IMPORTANT SAFETY INFORMATION
Do not take AZILECT® (rasagiline tablets) if you are taking meperidine as it could result in a serious reaction such as coma or death. Also, do not take AZILECT with tramadol, methadone, propoxyphene, dextromethorphan, St. John’s wort, or cyclobenzaprine. You also should not take AZILECT with other monoamine oxidase inhibitors (MAOIs), as it could result in an unsafe rise in blood pressure. Read More Important Safety Information
Valid only for qualified patients with a valid prescription for AZILECT® (rasagiline tablets). No substitutions are permitted. This card is valid only for
those with private insurance or for cash-paying patients. This card is not valid for prescriptions paid for in part or in full by any state or federally funded
program, including but not limited to Medicare or Medicaid, Medigap, VA, DOD, Tricare®, or the Puerto Rico Government Health Insurance Plan, or by
private health insurance plans or programs that reimburse patients for the entire costs of their prescription drugs. This card is not valid for patients
who are Medicare eligible and are enrolled in an employer-sponsored health plan or prescription drug benefit program for retirees (i.e., patients who are
eligible for Medicare Part D but receive a prescription drug benefit through a former employer). Patient discount with this card is valid to reduce the co-pay
to $5, with a maximum benefit of $110 per month. For example, if the total co-pay is $115 or less, the patient will pay no more than $5 per month. If the
co-pay is more than $115, the patient’s co-pay will be reduced by a maximum amount of $110 per month. Offer expires December 31, 2016.
Your acceptance of this offer must be consistent with the terms of any drug benefit provided by a health insurer, health plan, or other third-party payer, and you agree to report acceptance of this offer to your health insurer, health plan, or third-party payer as may be required. Offer limited to one card per person and may not be used with any other discount, coupon, or offer. Offer is not transferable. It is illegal to sell, purchase, trade, or counterfeit this card. This card is not health insurance. This card is the property of Teva Neuroscience, Inc., and must be returned upon request. Offer is valid only in the United States or the Commonwealth of Puerto Rico at participating pharmacies. Void in any state where prohibited by law, taxed, or restricted. Teva Neuroscience, Inc., reserves the right to change, rescind, revoke, or discontinue this offer at any time without notice. By participating in this program, you, the patient, certify that (a) you have read the above terms; (b) you are not reimbursed, nor will you submit a claim for reimbursement, nor will you seek to have any portion of this prescription counted toward your out-of-pocket costs (e.g., TROOP) under any federal, state, or private programs for this or other prescriptions for AZILECT to which this offer will apply; and (c) you will otherwise comply with the terms above.
AZILECT® (rasagiline tablets) is indicated for the treatment of Parkinson’s disease (PD).