*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 may pay as low as $0 per 30-day or 90-day fill.*

Resource Request


Request samples for your office today

Prior Authorization Support

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


Reimbursement Portal

Learn about the reimbursement program

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