Savings Card | RELPAX® (eletriptan HBr)

Savings Registration

 
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SEE HOW TO SAVE ON RELPAX

With the RELPAX Savings Card, you may pay as little as $4 for each 30-day fill of brand-name RELPAX.*

*Eligible patients could save up to $1,800 a year. Savings Card only works on brand-name RELPAX. Terms and Conditions apply.

You may be eligible for the RELPAX Savings Card IF...

  • You have insurance that:
    • Is provided by your employer or directly purchased by you
    • Is not Medicare, Medicaid, or any other state/federal health insurance
  • You are uninsured
  • You are 18 or older

Get Your RELPAX Savings Card

Already have a card?

First, fill out the following information. Then select the way you'd like to receive your Savings Card.

  • I do not have insurance from any Federal Healthcare Program (including Medicare, Medicaid, Tricare, or any other state or federal medical pharmaceutical benefit program or pharmaceutical assistance program)
  • Myself and my spouse/partner are both not over age 65 and retired
  • I do not receive Social Security Disability (SSDI) or any other Social Security Administration (SSA) benefits
  • Neither myself, my spouse or my parents are on active military duty and if so, I am not covered by their military health insurance
  • I do not have End Stage Renal Disease (ESRD)
  • I am over the age of 18
  • I agree to the Terms and Conditions

All fields are required.

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The information provided in RELPAXHCP.com is intended only for healthcare professionals in the United States.