Where can I send a SAJAZIR™ (icatibant) prescription?
Once you have completed the SAJAZIR enrollment form, you can send it to our product support platform, Cycle Vita™, where our expert team will take care of all the details so your patients can get started on their icatibant treatment as soon as possible.
You can either:
- Email the completed form to hello@cyclevita.com, or
- Fax it to + 1 (888) 385-8482
Please use the enrollment form on the SAJAZIR website and remember to specify dispense as written (DAW) on every enrollment form, new or refill, to ensure that your patients receive SAJAZIR and the support available through Cycle Vita.
Sending your own prescription can cause delays or could mean a Specialty Pharmacy may give a patient generic icatibant instead. This would mean your patients will not be able to access Cycle Vita, which can provide eligible* patients with:
- Hub Support: Including financial, logistic, and product support, as well as clinical education
- Quick Start Program: Helps your patients receive an immediate supply of medication while we support the finalization of the insurance paperwork
- Bridge Program: Provides support to eligible patients in the event of a transition between insurances by providing an uninterrupted supply of medicine
- $0 Co-pay Assistance Program: Commercially insured eligible patients may pay as little as $0
SAJAZIR has a limited distribution. If your patients are contacted by someone who is not from Cycle Vita or their Specialty Pharmacy, please let us know at + 1 (888) 385-8482 or hello@cyclevita.com.
To ensure faster turnaround times for you and your patients, please see our Rx Checklist to make sure you include everything required for a quick process.

References
*Some areas of support may not be accessible to all patients. Eligibility criteria may apply to ensure compliance with all applicable federal and state requirements, and benefits may be limited to commercially insured patients only. For more detailed information about eligibility, terms and conditions, please contact the Cycle Vita team at +1 (888) 360-8482.