Something went wrong

We encountered an unexpected error, we encourage you to try again later.

We're here to help

Should you have additional questions please contact PfizerPro customer service.

Representatives are available:
Monday-Friday 8:00am to 9:00pm Eastern time

Call 1 (800) 505-4426

PP-UNP-USA-5796
Order samples Unable to confirm your eligibility

Unfortunately, your registration is incomplete and we are unable to confirm your eligibility for sample ordering.

To gain access please enter your professional information within your account.

Open your account We're here to help

Should you need further support updating your account information, please contact PfizerPro customer service.

Representatives are available:
Monday-Friday 8:00am to 9:00pm Eastern time

Call 1 (800) 505-4426

​​​​​​​PP-UNP-USA-5796
Order samples
Thank you for expressing interest in Pfizer samples. Currently there are no samples available to order. Samples renew periodically, we encourage you to check back soon.
 We're here to help

Should you have additional questions please contact PfizerPro customer service.

Representatives are available:
Monday-Friday 8:00am to 9:00pm Eastern time

Call 1 (800) 505-4426

​​​​​​​PP-UNP-USA-5796
Order samples

All samples available online to you are included below. Availability is updated periodically.

PP-UNP-USA-5796
Important Notice

Savings cards will be shipped with Product Samples, if applicable.

Signature

Use your mouse, finger, or stylus to sign below.

Legal Notice

I certify that I am a licensed prescriber, eligible to request and receive the drug samples listed in the quantities indicated. I am also confirming that these samples will be used exclusively for the medical treatment of my patients in conformity with all relevant state and/or local prescribing and dispensing requirements. My signature will also serve as confirmation of my receipt of these medications, if delivered by a company representative, or my intention to acknowledge them upon delivery to my medical office if shipped via common carrier. I understand that these samples cannot be sold, traded, bartered returned for credit or utilized to seek or obtain reimbursement.

Your order has been placed

We have received your order and are getting it ready

More to explore Patient assistance

Download available co-pay cards and patient savings offers across select Pfizer products.

Explore patient assistance Loading Vaccines

Find out more about the diseases, treatments and prevention methods that are impacted by our Pfizer Vaccine portfolio.

Explore Vaccines Loading
PP-UNP-USA-5796
Leave ordering?

Changes you have made will not be saved.

This site is intended for U.S. healthcare professionals.

For patient resources and support click HERE

Menu

Close

Sign InLog OutTherapy AreasProductsOrder VaccinesOrder SamplesOrderMaterialsCo-pay Cards & Patient Savings OffersRequest SamplesHospital ProductsVaccinesPatient AssistancePfizer Oncology TogetherPfizer RxPathwaysPfizer Dermatology Patient AccessExplore ContentEventsMaterialsVideosContact
Search

Menu

Close

About ATTR-CMAbout
ATTR-CMUnderstanding ATTR-CMRed Flags of ATTR-CMDiagnosing ATTR-CMAbout VYNDAMAXAbout
VYNDAMAXEfficacy DataAdditional DataHow VYNDAMAX WorksSafety Profile Study DesignDosingAccess & SupportAccess & SupportAccessing VYNDAMAXFree Trial ProgramResourcesResourcesEventsMaterialsVideos
Prescribing InformationPatient InformationIndication Patient Site
Diagnosing ATTR Cardiac AmyloidosisTo diagnose ATTR-CM, order these 2 tests concurrently1*:AL tests

Order the following tests1,2†

  • Serum kappa/lambda free light chains
  • Serum protein electrophoresis with immunofixation
  • Urine protein electrophoresis with immunofixation
Tests Serum protein electrophoresis (SPEP) with immunofixation Urine protein electrophoresis (UPEP) with immunofixation Serum free light chain assay
Normal range No M-spike present No M-spike present Kappa:lambda ratio=0.26-1.65†
Tests Normal range
Serum protein electrophoresis (SPEP) with immunofixation No M-spike present
Urine protein electrophoresis (UPEP) with immunofixation No M-spike present
Serum free light chain assay Kappa:lambda ratio=0.26-1.65†
Electrophoresis alone is insufficient without immunofixation.2Kappa:lambda ratio is higher in patients with chronic kidney disease.AL test results interpretation 
AL test results2,3 Diagnosis2,3
Abnormal AL possible—refer to a hematology specialist for evaluation
Normal AL unlikely—refer to cardiac amyloid radionuclide imaging results to determine if ATTR cardiac amyloidosis is possible
PYP or HMDP scintigraphy‡

ASNC advises utilization of 99mTc-PYP or 99mTc-HMDP tracers to diagnose ATTR cardiac amyloidosis2§

  • SPECT to be performed in all amyloid imaging studies to confirm myocardial uptake and differentiate it from blood pool uptake3
  • SPECT imaging should be evaluated for diffuse uptake2
Imaging acquisition2Acquisition guidance
  • The recommended time between injection of 99mTc-PYP or 99mTc-HMDP and scan is 3 hours to maximize specificity§
  • SPECT imaging should be reviewed and interpreted, irrespective of the timing of the acquisition
99mTc-PYP and 99mTc-HMDP are not FDA approved for the diagnosis of ATTR cardiac amyloidosis. Please consult individual labeling for risks.If clinical suspicion is high despite a negative or inconclusive scan, a biopsy should be considered.2Imaging interpretationStep 1 - visual interpretation

Visual interpretation

  • Evaluate SPECT images to confirm diffuse radiotracer uptake in the myocardium and differentiate from blood or overlying bone uptake4
    • SPECT provides a more effective method of radiotracer localization compared to planar images, given the inability to distinguish myocardial uptake from blood pool uptake4
  • If myocardial tracer uptake is visually present on SPECT, proceed to Step 2, semi-quantitative visual grading. If no myocardial tracer uptake is present on SPECT, the visual grade is 02
99mTc-PYP SPECT/CT fusion showing myocardial uptake5|| Illustrative representation.Step 2 - distinguish AL from ATTR-CM

Semi-quantitative grading to distinguish AL from ATTR cardiac amyloidosis (1- or 3-hour approach)2

Once myocardial tracer activity is confirmed on SPECT, the degree of activity can be characterized using the following scale:

PYP imaging is used as an adjunct to diagnosis after ruling out AL. AL is ruled out by testing for the presence of monoclonal protein via serum and urine protein electrophoresis with immunofixation and serum free light chain assay.

The recommended time between injection of 99mTc-PYP and 99mTc-HMDP scan is 2 or 3 hours. The 1-hour approach is optional; if excess blood pool activity is noted, 3-hour imaging is recommended. 99mTc-HMDP has a shorter clearance half-life than 99mTc-PYP, and earlier imaging at 1 hour may be considered to avoid loss of sensitivity.Step 3 - H/CL uptake ratio assessment

Heart/contralateral lung (H/CL) uptake ratio assessment (when applicable)2

Circular target regions of interest (ROI) are drawn over the heart on the planar images and are mirrored over the contralateral chest to account for background and ribs.

  • An H/CL ratio is calculated as the fraction of heart ROI mean counts to contralateral lung ROI mean counts. If discordant or the visual grade is equivocal, H/CL ratio may be helpful to classify equivocal visual Grade 1 vs Grade 2 as positive or negative
  • H/CL ratios of ≥1.5 at 1 hour can accurately identify ATTR cardiac amyloidosis if myocardial tracer uptake is visually confirmed on SPECT and systemic AL amyloidosis is excluded. An H/CL ratio of ≥1.3 at 3 hours can identify ATTR cardiac amyloidosis
  • NOTE: Diagnosis of ATTR cardiac amyloidosis cannot be made solely based on H/CL ratio alone. H/CL ratio is not recommended if there is an absence of myocardial uptake on SPECT
Quantification of cardiac 99mTc-PYP|| uptake using H/CL ratio2# Adapted from Dorbala S, Ando Y, Bokhari S, et al. ASNC/AHA/ASE/EANM/HFSA/ISA/SCMR/SNMMI expert consensus recommendations for multimodality imaging in cardiac amyloidosis: part 1 of 2—evidence base and standardized methods of imaging. Circ Cardiovasc Imaging. 2021;14(7):e000029. Illustrative representation.Next: See the efficacy data for VYNDAMAX from the pivotal clinical trialContinue LoadingYou are now leaving PfizerPro You are now leaving www.pfizerpro.co.uk. Links to external websites are provided as a resource to the viewer. This website is neither owned nor controlled by Pfizer Ltd. Pfizer accepts no responsibility for the content or services of the linked site other than the information or other materials relating to Pfizer medicines or business which it has provided or reviewed. PP-PFE-GBR-3859. November 2021 99mTc-PYP and 99mTc-HMDP are not FDA approved for the diagnosis of ATTR cardiac amyloidosis. Please consult individual labeling for risks.99mTc-HMDP=technetium hydroxymethylene diphosphonate; 99mTc-PYP=technetium pyrophosphate; AL=amyloid light chain; ASNC=American Society of Nuclear Cardiology; ATTR=transthyretin amyloidosis; ATTR-CM=transthyretin amyloid cardiomyopathy; H/CL=heart/contralateral lung; HMDP=hydroxymethylene diphosphonate; PYP=pyrophosphate; SPECT=single photon emission computed tomography.
References: Witteles RM, Bokhari S, Damy T, et al. Screening for transthyretin amyloid cardiomyopathy in everyday practice. JACC Heart Fail. 2019;7(8):709-716. Dorbala S, Ando Y, Bokhari S, et al. ASNC/AHA/ASE/EANM/HFSA/ISA/SCMR/SNMMI expert consensus recommendations for multimodality imaging in cardiac amyloidosis: part 1 of 2—evidence base and standardized methods of imaging. Circ Cardiovasc Imaging. 2021;14(7):e000029.Heidenreich PA, Bozkurt B, Aguilar D, et al. 2022 AHA/ACC/HFSA guideline for the management of heart failure: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2022;145(18):e895-e1032. Hage FG, Bourque J, Pandey S, et al. American Society of Nuclear Cardiology quality metrics for cardiac amyloid radionuclide imaging. J Nucl Cardiol. 2024;40:102041.Data on file. Pfizer Inc., New York, NY.VYNDAQEL and VYNDAMAX [prescribing information]. New York, NY: Pfizer Inc; 2023.
About ATTR-CMA guide to interpreting PYP scansLearn about PYP and diagnosisLoadingReview an interactive resource on diagnostic signs of ATTR-CMRead nowLoadingA guide to getting your patients started on VYNDAMAX Learn moreLoading

To report an adverse event, please call 1-800-438-1985

Pfizer for Professionals 1-800-505-4426

This site is intended only for U.S. healthcare professionals. The products discussed in this site may have different product labeling in different countries. The information provided is for educational purposes only.

© 2026 Pfizer Inc. All rights reserved.

PP-VDM-USA-2791
You are now leaving Pfizer You are now leaving a Pfizer operated website. Links to all outside sites are provided as a resource to our visitors. Pfizer accepts no responsibility for the content of sites that are not owned and operated by Pfizer.

PP-VDM-USA-0908
INDICATION AND LIMITATIONS OF USE VYNDAQEL and VYNDAMAX are indicated for the treatment of the cardiomyopathy of wild-type or hereditary transthyretin-mediated amyloidosis in adults to reduce cardiovascular mortality and cardiovascular-related hospitalization.Please see Full Prescribing Information including Patient Information.
Important Safety InformationAdverse Reactions
In studies in patients with ATTR-CM, the frequency of adverse events in patients treated with VYNDAQEL® (tafamidis meglumine) was similar to placebo.

Specific Populations

Pregnancy: Based on findings from animal studies, VYNDAQEL and VYNDAMAX may cause fetal harm when administered to a pregnant woman.

Lactation: There are no available data on the presence of tafamidis in human milk, the effect on the breastfed infant, or the effect on milk production. Tafamidis is present in rat milk. When a drug is present in animal milk, it is likely the drug will be present in human milk. Breastfeeding is not recommended during treatment with VYNDAQEL and VYNDAMAX.IndicationVYNDAQEL® (tafamidis meglumine) and VYNDAMAX are indicated for the treatment of the cardiomyopathy of wild-type or hereditary transthyretin-mediated amyloidosis in adults to reduce cardiovascular mortality and cardiovascular-related hospitalization.

Please see Full Prescribing Information including Patient Information.