Interested in requesting a sample for your patient?

If you have an appropriate patient who would like to try TAKHZYRO, you may be able to obtain a trial dose for their use by filling out the form below. The form connects you with a TAKHZYRO rep to facilitate the sample process. TAKHZYRO is indicated for prophylaxis to prevent attacks of hereditary angioedema (HAE) in patients ≥2 years of age.¹

Request a Sample

*Takeda has limited quantities of sample product available. Physicians can obtain one sample per qualified patient. Takeda reserves the right to rescind, revoke or amend this program at any time without notice.

Not actual size.

How the TAKHZYRO Sample Program works

Fill out the request a TAKHZYRO sample form below

A TAKHZYRO REPRESENTATIVE WILL CONTACT YOU IN 72 HOURS

IF APPROVED, A SINGLE DOSE OF TAKHZYRO WILL BE DELIVERED TO YOUR OFFICE FOR YOUR PATIENT’S TRIAL USE—AT NO COST

The goal of the program

The TAKHZYRO Sample Program is not meant to evaluate the efficacy of the treatment, given that a patient will only receive a single dose. Rather, the program is meant to help you evaluate the tolerability of TAKHZYRO with your patient and to help your patient assess the administration process prior to prescription.

Request a TAKHZYRO sample

Complete this form and a Takeda representative will contact you in 72 hours.

* Required fields

First Name*

Last Name*

Professional Designation*

Pharmacist Physician Physician's Assistant Registered Nurse Other

National Provider Identifier (NPI)*

ZIP Code*

Email Address*

Phone Number*

Preferred Contact Method*

Phone Email

I would like to receive email communications with updates concerning product information, disease education, patient support programs and other topics from Takeda.

By clicking the box above and providing your information, you consent to receiving marketing and promotional communications related to hereditary angioedema (HAE) and HAE products and other information from Takeda. You hereby give consent to Takeda, its affiliates, and their agents and representatives to send communications and information to you via the contact information you have provided above. This consent will be in effect until such time as you opt out of communications from Takeda.

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By providing your information you certify that you are a healthcare provider.

References: 1. TAKHZYRO. Prescribing information. Dyax Corp; 2023.