75 SAVE NOW $ OFF
Transcription
75 SAVE NOW $ OFF
SAVE NOW * When You Fill Your Depakote, Depakote ER, or Depakote Sprinkle Capsules Prescription Up to 75 $ OFF * (after initial $5 patient payment) Present this coupon with your prescription. Restrictions Apply.* Offer valid for self-pay patients only. Patient Instructions: Present this Depakote, Depakote ER, or Depakote Sprinkle Capsules coupon when purchasing your prescription in order to receive a discount. This coupon is only valid for self-pay patients and cannot be used in conjunction with private insurance or the Together Rx Prescription Savings Program. You pay the first $5 of your cash payment on qualified prescriptions and the discount covers up to the next $75 off of your remaining out-of-pocket expenses. Minimum prescription requirement of 30 days supply and/or 30 pills to redeem coupon. This coupon is valid at mail-order pharmacies. Mail-order pharmacies may have different requirements, so please contact them directly for redemption instructions. Pharmacist Instructions: Offer only valid for self-pay patients. Minimum prescription requirement of 30 days supply and/or 30 pills to redeem coupon. Please submit the claim as U&C. You will receive a professional fee from OPUS Health with your next remittance. If you have questions, please call OPUS Health at: 1-800-364-4767. This offer may be changed or discontinued without notice. *Eligibility Restrictions: This coupon is the property of AbbVie Inc. and must be surrendered upon demand. This program is not valid for prescriptions reimbursed under Medicare, Medicaid, or similar federal or state programs or private insurance. Offer also void in Massachusetts and where prohibited by law. Please read Uses and Important Safety Information, including risks of liver problems, pancreas problems, and birth defects on the next page. Full Prescribing Information available at http://www.Depakote.com/prescribing-information ©2013 Cegedim Dendrite E ligibility: S e lf -Pay P atien t s BILL DIRECT TO OPUSHEALTH ONLY RxBIN: 601341 RxPCN: OHCP RxGrp: OH9001111 420100100836 RxID: Suf: 01 What is Depakote used for? Other serious side effects from taking Depakote: Depakote comes in different dosage forms. Depakote® (divalproex sodium) Tablets for Oral use and Depakote® ER (divalproex sodium) Tablet, Extended Release for Oral use are prescription medications used: • To treat acute manic episodes associated with bipolar disorder • Alone or with other medications to treat: – Complex partial seizures in adults and children 10 years of age and older – Simple and complex absence seizures, with or without other seizure types • To prevent migraine headaches Depakote® Sprinkle Capsules (divalproex sodium coated particles in capsules), for oral use is a prescription medicine used alone or with other medicines to treat: • Complex partial seizures in adults and children 10 years of age and older • Simple and complex absence seizures, with or without other seizure types • Low blood platelet counts • High blood ammonia levels • Hypothermia (body temperature less than 95º F) • Allergic reactions • Extreme drowsiness in some elderly patients. Causing less than normal eating or drinking Important Safety Information The most important information about Depakote: Do not stop taking Depakote without first talking to your doctor. Stopping Depakote suddenly can cause serious problems. Depakote can cause SERIOUS SIDE EFFECTS, including: • Serious liver damage that can cause death, especially in children younger than 2 years old. The risk of getting serious liver damage is more likely within the first 6 months of treatment. Liver damage may continue despite stopping the drug. Call your doctor right away if you develop any of these symptoms: nausea or vomiting that doesn’t go away, loss of appetite, pain on the right side of your stomach, dark urine, swelling of your face, or yellowing of your skin or whites of your eyes. • Depakote may harm your unborn baby. Taking Depakote during pregnancy puts your baby at risk for serious birth defects. The most common birth defects affect the brain and spinal cord, called spina bifida or neural tube defects, and occur in 1 to 2 out of every 100 babies born to mothers who use Depakote during pregnancy. These defects can begin in the first month, before you know you are pregnant. Other birth defects can also happen. If you take Depakote while you are pregnant, your child is at risk for having a lower IQ. Women who are pregnant must not take Depakote to prevent migraine headaches. All women of childbearing age should talk to their doctor about using other treatments instead of Depakote. There may be other medicines to treat your condition that have a lower chance of causing birth defects and decreased IQ in your child. If you use Depakote, use effective birth control. Tell your healthcare provider right away if you become pregnant while taking Depakote. Taking folic acid supplements before getting pregnant and during early pregnancy can lower the chance of having a baby with neural tube defects. • Inflammation of your pancreas that can cause death. Call your doctor right away if you develop severe stomach pain that you may also feel in your back, or nausea or vomiting that does not go away. • Depakote may cause suicidal thoughts and actions in a very small number of people, about 1 in 500. Be alert for any sudden changes in mood, behaviors, thoughts or feelings. Call your doctor right away if you have any of these symptoms, especially if they are new or worsen: thoughts of suicide or dying; attempting suicide; new or worse depression, anxiety or irritability; feeling agitated or restless, angry, aggressive, or violent; panic attacks; trouble sleeping; acting on dangerous impulses; or extreme increase in talking or activity. DO NOT TAKE Depakote if you: • Have liver problems • Have or think you have a genetic liver problem caused by a mitochondrial disorder (e.g., Alpers-Huttenlocher syndrome) • Are allergic to the ingredients • Have a genetic condition called urea cycle disorder, causing too much ammonia to build up in your body • DO NOT TAKE Depakote for the prevention of migraine headaches if you are pregnant BEFORE starting Depakote, tell your healthcare provider if you: • Have liver disease • Have a genetic liver problem caused by a mitochondrial disorder (e.g., Alpers-Huttenlocher syndrome) • Are pregnant, planning to become pregnant, or breastfeeding • Drink alcohol • Have depression, mood problems, or suicidal thoughts or behavior • Have a colostomy, ileostomy, or gastrointestinal disorder • Have any other medical condition • Take any medicines, including those with and without a prescription, vitamins, and herbal supplements and medicines ©2013 AbbVie Inc. North Chicago, IL 60064 809685-836310 June 2013 Tell your healthcare provider right away if you develop: • Red or purple spots on your skin • Bruising • Bleeding from your mouth, teeth, or nose • Abnormal drowsiness, a feeling of being more tired or drowsy than usual • Vomiting • Confusion, difficulty thinking, or difficulty staying awake or waking up • An inability to eat or drink as you normally do, a loss of appetite or not wanting to eat or drink as you normally do • Call your doctor immediately if you become pregnant or think you are pregnant. If you want to become pregnant, let your doctor know before you begin trying • Tell your doctor if you notice the shell of the Depakote tablet or capsule in your stool Or if you develop signs of an allergic reaction including the following: 1. Fever 5. Sores in mouth 2. Skin rash 6. Swelling of lymph nodes, face, 3. Hives eyes, lips, tongue, or throat 4. Blisters 7. Trouble swallowing or breathing Some common side effects of Depakote: • Nausea • Headache • Sleepiness • Tremor • Dizziness • Weakness • Hair loss • Diarrhea • Vomiting • Weight gain • Blurry vision • Loss of appetite • Increased appetite • Coordination problems • Walking problems • Stomach pain • Double vision References: 1. Depakote [package insert]. 2. Depakote ER [package insert]. 3. Depakote Sprinkle Capsules [package insert]. 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. If you cannot afford your medication, contact www.pparx.org or call the toll-free phone number (1-888-4PPA-NOW) for assistance.