ORALLY INHALED LEVODOPAINBRIJA—For Use As Needed When PD Symptoms Start To Return in Patients Treated With CD/LD
1. INBRIJA Prescription
Select an option for prescribing INBRIJA- Find and select Pacific LTC Pharmacy in your EMR by using the NPI, NCPDP or Fax numbers below.NCPDP: 5664417
NPI: 1871002485
Fax: (661) 253-5022
Include patient's current mobile phone number*. *You may receive a phone call from an INBRIJA patient support specialist if additional information is required to initiate prior authorization.
- Tell your patients to expect a textPatients will receive a text or phone call from an (844) number within 1-2 hours from sending the eRx to complete enrollment and confirm next steps including prescription fulfillment. *Standard text and data rates may apply

- Download and fill out a Prescription Request Form
- Fax completed form to 1-855-886-2484
If you do not have access to a fax machine, call us at 1-888-887-3447.
INBRIJA is now covered on most commercial plans. Commercial patients are eligible for a $0 initial prescription of INBRIJA. Use our Interactive Formulary Tool to check plans now.
2. Train Your Patient
- Utilize the Demonstration Kit to train your patient on how to administer INBRIJA.
- Provide the Helpful Hints Guide, Demonstration Video and the Instructions For Use to help prepare your patient to use INBRIJA.
Your patients may need several tries to become familiar with the inhalation process. Encourage them to try a few times, and to call the Nurse Educators for additional training and answers to any questions about how to use the inhaler. Your patients may contact them at 1-888-887-3447.
What Happens Next
Encourage your patient to add INBRIJA's Prescription Support Services phone number, 1-888-887-3447, to their phone contacts so they recognize the caller identity when they call.
Prescription Support Services will support your patient by:
- Determining coverage and eligibility for patient support programs including:
- Co-Pay Mitigation
- $0 Initial Prescription for eligible patients
- Patient Assistance Programs and Medicare Extra Help
- Arranging a one-on-one training session with an INBRIJA Nurse Educator to:
- Review appropriate use of INBRIJA
- Train on how-to-use and clean the device along with other helpful tips
- Schedule follow-up calls to provide ongoing support, answer questions and provide additional training
- Ensuring your patients receive a Start Kit with helpful resources, including the following:
Helpful Hints Brochure
Provide your patients with Helpful Hints on how to use INBRIJA to get started.
Demonstration Video
This demonstration video instructs patients on the correct use of INBRIJA.
please call Prescription Support Services: