Resources – Accordimids

Resources

The risk minimisation materials for Accord lenalidomide and thalidomide are available to download below

Materials available as editable pdfs:

Medicinal Name	Material	Description	Download
Lenalidomide	Healthcare Professional’s Pack	Contains the complete information needed by healthcare professionals for prescribing and dispensing Accord Lenalidomide, including information about the Pregnancy Prevention Programme (PPP). It is a requirement that healthcare professionals read and understand the PPP prior to prescribing and dispensing to any patient. The pack contains all educational risk minimisation materials	Download PDF
Thalidomide	Healthcare Professional’s Pack	Contains the complete information needed by healthcare professionals for prescribing and dispensing Accord Thalidomide, including information about the Pregnancy Prevention Programme (PPP). It is a requirement that healthcare professionals read and understand the PPP prior to prescribing and dispensing to any patient. The pack contains all educational risk minimisation materials	Download PDF
Lenalidomide	Pharmacy Registration Form (PRF)	Form for completion by the Chief Pharmacist, or their Appointed Deputy. Only pharmacies registered with Accord via the PRF can order and dispense Accord Lenalidomide	Download PDF
Thalidomide	Pharmacy Registration Form (PRF)	Form for completion by the Chief Pharmacist, or their Appointed Deputy. Only pharmacies registered with Accord via the PRF can order and dispense Accord Thalidomide	Download PDF
Lenalidomide	Prescription Authorisation Form (PAF)	Form for completion by the prescriber and pharmacist. Each prescription of Accord Lenalidomide must be accompanied by a newly completed Prescription Authorisation Form (PAF)	Download PDF
Thalidomide	Prescription Authorisation Form (PAF)	Form for completion by the prescriber and pharmacist. Each prescription of Accord Thalidomide must be accompanied by a newly completed Prescription Authorisation Form (PAF)	Download PDF
Lenalidomide	Male Treatment Initiation Form (TIF)	Form for completion by the prescriber for each male patient prior to the initiation of their Lenalidomide treatment. It is mandatory that all males receive counselling and education to be made aware of the risks with this medicine	Download PDF
Thalidomide	Male Treatment Initiation Form (TIF)	Form for completion by the prescriber for each male patient prior to the initiation of their Thalidomide treatment. It is mandatory that all males receive counselling and education to be made aware of the risks with this medicine	Download PDF
Lenalidomide	Women of Childbearing Potential (WCBP) Treatment Initiation Form (TIF)	Form for completion by the prescriber for each woman of childbearing potential prior to the initiation of their Lenalidomide treatment. It is mandatory that women of childbearing potential receive counselling and education to be made aware of the risks with this medicine	Download PDF
Thalidomide	Women of Childbearing Potential (WCBP) Treatment Initiation Form (TIF)	Form for completion by the prescriber for each woman of childbearing potential prior to the initiation of their Thalidomide treatment. It is mandatory that women of childbearing potential receive counselling and education to be made aware of the risks with this medicine	Download PDF
Lenalidomide	Women of Non-childbearing Potential (WNCBP) Treatment Initiation Form (TIF)	Form for completion by the prescriber for each woman of non-childbearing potential prior to the initiation of their Lenalidomide treatment. It is mandatory that women of non-childbearing potential receive counselling and education to be made aware of the risks with this medicine	Download PDF
Thalidomide	Women of Non-childbearing Potential (WNCBP) Treatment Initiation Form (TIF)	Form for completion by the prescriber for each woman of non-childbearing potential prior to the initiation of their Thalidomide treatment. It is mandatory that women of non-childbearing potential receive counselling and education to be made aware of the risks with this medicine	Download PDF
Lenalidomide	Adverse Event Form	Form to facilitate the reporting of adverse events in relation to this medicine to Accord	Download PDF
Thalidomide	Adverse Event Form	Form to facilitate the reporting of adverse events in relation to this medicine to Accord	Download PDF
Lenalidomide	Pregnancy Form	Form to facilitate the immediate reporting to Accord of any suspected, or confirmed, pregnancy whilst a patient is receiving this treatment	Download PDF
Thalidomide	Pregnancy Form	Form to facilitate the immediate reporting to Accord of any suspected, or confirmed, pregnancy whilst a patient is receiving this treatment	Download PDF
Lenalidomide	Pregnancy Outcome Form	Form to facilitate the report to Accord on the outcome of a pregnancy whilst a patient is receiving this treatment	Download PDF
Thalidomide	Pregnancy Outcome Form	Form to facilitate the report to Accord on the outcome of a pregnancy whilst a patient is receiving this treatment	Download PDF

Materials available for download and print:

Medicinal Name	Material	Description	Download
Lenalidomide	Information for Healthcare Professionals	Contains the information needed by healthcare professionals for prescribing and dispensing Accord Lenalidomide, including information about the Pregnancy Prevention Programme (PPP). It is a requirement that healthcare professionals read and understand the PPP prior to prescribing and dispensing to any patient	Download PDF
Thalidomide	Information for Healthcare Professionals	Contains the information needed by healthcare professionals for prescribing and dispensing Accord Thalidomide, including information about the Pregnancy Prevention Programme (PPP). It is a requirement that healthcare professionals read and understand the PPP prior to prescribing and dispensing to any patient	Download PDF
Lenalidomide	Treatment Checklist and Algorithm	Checklist to assist the healthcare professional with counselling a patient before they commence lenalidomide treatment to ensure it is used safely and correctly. The Algorithm provides high level steps for the process of pharmacy registration and the dispensing of lenalidomide	Download PDF
Thalidomide	Treatment Checklist and Algorithm	Checklist to assist the healthcare professional with counselling a patient before they commence thalidomide treatment to ensure it is used safely and correctly. The Algorithm provides high level steps for the process of pharmacy registration and the dispensing of thalidomide	Download PDF
Lenalidomide	Information for Patients	Information to be given to each patient receiving treatment to provide important details about the Pregnancy Prevention Programme, including what the patient needs to be aware of before, during and after taking Accord Lenalidomide along with how to report any side effects.	Download PDF
Thalidomide	Information for Patients	Information to be given to each patient receiving treatment to provide important details about the Pregnancy Prevention Programme, including what the patient needs to be aware of before, during and after taking Accord Thalidomide along with how to report any side effects.	Download PDF
Lenalidomide	Patient Information Card	Card to be given to each patient receiving treatment, as it provides important details about the Pregnancy Prevention Programme, including what the patient needs to be aware of before, during and after taking Accord Lenalidomide along with how to report any side effects.	Download PDF
Thalidomide	Patient Information Card	Card to be given to each patient receiving treatment, as it provides important details about the Pregnancy Prevention Programme, including what the patient needs to be aware of before, during and after taking Accord Thalidomide along with how to report any side effects.	Download PDF

Adverse events should be reported. Reporting forms and information can be found at www.mhra.gov.uk/yellowcard. Adverse events should also be reported to Accord-UK Ltd on 01271 385257 or email [email protected].

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