Eligible patients pay as little as $0 co-pay.*
*Restrictions apply. SEEBRI NEOHALER Savings Program Terms & Conditions.
Limitations apply. This card is valid for up to $250 off each of up to 12 qualifying prescriptions of SEEBRI for up to a 30-day supply. Valid only for those with commercial insurance. Offer not valid under Medicare, Medicaid, or any other federal or state program. Cash-paying patients will save up to $250 off the cost of their prescription. Offer is not valid where prohibited by law. Valid only in the US and Puerto Rico. This program is not health insurance. This card is the property of Sunovion Pharmaceuticals Inc. and must be returned upon request. Offer may not be combined with any other rebate, coupon, or offer.
To the Patient: You must present this card to the pharmacist along with your prescription to participate in this program. If you have any questions regarding your eligibility or benefits, or if you wish to discontinue your participation, call the SEEBRI NEOHALER Co-pay Card program at 844-276-8262 (8am-8pm ET Monday through Friday). When you use this card, you are certifying that you understand the program rules, regulations, and Terms and Conditions. You are not eligible if prescriptions are paid for by any state or other federally funded programs, including, but not limited to Medicare or Medicaid, Medigap, VA, DOD or TriCare, or where prohibited by law; and you will otherwise comply with the terms above.
To the Pharmacist: When you use this card, you are certifying that you have not submitted and will not submit a claim for reimbursement under any federal, state or other governmental programs for this prescription.
Sunovion Pharmaceuticals Inc. reserves the right to rescind, revoke, or amend this offer at any time.
Limit One TrialScript® voucher per patient. Redeem for product only when affixed to the back of a valid, signed prescription form for SEEBRI NEOHALER. Submit claim to McKesson Corporation using BIN #610524. For pharmacy processing questions, please call the Help Desk at 1-800-657-7613.
To the Patient: This voucher is good for one 30-day free trial of SEEBRI NEOHALER. Present this voucher at a participating pharmacy along with a valid prescription from your health care professional.
Need help? Call: 1-800-657-7613.
To the Pharmacist: Must be accompanied by a valid prescription for one 30-day supply of SEEBRI NEOHALER. Dispense as written at no cost to patient. For reimbursement, please submit to McKesson Corporation. The information provided above should be used when submitting for reimbursement. Do not submit to any other payer, public or private, for reimbursement. This voucher can be used up to 2 times (once per 12-month period).
For questions, please call the Help Desk at 1-800-657-7613.
No substitutions permitted. No purchase required. This is not a discount or rebate. Limitations apply.
Expiration Date: 03/31/2018.
TrialScript® is a registered trademark of McKesson Corporation.
SEEBRI NEOHALER is contraindicated in patients with a hypersensitivity to glycopyrrolate or to any of the ingredients.
SEEBRI NEOHALER should not be initiated in patients with acutely deteriorating or potentially life-threatening episodes of COPD or used as rescue therapy for acute episodes of bronchospasm. Acute symptoms should be treated with an inhaled short-acting beta2-agonist.
As with other inhaled medicines, SEEBRI NEOHALER can produce paradoxical bronchospasm that may be life threatening. If paradoxical bronchospasm occurs following dosing with SEEBRI NEOHALER, it should be treated immediately with an inhaled, short-acting bronchodilator; SEEBRI NEOHALER should be discontinued immediately and alternative therapy instituted.
Immediate hypersensitivity reactions have been reported with SEEBRI NEOHALER. If signs occur, discontinue immediately and institute alternative therapy. SEEBRI NEOHALER should be used with caution in patients with severe hypersensitivity to milk proteins.
SEEBRI NEOHALER should be used with caution in patients with narrow-angle glaucoma and in patients with urinary retention. Prescribers and patients should be alert for signs and symptoms of acute narrow-angle glaucoma (e.g., eye pain or discomfort, blurred vision, visual halos or colored images in association with red eyes from conjunctival congestion and corneal edema) and of urinary retention (e.g., difficulty passing urine, painful urination), especially in patients with prostatic hyperplasia or bladder-neck obstruction. Patients should be instructed to consult a physician immediately should any of these signs or symptoms develop.
The most common adverse events reported in ≥1% of patients taking SEEBRI NEOHALER, and occurring more frequently than in patients taking placebo, were upper respiratory tract infection (3.4% vs 2.3%), nasopharyngitis (2.1% vs 1.9%), oropharyngeal pain (1.8% vs 1.2%), urinary tract infection (1.4% vs 1.3%), and sinusitis (1.4% vs 0.7%).
SEEBRI capsules must not be swallowed as the intended effects on the lungs will not be obtained. SEEBRI capsules are only for oral inhalation and should only be used with the NEOHALER device.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.
SEEBRITM NEOHALER® (glycopyrrolate) is an anticholinergic indicated for the long-term, maintenance treatment of airflow obstruction in patients with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and/or emphysema.