Copay Savings Program
*Zenzedi Copay Savings Program Terms and Conditions
To the Patient: Eligible patients may receive their first fill of Evekeo® CII (amphetamine sulfate tablets, USP) or Zenzedi® CII (dextroamphetamine sulfate tablets, USP) prescription for $0. For remaining fills, if your copay exceeds $30 (insured patients) or $55 (noninsured patients), present this card to the pharmacist for an instant discount. Patients may use the savings card each time a prescription is filled for up to 365 days’ supply per year. Copays are based on 30-tablet count prescriptions. Benefit limitations apply. Patient is responsible for the remaining balance after benefit limits are reached. If you have any questions regarding your eligibility or benefits, or if you wish to discontinue your participation, call 855-558-1630 (8:00 am–8:00 pm EST, Monday–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 by any state or other federally funded programs, including, but not limited to, Medicare or Medicaid, Medigap, VA or 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.
- Submit transaction to McKesson Corporation using BIN #610524
- If primary commercial prescription insurance exists, input card information as secondary coverage and transmit using the COB segment of the NCPDP transaction. Applicable discounts will be displayed in the transaction response
- Acceptance of this card and your submission of claims for the Evekeo® and Zenzedi® Copay Savings program are subject to the LoyaltyScript® program Terms and Conditions posted at www.mckesson.com/mprstnc
- Patient is not eligible if prescriptions are paid in part or full by any state or federally funded programs, including, but not limited to, Medicare or Medicaid, Medigap, VA or DoD or TRICARE, or where prohibited by law
- For questions regarding setup, claim transmission, patient eligibility or other issues, call 855-558-1630 (8:00 am–8:00 pm EST, Monday–Friday).
Arbor Pharmaceuticals, LLC reserves the right to rescind, revoke, cancel, or adjust this offer at any time. It is a violation of federal law to buy, sell, or counterfeit this card.
Zenzedi (dextroamphetamine sulfate tablets, USP) is a prescription medicine for the treatment of narcolepsy. Zenzedi is also indicated as a treatment for ADHD in pediatric patients ages 3 to 16 years as an integral part of a total treatment program for ADHD that may include counseling or other therapies.
Important Safety Information
Zenzedi (dextroamphetamine sulfate tablets, USP) is a federally controlled substance (CII) with a high risk of abuse or dependence. Keep in a safe place to prevent misuse and abuse. Selling or sharing Zenzedi may harm others and is illegal.
Do not take Zenzedi if you or your child:
- has a history of advanced heart disease or hardening of the arteries, moderate to severe high blood pressure, hyperthyroidism, known hypersensitivity or other serious cardiac problems that may place you or your child at increased vulnerability to the sympathomimetic effects of a stimulant drug or glaucoma
- is very anxious, tense or agitated
- has a history of drug abuse
- is taking or has taken within the past 14 days an anti-depression medicine called a monoamine oxidase inhibitor or MAOI
Warnings and Precautions
Serious heart problems can occur when taking stimulant medicines, such as Zenzedi, and include:
- sudden death in people who have heart problems or heart defects
- sudden death, stroke and heart attack in adults
- increased blood pressure and heart rate
Tell your doctor if you or your child has any heart problems including heart defects, abnormal heart rhythm, high blood pressure, disease known as cardiomyopathy, coronary artery disease, or a family history of these problems or sudden cardiac death. Call your doctor right away if you or your child has any signs of heart problems such as chest pain, shortness of breath, or fainting while taking Zenzedi.
Mental (psychiatric) problems can occur including:
- new or worsening behavior and thought problems
- new or worsening bipolar illness
New aggressive behavior or psychotic symptoms can occur in children and teenagers such as:
- seeing things or hearing voices
- believing things that are not true
- being suspicious
Tell your doctor about any drug abuse, alcohol abuse or mental problems that you or your child has had, or about a family history of suicide, bipolar illness, or depression, new or worsening aggressive behavior or hostility. Call your doctor right away if you or your child has any new or worsening mental symptoms or problems while taking Zenzedi.
Circulation problems in fingers and toes:
- fingers or toes may feel numb, cool, painful
- fingers or toes may change color from pale, to blue, to red
Tell your doctor if you or your child has any numbness, pain, color change, or sensitivity to temperature in your fingers and toes or a family history of health conditions including circulation problems in fingers and toes. Call your doctor right away if you or your child has any signs of unexplained wounds appearing on fingers and toes while taking Zenzedi.
Zenzedi may cause serious side effects, including:
- slowing of growth (height and weight) in children. Your child should have his or her height and weight checked often while taking Zenzedi. The doctor may stop treatment if a problem is found during these check-ups.
The most common side effects reported with Zenzedi treatment were:
|• seizures||• rapid heart beat||• trouble sleeping||• weight loss|
|• blurred vision||• tremors||• stomach upset||• dizziness|
|• dry mouth||• decreased appetite||• headache|
For additional safety information, consult the Zenzedi full Prescribing Information and Medication Guide.
Talk to your doctor to see if Zenzedi is right for you or your child.
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.