Sodium Oxybate Oral Solution Copay Savings

Click here for a PDF of the sodium oxybate oral solution copay card.(opens in a new tab)

Click here for full Prescribing Information including Boxed Warning.(opens in a new tab)

Pay as little as $0* for each prescription of Amneal Sodium Oxybate Oral Solution

BIN: 610020
PCN: ACR
GROUP: 99995012
ID: 45266800201
*Max benefit of $500 per monthly prescription fill. See Eligibility and Terms below.

Exclusively for Amneal-labeled Sodium Oxybate Oral Solution

NDC: 65162-0065-87

Here’s how the Sodium Oxybate Oral Solution Copay Card works:

Present this card or BIN, Group and ID numbers to your pharmacist along with a valid prescription.
Eligible, commercially insured patients may receive their Amneal Sodium Oxybate Oral Solution monthly prescription for $0*.
If you have any questions, please feel free to call 330-757-8402.

To Patient: Commercially insured patients can use this copay card to reduce out-of-pocket expenses on eligible prescriptions filled with Amneal Sodium Oxybate Sodium Oral Solution. Mention this offer to your pharmacy along with a valid sodium oxybate 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:

This offer is only good for use by patients with a valid prescription for an eligible product with an approved indication at the time the prescription is filled and dispensed to the patient.
This card is not valid for use by patients enrolled in Medicare, Medicaid, or other federal or state programs (including any state pharmaceutical assistance programs), or private indemnity or HMO insurance plans that reimburse you for the entire cost of your prescription drugs. Patients may not use this card if they are Medicare-eligible and enrolled in an employer-sponsored health plan or prescription drug benefit program for retirees. This offer is not valid for cash-paying patients.
Maximum savings limit applies; patient out-of-pocket expense may vary. Offer applies only to prescriptions filled before the program expires.
Amneal Pharmaceuticals LLC reserves the right to rescind, revoke, or amend this offer without notice. Offer good only in the USA, including Puerto Rico, at participating pharmacies. This offer is not valid for residents of Massachusetts. Void if prohibited by law, taxed, or restricted.
This card is not transferable. The selling, purchasing, trading, or counterfeiting of this card is prohibited by law. This card has no cash value and may not be used in combination with any other discount, coupon, rebate, free trial, or similar offer for the specified prescription. This offer is not health insurance.
By redeeming this card, you acknowledge that you are an eligible patient and that you understand and agree to comply with the terms and conditions of this offer.

*Max 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.

Central Nervous System Depression

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.

Abuse and Misuse

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), drinks alcohol, or has 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.

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:

Breathing problems, including slower breathing, trouble breathing, and/or short periods of not breathing while sleeping (sleep apnea). People who already have breathing or lung problems have a higher chance of having breathing problems when they take sodium oxybate oral solution.
Mental health problems, including confusion, seeing or hearing things that are not real (hallucinations), unusual or disturbing thoughts (abnormal thinking), feeling anxious or upset, depression, thoughts of killing yourself or trying to kill yourself, increased tiredness, feelings of guilt or worthlessness, and/or difficulty concentrating. Call your doctor right away if you have symptoms of mental health problems or a change in weight or appetite.
Sleepwalking. Sleepwalking can cause injuries. Call your doctor if you start sleepwalking. Your doctor should check you.

Before taking sodium oxybate oral solution tell your doctor about all medical conditions, including if you areon 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 of 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)