on.
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