Tools & Resources

Helpful and informative resources for you and your patients

KEVEYIS Start Form

This easy-to-use form is the first step in initiating a patient on KEVEYIS. Get your patient(s) started in 3 easy steps:

  1. Complete the form
  2. If able, have the patient sign the form
  3. Fax the form back to 844-KEV-1030 (844-538-1030)

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Disease Education Brochure

This printable brochure provides a robust level of information to help you better understand Primary Periodic Paralysis and its diagnosis and management, including:

  • Insight into the disease and its diagnosis
  • Recommended tests and other evaluations
  • Disease management strategies

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Primary Periodic Paralysis Daily Tracker & 3-Month Diary

The printable tool is provided for you to give your patients to help them keep track of important aspects of their disease, including:

  • Attacks
  • Triggers
  • Symptoms
  • Emotions
  • And more

Keeping a written record of how they have been feeling and how the disease has affected them between visits will help facilitate more informed conversations during their scheduled appointments with you.

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Prior Authorization Checklist

This checklist is a useful resource for ensuring the most common clinical criteria are met when submitting a prior authorization for your patient.

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Letter of Medical Necessity

This sample Letter of Medical Necessity outlines support for coverage of KEVEYIS. Use of this document does not guarantee assistance in the payer’s review of a Letter of Medical Necessity for the medication for your patient. Be sure to replace all bolded and bracketed text with the appropriate patient-specific information before forwarding your customized letter to your patient’s insurance provider. If the provided fields do not accurately reflect your practices, please modify them to represent your particular circumstances.

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Advocacy partners

Periodic Paralysis Association
The Periodic Paralysis Association is a nonprofit charitable corporation founded to foster awareness of the periodic paralyses, promote science-based information regarding this class of disorder, and champion the interests of the periodic paralysis community.
Learn more

Periodic Paralysis International
A mission-driven, independent and not-for-profit whose goal is to help create successful partnerships between physicians, researchers, and periodic paralysis patients in order to speed diagnosis and improve therapy and management strategies, thereby improving quality of life and clinical outcomes for patients.
Learn more
KEVEYIS is the first and only FDA-approved treatment for hyperkalemic, hypokalemic, and related variants of Primary Periodic Paralysis. Learn more.

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INDICATION

KEVEYIS is indicated for the treatment of primary hyperkalemic periodic paralysis, primary hypokalemic periodic paralysis, and related variants.

IMPORTANT SAFETY INFORMATION

CONTRAINDICATIONS

  • Hypersensitivity to dichlorphenamide or other sulfonamides
  • Concomitant use of KEVEYIS and high-dose aspirin
  • Severe pulmonary disease, limiting compensation to metabolic acidosis caused by KEVEYIS
  • Hepatic insufficiency: KEVEYIS may aggravate hepatic encephalopathy

WARNINGS AND PRECAUTIONS

Hypersensitivity/Anaphylaxis/Idiosyncratic Reactions

  • Fatalities associated with the administration of sulfonamides have occurred due to adverse reactions including Stevens-Johnson syndrome, toxic epidermal necrolysis, fulminant hepatic necrosis, agranulocytosis, aplastic anemia and other blood dyscrasias
  • Pulmonary involvement can occur in isolation or as part of a systemic reaction
  • Discontinue KEVEYIS at the first appearance of skin rash or any sign of immune-mediated or idiosyncratic adverse reaction

Concomitant Use of Aspirin

  • Anorexia, tachypnea, lethargy, and coma have been reported with concomitant use of dichlorphenamide and high-dose aspirin
  • The concomitant use of KEVEYIS and high-dose aspirin is contraindicated
  • Use with caution in patients receiving low-dose aspirin

Hypokalemia

  • KEVEYIS increases potassium excretion and can cause hypokalemia
  • The risk of hypokalemia is greater when KEVEYIS is used in patients with conditions associated with hypokalemia (eg, adrenocortical insufficiency, hyperchloremic metabolic acidosis, or respiratory acidosis), and in patients receiving other drugs that may cause hypokalemia (eg, loop diuretics, thiazide diuretics, laxatives, antifungals, penicillin, and theophylline)
  • Baseline and periodic measurements of serum potassium are recommended
  • If hypokalemia develops or persists, consider reducing the dose or discontinuing KEVEYIS

Metabolic Acidosis

  • KEVEYIS can cause hyperchloremic non–anion gap metabolic acidosis
  • Concomitant use of KEVEYIS with other drugs that cause metabolic acidosis may increase the severity of metabolic acidosis
  • Baseline and periodic measurements of serum bicarbonate are recommended
  • If metabolic acidosis develops or persists, consider reducing the dose or discontinuing KEVEYIS

Falls

  • KEVEYIS increases the risk of falls; risk is greater in the elderly and with higher doses
  • Consider dose reduction or discontinuation of KEVEYIS in patients who experience falls while treated with KEVEYIS

PREGNANCY AND LACTATION

Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is not known in humans whether dichlorphenamide is excreted in human milk; exercise caution when administered to a nursing woman.

ADVERSE REACTIONS

The most common adverse reactions seen in clinical trials (incidence ≥ 10% and greater than placebo) include paresthesias, cognitive disorder, dysgeusia, and confusional state.

Please see Full Prescribing Information.