*This offer is not valid for patients enrolled in Medicare, Medicaid, or other state or federal healthcare programs. Maximum savings limit applies; patient out-of-pocket expense may vary. See full Program Terms, Conditions, and Eligibility Criteria on card.

Eligible patients pay as little as $40 then save up to $75 per 30/60 day prescription fill.
Patients pay $40, then save up to $150 on a 90‑day prescription fill.*

Prior Authorization Support

Online tools to help prescribers navigate the PA and medical necessity process


Contact Allergan Medical Information toll-free at 1-800-678-1605.