Savings Card | RELPAX® (eletriptan HBr)

Savings Registration

 
1 Start 2 Next 3 Complete

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.*

RELPAX Savings Card

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

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 Insurance (SSDI) or any other Social Security Administration (SSA) benefits
  • Neither myself, my spouse nor 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.

Privacy is important to us. To learn more about our use of your information and your rights, please consult our Privacy Policy.

CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
 
X

You Are Now Leaving RELPAX.com

Links to another site are provided as a convenience to the viewer.

We accept no responsibility for the content of linked sites.

X

You Are Now Leaving RELPAX.com

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