Hot flash relief that fits your life
RxBIN:
610524
RxPCN:
Loyalty
rGrP:
50775352
ISSUEr:
80840
ID: 675800197

Patient:
Present this coupon to the pharmacist along with your prescription for Divigel® to receive this benefit.

*For eligible patients only and limited to a maximum savings of $25 each on 12 Divigel® prescriptions

Indication & Important Safety Information
Divigel® (estradiol gel) 0.1% is indicated for moderate to severe vasomotor symptoms (hot flashes and night sweats) due to menopause.

What is the most important information I should know about Divigel® (an estrogen hormone)?
  • Using estrogen alone increases your chance of getting cancer of the uterus (womb). Report any unusual vaginal bleeding right away while you are using Divigel® .
  • Vaginal bleeding after menopause may be a warning sign of cancer of the uterus (womb). Your healthcare provider should check any unusual bleeding to find out the cause.
  • Do not use estrogen alone to prevent heart disease, heart attacks, strokes or dementia (decline of brain function).
  • Using estrogen alone may increase your chance of getting dementia, based on a study of women 65 years of age or older.
  • Do not use estrogens with progestins to prevent heart disease, heart attacks, strokes or dementia.
  • Using estrogens with progestins may increase your chances of getting heart attacks, strokes, breast cancer, or blood clots.
  • Using estrogens with progestins may increase your chance of getting dementia, based on a study of women 65 years of age or older.
  • You and your healthcare provider should talk regularly about whether you still need treatment with Divigel®.

Divigel® should not be used if you have unusual vaginal bleeding, currently have or have had certain cancers, including cancer of the breast or uterus, have had a stroke or heart attack, currently have or have had blood clots, currently have or have had liver problems, have been diagnosed with a bleeding disorder, are allergic to Divigel® or any of its ingredients, or think you may be pregnant.

Tell your healthcare provider about all of your medical problems and the medicines you take, if you are going to have surgery or will be on bed rest, and if you are breastfeeding.

Call your healthcare provider right away if you get any of the following symptoms: new breast lumps, unusual vaginal bleeding, changes in vision or speech, sudden new severe headaches, or severe pains in your chest or legs with or without shortness of breath, weakness and fatigue.
Common side effects that may occur with Divigel® include: headache, breast pain, irregular vaginal bleeding or spotting, stomach or abdominal cramps, bloating, nausea and vomiting, hair loss, fluid retention and vaginal yeast infection.

Serious but less common side effects include: heart attack, stroke, blood clots, dementia, breast cancer, cancer of the uterus, ovarian cancer, high blood pressure, high blood sugar, gallbladder disease, liver problems, and enlargement of benign uterus tumors (fibroids).

Alcohol-based gels are flammable. Avoid fire, flame or smoking until the gel has dried.

Please see full Prescribing Information for Divigel® provided with your prescription and talk to your healthcare provider.
For more information visit www.Divigel.com.

You are encouraged to report negative side effects to Vertical Pharmaceuticals, LLC at 1-877-95-VERTI (1-877-958-3784), or to the FDA by visiting www.fda.gov/mediwatch or calling 1-800-FDA-1088.

To the Patient: You must present this coupon 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 Divigel® Patient Savings Program at 1-800-657-7613 (8:00 AM-8:00 PM EST, Monday-Friday). When you use this coupon, 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, DOD, or TRICARE, or where prohibited by law, and you will otherwise comply with the terms above. Cash payers are eligible for this program. There are no age restrictions to this program. Vertical Pharmaceuticals, LLC reserves the right to amend or cancel this offer without notice.

To the Pharmacist: When you use this coupon, 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 coverage exists, input coupon 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 coupon and your submission of claims for the Divigel® Patient 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, DOD, or TRICARE, or where prohibited by law
  • For questions regarding setup, claim transmission, patient eligibility or other issues, call the LoyaltyScript® for Divigel® (estradiol gel) 0.1% program at 1-800-657-7613 (8:00 AM-8:00 PM EST, Monday-Friday)