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ORIJIN Enrolment Form
For patients
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The ORIJIN® Patient Support Program is here for your patients taking PrVELPHORO®

What the ORIJIN Program has to offer:

Counselling services from an ORIJIN nurse on:

How to take
VELPHORO

What to expect during treatment

Information related to treating hyperphosphatemia

Keeping a low-phosphorus diet

Access to reimbursement specialists to help with:

Financial assistance

Reimbursement navigation

ORIJIN nurses are trained and supported by a Canadian dietician following the most up-to-date nutritional recommendations.

ORIJIN nurses are trained and supported by a Canadian dietician following the most up-to-date nutritional recommendations.

Helping you register your patients with ORIJIN

  • You can help your patients register by:
  • Simply filling out an enrolment form with their signature and faxing it to 1-844-354-6272.
  • Once registered, an ORIJIN nurse will contact your patient.
  • Your patients can also register for the ORIJIN Program by calling:

Download your patient enrolment forms

Download form
enrForm thumbnail

Download your patient enrolment forms

Important Safety Information

Important Safety Information

  • Clinical use:
  • Efficacy and safety in pediatric population (<18 years of age) have not been evaluated.
  • No overall differences in safety or efficacy were observed between subjects ≥65 and younger subjects.
  • Contraindications:
  • Patients who are hypersensitive to this drug or to any ingredient in the formulation, including any non-medicinal ingredient, or component of the container.
  • Patients with hemochromatosis or any other iron accumulation disorders.
  • Relevant warnings and precautions:
  • Diabetes, hereditary fructose intolerance, glucose-galactose malabsorption, and sucrase-isomaltase insufficiency
  • Caution in patients with gastrointestinal issues
  • VELPHORO may cause black stools which may mask gastrointestinal bleeding
  • Patients with hepatic/biliary/pancreatic disorders/disease
  • Monitoring and laboratory tests regarding serum phosphorus and iron
  • Pregnant or nursing women
  • Less common clinical trial or post-market adverse reactions:
  • In the 6-week and 55-week clinical studies, tooth discolouration and product taste were some of the less common (<1%), treatment-related treatment emergent adverse events reported in more than one patient.
  • Eosinophilic peritonitis has been listed in post-market spontaneous reports.
  • For more information:
  • Please consult the Product Monograph at http://velphoromonograph.ca for important information relating to adverse reactions, drug interactions, and dosing information which have not been discussed in this piece. The Product Monograph is also available by calling us at 1-877-341-9245.
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© Otsuka Canada Pharmaceutical Inc. All rights reserved.
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  • All trademarks identified by a ® or a ™ are protected trademarks (registered or unregistered) of their owners or licensors.
  • For more information, please visit www.otsukacanadatm-mc.ca.
  • © Otsuka Canada Pharmaceutical Inc. All rights reserved.
  • OCPI-VPO-00210E
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