Click here for a PDF of the sodium oxybate oral solution copay card.(opens in a new tab)
Click here to download full Prescribing Information including Boxed Warning.(opens in a new tab)

BIN: 610020
PCN: ACR
GROUP: 99995012
ID: 45266800201
*Monthly maximum benefit applies. See Eligibility and Terms below.
Exclusively for Amneal-labeled Sodium Oxybate Oral Solution:
To Patient: Commercially insured patients can use this copay card to reduce out-of-pocket expenses on eligible prescriptions filled with Amneal Sodium Oxybate Oral Solution. Mention this offer to your pharmacy along with a valid sodium oxybate oral solution prescription for an FDA-approved use. A monthly and yearly maximum savings benefit applies. By using this offer, you acknowledge that you meet the Eligibility Criteria and will comply with the Terms and Conditions set forth below.
To Pharmacist: Offer valid for SECONDARY claims only. Process a Coordination of Benefits (COB/split bill) claim using the patient’s prescription insurance for the PRIMARY claim. Submit the SECONDARY claim to PDMI under BIN: 610020. Patient will receive a maximum of $500 off per monthly prescription fill for their out-of-pocket cost.
For pharmacy processing questions, please call 330-757-8402.
Eligibility Criteria/Terms & Conditions:
*Maximum benefit applies.
Note: Sodium oxybate oral solution is available only through a restricted distribution program called the Sodium Oxybate REMS Program because of the risks of central nervous system depression and abuse and misuse. Further information is available at www.SOXREMSProgram.com or 1-833-769-7367 (1-833-SOX-REMS).
Sodium Oxybate Oral Solution Important Safety Information
WARNING: CENTRAL NERVOUS SYSTEM (CNS) DEPRESSION and ABUSE AND MISUSE.
Sodium oxybate oral solution is a CNS depressant. In clinical trials at recommended doses, obtundation and clinically significant respiratory depression occurred in adult patients treated with sodium oxybate oral solution. Many patients who received sodium oxybate oral solution during clinical trials in narcolepsy were receiving central nervous system stimulants.
Sodium oxybate oral solution is the sodium salt of gamma-hydroxybutyrate (GHB). Abuse or misuse of illicit GHB, either alone or in combination with other CNS depressants, is associated with CNS adverse reactions, including seizure, respiratory depression, decreases in the level of consciousness, coma, and death.
Because of the risks of CNS depression and abuse and misuse, sodium oxybate oral solution is available only through a restricted program under a Risk Evaluation and Mitigation Strategy (REMS) called the Sodium Oxybate REMS Program.
Do not take sodium oxybate oral solution if you take other sleep medicines or sedatives (medicines that cause sleepiness), drink alcohol, or have a rare problem called succinic semialdehyde dehydrogenase deficiency.
Keep sodium oxybate oral solution in a safe place to prevent abuse and misuse. Selling or giving away sodium oxybate oral solution may harm others, and is against the law. Tell your doctor if you have ever abused or been dependent on alcohol, prescription medicines, or street drugs.
Anyone who takes sodium oxybate oral solution should not do anything that requires them to be fully awake or is dangerous, including driving a car, using heavy machinery, or flying an airplane, for at least 6 hours after taking sodium oxybate oral solution. Those activities should not be done until you know how sodium oxybate oral solution affects you or your child.
Falling asleep quickly, including while standing or while getting up from the bed, has led to falls with injuries that have required some people to be hospitalized.
Sodium oxybate oral solution can cause serious side effects, including the following:
Tell your doctor if you are on a salt-restricted diet or if you have high blood pressure, heart failure, or kidney problems. Sodium oxybate oral solution contains a lot of sodium (salt) and may not be right for you.
The most common side effects of sodium oxybate oral solution in adults include: nausea, sleepiness, dizziness, vomiting, bedwetting, tremor.
Sodium oxybate oral solution can cause physical dependence and craving for the medicine when they are not taken as directed. These are not all the possible side effects sodium oxybate oral solution.
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.
Please see full Prescribing Information including Boxed Warning.(opens in a new tab)
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