Am I eligible for Sunovion Support® prescription assistance?

It's easy to find out if you or someone you care for may qualify for the Sunovion Support® Prescription Assistance Program. If you can answer "yes" to the statements below, you may be eligible to participate in this Program.

Are you or someone you care for:

  • A resident of the United States, Puerto Rico, or the U.S. Virgin Islands
  • Under the care of a U.S. healthcare professional with a valid prescription
  • Without prescription insurance coverage (this includes Medicare and Medicaid)
  • At a household annual income at or below 300% of the federal poverty level for the number of people in the household (See chart*).

If you or someone you care for may be eligible for prescription assistance based on your answers, apply by clicking on the link below.

I'd Like to Apply:

Mail the completed application form, your
prescription, and proof of income to:

Sunovion Support®
PO Box 220285, Charlotte, NC 28222-0285
Or FAX to: 1-877-850-0821



IMPORTANT SAFETY INFORMATION and INDICATION for SEEBRI NEOHALER

SEEBRI NEOHALER does not relieve sudden symptoms of COPD and should not be used more than twice daily. Always have a short-acting beta2-agonist with you to treat sudden symptoms.

Do not use SEEBRI NEOHALER unless your health care provider has taught you how to use the inhaler and you understand how to use it correctly. Use SEEBRI NEOHALER exactly as your health care provider tells you to use it.

Do not use SEEBRI NEOHALER more often than it is prescribed for you. Do not stop using SEEBRI NEOHALER or other medicines to control or treat your COPD unless told to do so by your health care provider because your symptoms might get worse. Your health care provider will change your medicines as needed.

Get emergency medical care if your breathing problems worsen quickly, you need to use your rescue medication more often than usual, or your rescue medication does not work as well to relieve your symptoms.

Do not use SEEBRI NEOHALER if you are allergic to glycopyrrolate or any of the ingredients in SEEBRI NEOHALER. Ask your health care provider if you are not sure.

Tell your health care provider about all of your health conditions, including if you:

Tell your health care provider about all the medicines you take, including prescription medicines, over-the-counter medicines, vitamins, and herbal supplements. SEEBRI NEOHALER and certain other medicines may interact with each other. This may cause serious side effects.

Especially tell your health care provider if you take anticholinergics (including umeclidinium, tiotropium, ipratropium, aclidinium, glycopyrrolate).

SEEBRI NEOHALER can cause serious side effects, including:

Common side effects of SEEBRI NEOHALER include upper respiratory tract infection, sore throat, and runny nose.

These are not all of the possible side effects with SEEBRI NEOHALER. Tell your health care provider about any side effect that bothers you or that does not go away.

Do not swallow SEEBRI capsules. SEEBRI capsules are for inhalation only with the NEOHALER device. Never place a capsule in the mouthpiece of the NEOHALER device.

SEEBRI capsules should always be stored in the blister strip and only removed immediately before use.

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.

This information is not comprehensive.

How to get more information:

For additional information, please see full Prescribing Information and Patient Information for SEEBRI NEOHALER at www.SEEBRI.us.

INDICATION
SEEBRI™ NEOHALER® (glycopyrrolate) is a medicine called an anticholinergic. SEEBRI NEOHALER is used long term, twice each day (morning and evening), for maintenance treatment of chronic obstructive pulmonary disease (COPD), including chronic bronchitis and/or emphysema.