*Offer covers commercially insured patients only.
Please note, this offer is not available for patients eligible for Medicare, Medicaid, or any other form of government insurance. Out-of-pocket costs may vary based on insurance coverage. Limitations apply. See full Terms and Conditions for eligibility restrictions.
Terms and Conditions: Patients are not eligible if prescriptions are paid for in part or full by any state or federally funded programs, including but not limited to Medicare, Medicaid, Medigap, VA, DOD, TRICARE, or by private health benefit programs which reimburse for the entire cost of prescription drugs. This card is not valid for patients who are Medicare eligible and are enrolled in an employer-sponsored health plan or prescription drug benefit program for retirees (i.e., patients who are eligible for Medicare Part D but who receive a prescription drug benefit through a former employer). Cash Discount Cards and other non-insurance plans are not valid as primary under this offer. If the patient is eligible for drug benefits under any such program, the patient cannot use this offer. By redeeming this offer, the patient and the pharmacist attest that the patient is eligible, and the patient and the pharmacist understand and agree to comply with the Terms and Conditions of this offer.
Void if copied, transferred, purchased, altered, or traded and where prohibited and restricted by law. This is not an insurance program. This offer may not be used with any other discount, coupon, or offer. This offer expires on 12/31/2024. This program is managed by Mercalis on behalf of Teva Pharmaceuticals USA, Inc. Teva reserves the right to limit, change, or discontinue this offer at any time without notice. If you have any questions regarding your eligibility or benefits, please call 844-248-7949.
Valid only for Teva’s Tobramycin Inhalation Solution, USP, National Drug Code #00093-3750-28 and #00093-3750-63
To the Patient: This offer is for eligible Commercially Insured Patients only. Patients pay as little as $0 out-of-pocket for Teva’s Tobramycin Inhalation Solution, USP. Maximum Program assistance per prescription and annual benefits apply and out of pocket expenses may vary. Patient is responsible for costs above maximum benefit amounts. This offer must be presented along with your prescription for Tobramycin Inhalation Solution, USP and your primary insurance card to participate in this program. Offer not valid for Non-Insured/Cash-Paying patients or where Tobramycin Inhalation Solution, USP is not covered by the primary insurance.
To the Pharmacist: By redeeming this offer, the Pharmacist certifies that Teva’s Tobramycin Inhalation Solution, USP is being dispensed to a patient eligible for this offer in compliance with these Terms and Conditions and that the Pharmacy has not submitted and will not submit a claim for reimbursement under any federal, state, or other governmental program for this prescription. For Commercially-Insured Patients: Please submit this claim to the primary Payer first, then submit the balance due to Mercalis as a Secondary Payer COB (coordination of benefits) with patient responsibility and a valid Other Coverage Code (e.g. 8). Reimbursement will be received from Mercalis. For questions about processing, please call 844-248-7949.
IMPORTANT SAFETY INFORMATION
Do not take tobramycin inhalation solution if you are allergic to tobramycin, any of the ingredients in tobramycin inhalation solution, or to any other aminoglycoside antibacterial.
See the end of the Patient Information Leaflet found in the Prescribing Information for a complete list of ingredients in tobramycin inhalation solution.
Before you take tobramycin inhalation solution, tell your healthcare provider about all of your medical conditions, including if you:
Call your baby’s healthcare provider if your breastfed baby has any of these problems. Talk to your healthcare provider about the best way to feed your baby during treatment with tobramycin inhalation solution.
Tell your healthcare provider about all the medicines you take, including prescription medicines, over-the-counter medicines, vitamins, and herbal supplements.
What are the possible side effects of tobramycin inhalation solution?
Tobramycin inhalation solution can cause serious side effects, including:
The most common side effects of tobramycin inhalation solution include:
These are not all of the possible side effects of tobramycin inhalation solution.
Call your doctor for medical advice about side effects. You are encouraged to report side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.
Please read the Patient Leaflet in the full Prescribing Information.
What is tobramycin inhalation solution?
Tobramycin inhalation solution is a prescription medicine that is used to treat people with cystic fibrosis who have a bacterial infection called Pseudomonas aeruginosa. Tobramycin inhalation solution contains an antibacterial medicine called tobramycin (an aminoglycoside).
It is not known if tobramycin inhalation solution is safe and effective: