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Co-Pay Assistance Program

Xubex offer co-pay assistance program to eligible individuals. Our program covers all or part of the co-pay you may be responsible for. Our program can save you hundreds of dollars each month. Programs we offer are sponsored by major pharmaceutical manufacturer. The requirement is straight forward and simple to understand. To be eligible:

  • You must have coverage under individual or employer sponsored prescription drug coverage
  • You must not have coverage under Medicaid, Medicare or similar state or federal program
  • Massachusetts residents are not eligible


Our state of the art mail service program delivers all your medications directly to your home or office. There are no hidden charges or fees, even the shipping is FREE. Start today and get all your eligible medications at low or no cost to you. Our sponsored assistance program varies depending on medication. In most cases our program covers part or all of the co-pay that you may be responsible for depending on the medication. The list below shows each eligible medication and the maximum amount your co-pay will be reduced by. If the amount shown is more than your co-pay then your medication will be free of charge. If your co-pay is more than the amount shown, then you pay the difference between your co-pay and the maximum amount our program pays.

Here's how it works:

Drug ADrug B
Co-pay Amount$50.00 $75.00
Program Coverage$25.00 $75.00
Your Cost$25.00 Zero



 



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Current Medication List

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A

You can apply online or you may choose to print an online prescription form to take to your physician. Click on Medication Name for the Monograph.
Mail in form ABILIFY 20MG (ARIPIPRAZOLE) UP TO $50 OFF
Mail in form ABILIFY 2MG (ARIPIPRAZOLE) UP TO $50 OFF
Mail in form ABILIFY 30MG (ARIPIPRAZOLE) UP TO $50 OFF
Mail in form ABILIFY 5MG (ARIPIPRAZOLE) UP TO $50 OFF
Mail in form ABILIFY 10MG (ARIPIPRAZOLE) UP TO $50 OFF
Mail in form ABILIFY 15MG (ARIPIPRAZOLE) UP TO $50 OFF
Mail in form ABILIFY OS 1MG/ML (ARIPIPRAZOLE) UP TO $50 OFF
Mail in form ACANYA 1.2-2.5% (CLINDAMYCIN PHOS/BENZ PER) UP TO $25 OFF
Mail in form ACIPHEX 20MG (RABEPRAZOLE SODIUM DR) UP TO $55 OFF
Mail in form ACTOPLUS MET (PIOGLITAZONE HCL/METFORMN) Up to $60 off
Mail in form ACTOPLUS MET 15-500MG (PIOGLITAZONE HCL/METFORMN) Up to $60 off
Mail in form ACTOPLUS MET 15-850MG (PIOGLITAZONE HCL/METFORMN) Up to $60 off
Mail in form ACTOS 15MG (PIOGLITAZONE HCL) UP TO $60 OFF
Mail in form ACTOS 45MG (PIOGLITAZONE HCL) UP TO $50 OFF
Mail in form ACTOS 30 MG (PIOGLITAZONE HCL) Up to $60 off
Mail in form ADVAIR DISKUS 100-50MCG (FLUTICASONE/SALMETEROL) UP TO $10 OFF
Mail in form ADVAIR DISKUS 250-50MCG (FLUTICASONE/SALMETEROL) UP TO $10 OFF
Mail in form ADVAIR DISKUS 500-50MCG (FLUTICASONE/SALMETEROL) UP TO $10 OFF
Mail in form ADVAIR HFA 115-21MCG (FLUTICASONE/SALMETEROL) UP TO $10 OFF
Mail in form ADVAIR HFA 230-21MCG (FLUTICASONE/SALMETEROL) UP TO $10 OFF
Mail in form ADVAIR HFA 45-21MCG (FLUTICASONE/SALMETEROL) UP TO $10 OFF
Mail in form AGGRENOX 200 200-25MG (ASPIRIN/DIPYRIDAMOLE MPH) UP TO $20 OFF
Mail in form ALCORTIN A 2-1-1% (HYDROCORT/IODOQUIN/ALOE#2) UP TO $20 OFF
Mail in form ALMOTRIPTAN MALATE ORAL T 12.5 MG (AXERT) UP TO $25 OFF
Mail in form ALMOTRIPTAN MALATE ORAL T 6.25 MG (AXERT) UP TO $25 OFF
Mail in form ALPHAGAN P 0.1% (BRIMONIDINE TARTRATE) UP TO $20 OFF
Mail in form ALPHAGAN P 0.1% (BRIMONIDINE TARTRATE) UP TO $20 OFF
Mail in form ALPHAGAN P 0.1% (BRIMONIDINE TARTRATE) UP TO $20 OFF
Mail in form ALVESCO 80MCG (CICLESONIDE) UP TO $75 OFF
Mail in form ALVESCO 60 IH 160MCG (CICLESONIDE) UP TO $75 OFF
Mail in form AMITIZA 24MCG (LUBIPROSTONE) UP TO $35 OFF
Mail in form AMITIZA 8MCG (LUBIPROSTONE) UP TO $35 OFF
Mail in form AMRIX 15MG (CYCLOBENZAPRINE HCL 24H) UP TO $30 OFF
Mail in form AMRIX 30MG (CYCLBENZAPRINE HCL 24H) UP TO $30 OFF
Mail in form ANDROGEL 1% (TESTOSTERONE) UP TO $10 OFF
Mail in form ANDROGEL 1% (TESTOSTERONE) UP TO $10 OFF
Mail in form ANDROGEL PUMP 1% (TESTOSTERONE) UP TO $10 OFF
Mail in form ANDROGEL PUMP 1.62% (TESTOSTERONE) UP TO $10 OFF
Mail in form ANGELIQ 0.5-1MG (ESTRADIOL/DROSPIRENONE) UP TO $20 OFF
Mail in form ANIMI-3 (OMEGA-3/B12/DFA/B6/PHYTOS) UP TO $10 OFF
Mail in form ANTARA 130MG (FENOFIBRATE MICRONIZED) UP TO $100 OFF
Mail in form ANTARA 43MG (FENOFIBRATE MICRONIZED) UP TO $100 OFF
Mail in form APIDRA 100U/ML (INSULIN GLULISINE) Up to $100 off
Mail in form APRISO 0.375GM (MESALAMINE) UP TO $75 OFF
Mail in form ARTHROTEC 50-0.2MG (DICLOFENAC/MISOPROSTOL EC) Up to $100 off
Mail in form ARTHROTEC 75-0.2MG (DICLOFENAC/MISOPROSTOL EC) Up to $100 off
Mail in form ASACOL HD 800MG (MESALAMINE) UP TO $20 OFF
Mail in form ASMANEX TWST 220MCG (MOMETASONE FUROATE #120) UP TO $15 OFF
Mail in form ASMANEX TWST 110MCG (MOMETASONE FUROATE) UP TO $15 OFF
Mail in form ASMANEX TWST 220MCG (MOMETASONE FUROATE #30) UP TO $10 OFF
Mail in form ASMANEX TWST 220MCG (MOMETASONE FUROATE #60) UP TO $15 OFF
Mail in form ASTEPRO .15% 0.15% (AZELASTINE HCL) UP TO $25 OFF
Mail in form ATACAND 16MG (CANDESARTAN CILEXETIL) UP TO $50 0FF
Mail in form ATACAND 32MG (CANDESARTAN CILEXETIL) UP TO $50 0FF
Mail in form ATACAND 4MG (CANDESARTAN CILEXETIL) UP TO $50 0FF
Mail in form ATACAND 8MG (CANDESARTAN CILEXETIL) UP TO $50 0FF
Mail in form ATRALIN 0.05% (TRETINOIN) UP TO $25 OFF
Mail in form ATRIPLA 200-300-600MG (EMTRICITABINE/TENOF/EFAVR) UP TO $200 OFF
Mail in form AVINZA 120MG (MORPHINE SULFATE MPHASE) UP TO $30 OFF
Mail in form AVINZA 30MG (MORPHINE SULFATE MPHASE) UP TO $30 OFF
Mail in form AVINZA 45MG (MORPHINE SULFATE) UP TO $30 OFF
Mail in form AVINZA 60MG (MORPHINE SULFATE MPHASE) UP TO $30 OFF
Mail in form AVINZA 75MG (MORPHINE SULFATE) UP TO $30 OFF
Mail in form AVINZA 90MG (MORPHINE SULFATE MPHASE) UP TO $30 OFF
Mail in form AVODART 0.5MG (DUTASTERIDE) UP TO $15 OFF
Mail in form AXONA (NUT.MIN.MET.DIS.MV, MIN#2) UP TO $15 OFF
Mail in form AZOR 10-20MG (AMLODIPINE BES/OLMESA MED) UP TO $25 OFF
Mail in form AZOR 10-40MG (AMLODIPINE BES/OLMESA MED) UP TO $25 OFF
Mail in form AZOR 5-20MG (AMLODIPINE BES/OLMESA MED) UP TO $25 OFF
Mail in form AZOR 5-40MG (AMLODIPINE BES/OLMESA MED) UP TO $25 OFF
Mail in form AZOR 5-40MG (AMLODIPINE BES/OLMESA MED) UP TO $25 OFF


B

You can apply online or you may choose to print an online prescription form to take to your physician. Click on Medication Name for the Monograph.
Mail in form BARACLUDE 0.5 MG (ENTECAVIR) Up to $200 off
Mail in form BARACLUDE 1 MG (ENTECAVIR) Up to $200 off
Mail in form BAYER BRZ2 (DIAG TEST/BLOOD SUGAR) UP TO $35 OFF
Mail in form BAYER CONTOUR (DIAG TEST/BLOOD SUGAR) UP TO $35 OFF
Mail in form BENICAR 20MG (OLMESARTAN MEDOXOMIL) UP TO $25 OFF
Mail in form BENICAR 40MG (OLMESARTAN MEDOXOMIL) UP TO $25 OFF
Mail in form BENICAR 5MG (OLMESARTAN MEDOXOMIL) UP TO $25 OFF
Mail in form BENICAR HCT 20-12.5MG (OLMESARTAN MEDOX/HCTZ) UP TO $25 OFF
Mail in form BENICAR HCT 40-12.5MG (OLMESARTAN MEDOX/HCTZ) UP TO $25 OFF
Mail in form BENICAR HCT 40-25MG (OLMESARTAN MEDOX/HCTZ) UP TO $25 OFF
Mail in form BETAMETHASONE VALERATE TO 0.12 % (LUXIQ) UP TO $25 OFF
Mail in form BETASERON 0.3MG (INTERFERON BETA-1B) COPAY ASSISTANCE
Mail in form BEYAZ NOT AVAILABLE (DROSPIR/ETH ESTRA/LEVOMEF) UP TO $25 OFF
Mail in form BRILINTA 90MG (TICAGRELOR) UP TO $25 OFF
Mail in form BROVANA 15MCG/2ML (ARFORMOTEROL TART) Up to $30 off
Mail in form BROVANA 15MCG/2ML (ARFORMOTEROL TART) Up to $30 off
Mail in form BUTRANS 10MCG/HR (BUPRENORPHINE) Up to $40 off
Mail in form BUTRANS 20MCG/HR (BUPRENORPHINE) Up to $40 off
Mail in form BUTRANS 5MCG/HR (BUPRENORPHINE) Up to $40 off


C

You can apply online or you may choose to print an online prescription form to take to your physician. Click on Medication Name for the Monograph.
Mail in form CADUET 10-10MG (AMLODIPINE/ATORVAST CAL) UP TO $100 OFF
Mail in form CADUET 10-20MG (AMLODIPINE/ATORVAST CAL) UP TO $100 OFF
Mail in form CADUET 10-40MG (AMLODIPINE/ATORVAST CAL) UP TO $100 OFF
Mail in form CADUET 10-80MG (AMLODIPINE/ATORVAST CAL) UP TO $100 OFF
Mail in form CADUET 2.5-10MG (AMLODIPINE/ATORVAST CAL) UP TO $100 OFF
Mail in form CADUET 2.5-20MG (AMLODIPINE/ATORVAST CAL) UP TO $100 OFF
Mail in form CADUET 2.5-40MG (AMLODIPINE/ATORVAST CAL) UP TO $100 OFF
Mail in form CADUET 5-10MG (AMLODIPINE/ATORVAST CAL) UP TO $100 OFF
Mail in form CADUET 5-20MG (AMLODIPINE/ATORVAST CAL) UP TO $100 OFF
Mail in form CADUET 5-40MG (AMLODIPINE/ATORVAST CAL) UP TO $100 OFF
Mail in form CADUET 5-80MG (AMLODIPINE/ATORVAST CAL) UP TO $100 OFF
Mail in form CAMBIA 50MG (DICLOFENAC POTASSIUM) UP TO $90 OFF
Mail in form CANASA 1000MG (MESALAMINE) UP TO $60 OFF
Mail in form CARAC TOPICAL 0.5% (FLUOROURACIL) UP TO $30 OFF
Mail in form CARDURA XL 4MG (DOXAZOSIN MESYLATE SR) UP TO $20 OFF
Mail in form CARDURA XL 8MG (DOXAZOSIN MESYLATE SR) UP TO $20 OFF
Mail in form CELEBREX 200MG (CELECOXIB) UP TO $15 OFF
Mail in form CELEBREX 400MG (CELECOXIB) UP TO $15 OFF
Mail in form CELEBREX 50MG (CELECOXIB) UP TO $15 OFF
Mail in form CELEBREX 100 MG (CELECOXIB) Up to $15 off
Mail in form CELLCEPT 250 MG (MYCOPHENOLATE MOFETIL) Up to $100 off
Mail in form CELLCEPT 200MG/ML (MYCOPHENOLATE MOFETIL) UP TO $100 OFF
Mail in form CELLCEPT 500MG (MYCOPHENOLATE MOFETIL) UP TO $100 OFF
Mail in form CHANTIX 0.5MG (VARENICLINE TARTRATE) $30 OFF
Mail in form CHANTIX 1MG (VARENICLINE TARTRATE F/C) $30 OFF
Mail in form CIMZIA PFS 200MG (CERTOLIZUMAB PEGOL) UP TO $500 OFF
Mail in form CLARINEX 0.5MG/ML (DESLORATADINE) UP TO $25 OFF
Mail in form CLARINEX 5MG (DESLORATADINE) UP TO $25 OFF
Mail in form CLARINEX REDI 2.5MG (DESLORATIDINE DIS) UP TO $25 OFF
Mail in form CLARINEX REDI 5MG (DESLORATADINE DIS) UP TO $25 OFF
Mail in form CLARINEX-D 120-2.5MG (P-EPHED SUL/DESLORATADINE) UP TO $25 OFF
Mail in form CLINDAMYCIN PHOSPHATE TOP 1 % (EVOCLIN) UP TO $25 OFF
Mail in form CLINDAMYCIN PHOSPHATE TOP 1 % (EVOCLIN) UP TO $25 OFF
Mail in form CLOBEX 0.05% (CLOBETASOL PROPIONATE) UP TO $25 OFF
Mail in form CLOBEX 0.05% (CLOBETASOL PROPIONATE) UP TO $45 OFF
Mail in form COLCHICINE ORAL TABLET 0. 0.6 MG (COLCRYS) UP TO $50 OFF
Mail in form COMBIGAN 0.2-0.5% (BRIMONIDINE TART/TIMOLOL) UP TO $100 OFF
Mail in form COMBIGAN 0.2-0.5% (BRIMONIDINE TART/TIMOLOL) UP TO $25 OFF
Mail in form COMBIVIR 150-300MG (ZIDOVUDINE/LAMIVUDINE) UP TO $100 OFF
Mail in form COMPLERA 200-25-300 (EMTRICITAB/RILPIVIR/TENOF) Up to $200 off
Mail in form COPAXONE 20MG/ML (GLATIRAMER ACETATE) Up to $250 off
Mail in form COREG CR 10MG (CARVEDILOL 24HR) UP TO $10 OFF
Mail in form COREG CR 20MG (CARVEDILOL 24HR) UP TO $10 OFF
Mail in form COREG CR 40MG (CARVEDILOL 24HR) UP TO $10 OFF
Mail in form COREG CR 80MG (CARVEDILOL 24HR) UP TO $10 OFF
Mail in form CRESTOR 10MG (ROSUVASTATIN CALCIUM) UP TO $50 OFF
Mail in form CRESTOR 20MG (ROSUVASTATIN CALCIUM) UP TO $50 OFF
Mail in form CRESTOR 40MG (ROSUVASTATIN CALCIUM) UP TO $50 OFF
Mail in form CRESTOR 5MG (ROSUVASTATIN CALCIUM) UP TO $50 OFF


D

You can apply online or you may choose to print an online prescription form to take to your physician. Click on Medication Name for the Monograph.
Mail in form DAYTRANA 10MG (METHYLPHENIDATE) UP TO $60 OFF
Mail in form DAYTRANA 20MG (METHYLPHENIDATE) UP TO $60 OFF
Mail in form DAYTRANA 30MG (METHYLPHENIDATE) UP TO $60 OFF
Mail in form DEPAKOTE 125MG (DIVALPROEX SODIUM SPRINK) UP TO $75 OFF
Mail in form DEPAKOTE DR 125MG (DIVALPROEX SODIUM EC) UP TO $75 OFF
Mail in form DEPAKOTE DR 250MG (DIVALPROEX SODIUM EC) UP TO $75 OFF
Mail in form DEPAKOTE DR 500MG (DIVALPROEX SODIUM EC) UP TO $75 OFF
Mail in form DEPAKOTE ER 250MG (DIVALPROEX SODIUM SR 24H) UP TO $75 OFF
Mail in form DEPAKOTE ER 500MG (DIVALPROEX SODIUM SR 24H) UP TO $75 OFF
Mail in form DETROL LA 2MG (TOLTERODINE TART SA 24HR) UP TO $20 OFF
Mail in form DETROL LA 4MG (TOLTERODINE TART SA 24HR) UP TO $20 OFF
Mail in form DEXILANT 30MG (DEXLANSOPRAZOLE) UP TO $55 OFF
Mail in form DEXILANT 60MG (DEXLANSOPRAZOLE) UP TO $55 OFF
Mail in form DIASTAT ACUD 10MG (DIAZEPAM) UP TO $60 OFF
Mail in form DIASTAT ACUD 20MG (DIAZEPAM) UP TO $60 OFF
Mail in form DIASTAT-PEDTR 2.5MG (DIAZEPAM PED) UP TO $60 OFF
Mail in form DILANTIN 100MG (PHENYTOIN SODIUM EXTENDED) UP TO $50 OFF
Mail in form DIOVAN 320MG (VALSARTAN) UP TO $25 OFF
Mail in form DIOVAN 40MG (VALSARTAN) UP TO $25 OFF
Mail in form DIOVAN HCT 80-12.5MG (VALSARTAN/HCTZ) UP TO $35 OFF
Mail in form DORYX 150MG (DOXYCYCLINE HYCLATE DR) UP TO $50 OFF CO-PAY
Mail in form DORYX 150 MG (DOXYCYCLINE HYCLATE DR) UP TO $50 OFF CO-PAY
Mail in form DUETACT 30-2MG (PIOGLITAZONE/GLIMEPIRIDE) UP TO $60 OFF
Mail in form DUETACT 30-4MG (PIOGLITAZONE/GLIMEPIRIDE) UP TO $60 OFF
Mail in form DUEXIS 800-26.6MG (IBUPROFEN/FAMOTIDINE) UP TO $50 0FF
Mail in form DULERA 100 /5MCG (MOMETASONE/FORMOTEROL INH) Up to $20 off
Mail in form DULERA 100/5 MCG (MOMETASONE/FORMOTEROL INH) Up to $20 off
Mail in form DULERA 200 /5MCG (MOMETASONE/FORMOTEROL INH) Up to $20 off
Mail in form DULERA 200/5 MCG (MOMETASONE/FORMOTEROL INH) Up to $20 off
Mail in form DURAGESIC 100MCG/HR (FENTANYL TRANSDERMAL) UP TO $50 OFF
Mail in form DURAGESIC 12MCG/HR (FENTANYL TRANSDERMAL) UP TO $50 OFF
Mail in form DURAGESIC 25MCG/HR (FENTANYL TRANSDERMAL) UP TO $50 OFF
Mail in form DURAGESIC 50MCG/HR (FENTANYL TRANSDERMAL) UP TO $50 OFF
Mail in form DURAGESIC 75MCG/HR (FENTANYL TRANSDERMAL) UP TO $50 OFF
Mail in form DYSPORT DS 500 UNIT (ABOBOTULINUMTOXINA) Up to $50 off


E

You can apply online or you may choose to print an online prescription form to take to your physician. Click on Medication Name for the Monograph.
Mail in form EDARBI 40MG (AZILSARTAN) Up to $50 off
Mail in form EDARBI 80MG (AZILSARTAN) Up to $50 off
Mail in form EDARBYCLOR 40 MG-25MG (AZILSARTAN MED/CHLORTHAL) Up to $50 off
Mail in form EDARBYCLOR 40-12.5 MG (AZILSARTAN MED/CHLORTHAL) Up to $50 off
Mail in form EDLUAR 10 MG (ZOLPIDEM TART) UP TO $100 OFF
Mail in form EDURANT 25 MG (RILPIVIRINE HCL) Up to $100 off
Mail in form EFFEXOR XR 150MG (VENLAFAXINE HCL SA) UP TO $75 OFF
Mail in form EFFEXOR XR 37.5MG (VENLAFAXINE HCL SA) UP TO $75 OFF
Mail in form EFFEXOR XR 75MG (VENLAFAXINE HCL SA) UP TO $75 OFF
Mail in form ELETONE 100GM (EMOLLIENT COMBINATION #25) UP TO $20 OFF
Mail in form ELMIRON 100MG (PENTOSAN POLYSUFATE SOD) UP TO $50 OFF
Mail in form ENBREL 25MG (ETANERCEPT) UP TO $750 OFF
Mail in form ENBREL 25MG/0.5ML (ETANERCEPT) UP TO $750 OFF
Mail in form ENBREL 50MG/ML (ETANERCEPT) UP TO $750 OFF
Mail in form ENBREL SURCLK 50MG/ML (ETANERCEPT) UP TO $750 OFF
Mail in form EPIDUO GEL 0.1-2.5% (ADAPALENE/BENZOYL PEROX) UP TO $10 OFF
Mail in form EPIVIR 10MG/ML (LAMIVUDINE) UP TO $100 OFF
Mail in form EPIVIR 150MG (LAMIVUDINE) UP TO $100 OFF
Mail in form EPIVIR 300MG (LAMIVUDINE) UP TO $100 OFF
Mail in form EPZICOM 600-300MG (ABACAVIR SULF/LAMIVUDINE) UP TO $100 OFF
Mail in form ESTRING VAGNL 7.5MCG/24H (ESTRADIOL VAGINAL RING) UP TO $20 OFF
Mail in form ESTROGEL 0.06% (ESTRADIOL) UP TO $20 OFF
Mail in form ETONOGESTREL/ETHINYL ESTR (NUVARING VAG) UP TO $15 OFF
Mail in form EVAMIST 1.53MG (ESTRADIOL) UP TO $10 OFF
Mail in form EXALGO ER 12MG (HYDROMORPHONE HCL) UP TO $60 OFF
Mail in form EXALGO ER 16MG (HYDROMORPHONE HCL) UP TO $60 OFF
Mail in form EXALGO ER 8MG (HYDROMORPHONE HCL) UP TO $60 OFF
Mail in form EXFORGE 10-160MG (AMLODIPINE/VALSARTAN) UP TO $25 OFF
Mail in form EXFORGE 10-320MG (AMLODIPINE/VALSARTAN) UP TO $25 OFF
Mail in form EXFORGE 5-160MG (AMLODIPINE/VALSARTAN) UP TO $25 OFF
Mail in form EXFORGE 5-320MG (AMLODIPINE/VALSARTAN) UP TO $25 OFF
Mail in form EXFORGE HCT 10-160-25MG (AMLODIPINE/VALSARTAN/HCTZ) UP TO $25 OFF
Mail in form EXFORGE HCT 10-320-25MG (AMLODIPINE/VALSARTAN/HCTZ) UP TO $25 OFF
Mail in form EXFORGE HCT 5-160-25MG (AMLODIPINE/VALSARTAN/HCTZ) UP TO $25 OFF
Mail in form EXFORGE HCT 5 5-160-12.5MG (AMLODIPINE/VALSARTAN/HCTZ) UP TO $25 OFF
Mail in form EXFORGE HCT10 10-160-12.5MG (AMLODIPINE/VALSARTAN/HCTZ) UP TO $25 OFF
Mail in form EXTINA 2% (KETOCONAZOLE) UP TO $25 OFF
Mail in form EXTINA 2% (KETOCONAZOLE) UP TO $25 OFF


F

You can apply online or you may choose to print an online prescription form to take to your physician. Click on Medication Name for the Monograph.
Mail in form FEMARA 2.5MG (LETROZOLE) UP TO $100.00 OFF COPAY
Mail in form FENOFIBRATE ORAL TABLET 1 120 MG (FENOGLIDE) UP TO $50 OFF
Mail in form FENOGLIDE 40MG (FENOFIBRATE) UP TO $50 OFF
Mail in form FINACEA 15% (AZELAIC ACID) UP TO $10 OFF
Mail in form FINACEA PLUS 15% (AZELAIC ACID/CERAMIDE) UP TO $10 OFF
Mail in form FLECTOR 1.3% (DICLOFENAC EPOLAMINE) UP TO $30 OFF
Mail in form FOCALIN XR 25MG (DEXMETHYLPHENIDATE HCL) UP TO $60 OFF
Mail in form FOCALIN XR 35MG (DEXMETHYLPHENIDATE HCL) UP TO $60 OFF
Mail in form FOCALIN XR 40MG (DEXMETHYLPHENIDATE HCL) UP TO $60 OFF
Mail in form FOCALIN XR 10MG (DEXMETHYLPHENIDATE HCL ER) UP TO $60 OFF
Mail in form FOCALIN XR 15MG (DEXMETHYLPHENIDATE HCL ER) UP TO $60 OFF
Mail in form FOCALIN XR 20MG (DEXMETHYLPHENIDATE HCL ER) UP TO $60 OFF
Mail in form FOCALIN XR 30MG (DEXMETHYLPHENIDATE HCL) UP TO $60 OFF
Mail in form FORADIL INHLR 12 MCG (FORMOTEROL FUMARATE) $20 OFF COPAY
Mail in form FORFIVO XL 450 MG (BUPROPION HCL ORAL TAB ER) Up to $50 off
Mail in form FORTAMET 1000MG (METFORMIN HCL SR 24H) UP TO $30 OFF
Mail in form FORTAMET ER 500MG (METFORMIN HCL SR 24H) UP TO $30 OFF
Mail in form FORTESTA 10MG (TESTOSTERONE) PAY NO MORE THAN $25
Mail in form FOSAMPRENAVIR CALCIUM ORA 700 MG (LEXIVA) UP TO $100 OFF
Mail in form FROVA BP 2.5MG (FROVATRIPTAN SUCCINATE) UP TO $35 OFF


G

You can apply online or you may choose to print an online prescription form to take to your physician. Click on Medication Name for the Monograph.

H

You can apply online or you may choose to print an online prescription form to take to your physician. Click on Medication Name for the Monograph.
Mail in form HECTOROL 0.5MCG (DOXERCALCIFEROL) UP TO $250 OFF
Mail in form HECTOROL 1MCG (DOXERCALCIFEROL) UP TO $250 OFF
Mail in form HECTOROL 2.5MCG (DOXERCALCIFEROL) UP TO $250 OFF
Mail in form HUMIRA 20MG/0.4ML (ADALIMUMAB SYG) UP TO $100 OFF
Mail in form HUMIRA 40MG/0.8ML (ADALIMUMAB SYG) UP TO $100 OFF
Mail in form HUMIRA PEN 40MG/0.8ML (ADALIMUMAB PEN) UP TO $100 OFF
Mail in form HUMIRA PEN PS 40MG/0.8ML (ADALIMUMAB PEN) UP TO $100 OFF
Mail in form HUMIRA STRT C 40MG/0.8ML (ADALIMUMAB PEN) UP TO $100 OFF
Mail in form HYDROCODONE/CHLORPHEN POL 10/8 MG (TUSSICAPS)
Mail in form HYDROCODONE/CHLORPHEN POL 5/4 MG (TUSSICAPS)
Mail in form HYZAAR 100-12.5MG (LOSARTAN POTASSIUM/HCTZ) UP TO $10 OFF
Mail in form HYZAAR UOU 100-25MG (LOSARTAN POTASSIUM/HCTZ) UP TO $10 OFF
Mail in form HYZAAR UOU 50-12.5MG (LOSARTAN POTASSIUM/HCTZ) UP TO $10 OFF


I

You can apply online or you may choose to print an online prescription form to take to your physician. Click on Medication Name for the Monograph.

J

You can apply online or you may choose to print an online prescription form to take to your physician. Click on Medication Name for the Monograph.

K

You can apply online or you may choose to print an online prescription form to take to your physician. Click on Medication Name for the Monograph.

L

You can apply online or you may choose to print an online prescription form to take to your physician. Click on Medication Name for the Monograph.
Mail in form LACRISERT 5MG (HYDROXYETHYCELLULOSE) UP TO $20 OFF
Mail in form LAMICTAL 100MG (LAMOTRIGINE) UP TO $40 OFF
Mail in form LAMICTAL 150MG (LAMOTRIGINE) UP TO $40 OFF
Mail in form LAMICTAL 200MG (LAMOTRIGINE) UP TO $40 OFF
Mail in form LAMICTAL 25MG (LAMOTRIGINE) UP TO $40 OFF
Mail in form LAMICTAL ODT 100MG (LAMOTRIGINE ODT) UP TO $40 OFF
Mail in form LAMICTAL ODT 200MG (LAMOTRIGINE ODT) UP TO $40 OFF
Mail in form LAMICTAL ODT 25MG (LAMOTRIGINE ODT) UP TO $40 OFF
Mail in form LAMICTAL ODT 50MG (LAMOTRIGINE ODT) UP TO $40 OFF
Mail in form LAMICTAL STRT (LAMOTRIGINE)
Mail in form LAMICTAL XR 50 MG (LAMOTRIGINE) UP TO $40 OFF
Mail in form LAMICTAL XR 100MG (LAMOTRIGINE) UP TO $40 OFF
Mail in form LAMICTAL XR 200MG (LAMOTRIGINE) UP TO $40 OFF
Mail in form LAMICTAL XR 25MG (LAMOTRIGINE) UP TO $40 OFF
Mail in form LANTUS SOLO 100U/ML (INSULIN GLARGINE.HM.RC.AN) UP TO $25 OFF
Mail in form LEVAQUIN 250MG (LEVOFLOXACIN/D5W) UP TO $15 OFF
Mail in form LEVAQUIN 500 MG (LEVOFLOXACIN) UP TO $15 OFF
Mail in form LEVAQUIN 750MG (LEVOFLOXACIN) UP TO $15 OFF
Mail in form LIALDA 1.2 GM 1200MG (MESALAMINE SA) Up to $100 off
Mail in form LIMBREL 500 MG (BAICALIN/CATECHIN ORAL CA) Up to $50 off
Mail in form LIMBREL250 250-50MG (BAICALIN/CATECHIN/CITRA) Up to $50 off
Mail in form LIMBREL500 500-50MG (BAICALIN/CATECHIN/CITRA) Up to $50 off
Mail in form LIPITOR 10MG (ATORVASTATIN CALCIUM) UP TO $10 OFF
Mail in form LIPITOR 20MG (ATORVASTATIN CALCIUM) UP TO $10 OFF
Mail in form LIPITOR 40MG (ATORVASTATIN CALCIUM) UP TO $10 OFF
Mail in form LIPITOR 80MG (ATORVASTATIN CALCIUM) UP TO $10 OFF
Mail in form LIPOFEN 150MG (FENOFIBRATE) UP TO $25 OFF
Mail in form LIPOFEN 50MG (FENOFIBRATE) UP TO $25 OFF
Mail in form LOCOID 0.1% (HYDROCORTISONE BUTYRATE) UP TO $30 OFF
Mail in form LOCOID 0.1% (HYDROCORTISONE BUTYRATE) UP TO $30 OFF
Mail in form LOCOID LIPCRM 0.1% (HYDROCORTISONE BUTY/EMOLL) UP TO $30 OFF
Mail in form LOCOID LIPCRM 0.1% (HYDROCORTISONE BUTY/EMOLL) UP TO $35 OFF
Mail in form LOESTRIN 24 1-0.02MG (NORETHIN A/ETHINYL EST/FE) UP TO $20 OFF
Mail in form LOVAZA 1GM (OMEGA-3 ACID ETHYL ESTERS) UP TO $20 OFF
Mail in form LUNESTA 1MG (ESZOPICLONE) SAVE UP TO $50
Mail in form LUNESTA 2MG (ESZOPICLONE) SAVE UP TO $50
Mail in form LUNESTA 3MG (ESZOPICLONE) SAVE UP TO $50
Mail in form LUPRON 3 MO 11.25MG (LEUPROLIDE ACETATE) PAY MAX $10
Mail in form LUPRON DEPOT 3.75MG (LEUPROLIDE ACETATE) PAY MAX $10
Mail in form LUVOX CR 100MG (FLUVOXAMINE MALEATE) UP TO $50 OFF
Mail in form LUVOX CR 150MG (FLUVOXAMINE MALEATE) UP TO $50 OFF


M

You can apply online or you may choose to print an online prescription form to take to your physician. Click on Medication Name for the Monograph.
Mail in form MAXAIR AUTOH 0.2MG (PIRBUTEROL ACET ORAL INH) UP TO $25 OFF
Mail in form MAXALT 10MG (RIZATRIPTAN BENZOATE) UP TO $20 OFF
Mail in form MAXALT 5MG (RIZATRIPTAN BENZOATE) UP TO $20 OFF
Mail in form MAXALT-MLT 10MG (RIZATRIPTAN BENZOATE MLT) UP TO $20 OFF
Mail in form MAXALT-MLT 5MG (RIZATRIPTAN BENZOATE MLT) UP TO $20 OFF
Mail in form METROGEL 1% (METRONIDAZOLE TOPICAL) UP TO $20 OFF
Mail in form MIMYX CREAM (EMOLLIENT COMBINATION #35) UP TO $25 OFF
Mail in form MINOCIN 100MG (MINOCYCLINE HCL/SKIN CL#4) UP TO $40 OFF
Mail in form MINOCIN 50MG (MINOCYCLINE HCL/SKIN CL#4) UP TO $40 OFF
Mail in form MIRAPEX 0.125MG (PRAMIPEXOLE DI-HCL) UP TO $20 OFF
Mail in form MIRAPEX 0.25MG (PRAMIPEXOLE DI-HCL) UP TO $20 OFF
Mail in form MIRAPEX 0.5MG (PRAMIPEXOLE DI-HCL) UP TO $20 OFF
Mail in form MIRAPEX 1.5MG (PRAMIPEXOLE DI-HCL) UP TO $20 OFF
Mail in form MIRAPEX 1MG (PRAMIPEXOLE DI-HCL) UP TO $20 OFF
Mail in form MIRAPEX ER 0.375MG (PRAMIPEXOLE DI-HCL) UP TO $40 OFF
Mail in form MIRAPEX ER 0.75MG (PRAMIPEXOLE DI-HCL) UP TO $40 OFF
Mail in form MIRAPEX ER 1.5MG (PRAMIPEXOLE DI-HCL) UP TO $40 OFF
Mail in form MIRAPEX ER 3MG (PRAMIPEXOLE DI-HCL) UP TO $40 OFF
Mail in form MIRAPEX ER 4.5MG (PRAMIPEXOLE DI-HCL) UP TO $40 OFF
Mail in form MONTELUKAST SODIUM ORAL T 10 MG (SINGULAIR) UP TO $20 OFF
Mail in form MULTAQ 400MG (DRONEDARONE HYDROCHL) UP TO $35 OFF


N

You can apply online or you may choose to print an online prescription form to take to your physician. Click on Medication Name for the Monograph.
Mail in form NAPRELAN 375MG (NAPROXEN SODIUM) UP TO $30 OFF
Mail in form NAPRELAN 500MG (NAPROXEN SODIUM) UP TO $30 OFF
Mail in form NAPRELAN 750MG (NAPROXEN SODIUM SR 24H) UP TO $30 OFF
Mail in form NASONEX 50MCG (MOMETASONE FUROATE) UP TO $15 OFF
Mail in form NEXIUM 10MG (ESOMEPRAZOLE MAG TRIHYDRT) UP TO $50 OFF
Mail in form NEXIUM 20MG (ESOMEPRAZOLE MAG EC 24H) UP TO $50 OFF
Mail in form NEXIUM 40MG (ESOMEPRAZOLE MAG EC 24H) UP TO $50 OFF
Mail in form NEXIUM 20MG (ESOMEPRAZOLE MAG TRIHYDRT) UP TO $50 OFF
Mail in form NEXIUM 40MG (ESOMEPRAZOLE MAG TRIHYDRT) UP TO $50 OFF
Mail in form NITROLINGUAL 0.4MG/DOSE (NITROGLYCERIN PUMP) UP TO $50 OFF
Mail in form NITROLINGUAL 0.4MG/DOSE (NITROGLYCERIN PUMP) UP TO $50 OFF
Mail in form NITROMIST 0.4MG (NITROGLYCERIN TRANS) UP TO $50 OFF
Mail in form NITROMIST 0.4MG (NITROGLYCERIN TRANS) UP TO $50 OFF
Mail in form NOVOLOG 100U/ML (INSULIN ASPART) UP TO $25 OFF
Mail in form NOVOLOG MIX 70-30U/ML (INSULIN ASPART/ASPART) UP TO $25 OFF
Mail in form NUCYNTA ER 100 MG (TAPENTADOL HCL) UP TO $100 OFF
Mail in form NUCYNTA ER 150 MG (TAPENTADOL HCL) UP TO $100 OFF
Mail in form NUCYNTA ER 200 MG (TAPENTADOL HCL) UP TO $100 OFF
Mail in form NUCYNTA ER 250 MG (TAPENTADOL HCL) UP TO $100 OFF
Mail in form NUCYNTA ER 50 MG (TAPENTADOL HCL) UP TO $100 OFF
Mail in form NUEDEXTA 20-10MG (DEXTROMETH HBR/QUINIDINE) PAY NO MORE THAN $30
Mail in form NUVIGIL 150MG (ARMODAFINIL) UP TO $5.00 OFF
Mail in form NUVIGIL 250MG (ARMODAFINIL) UP TO $5.00 OFF
Mail in form NUVIGIL 50MG (ARMODAFINIL) UP TO $5.00 OFF


O

You can apply online or you may choose to print an online prescription form to take to your physician. Click on Medication Name for the Monograph.
Mail in form OLEPTRO TM 150MG (TRAZODONE) UP TO $30 OFF
Mail in form OLEPTRO TM 300MG (TRAZODONE) UP TO $30 OFF
Mail in form OLUX 0.05% (CLOBETASOL PROPIONATE) UP TO $25 OFF
Mail in form OLUX-E 0.05% (CLOBETASOL PROP/EMOLL) UP TO $25 OFF
Mail in form OLUX-E 0.05% (CLOBETASOL PROP/EMOLL) UP TO $25 OFF
Mail in form OMNARIS NASAL 50MCG (CICLESONIDE) UP TO $40 OFF
Mail in form ONFI 10 MG (CLOBAZAM) UP TO $50 OFF
Mail in form ONFI 20 MG (CLOBAZAM) UP TO $50 OFF
Mail in form ONFI 5 MG (CLOBAZAM) UP TO $50 OFF
Mail in form ONGLYZA 2.5MG (SAXAGLIPTIN HYDROCHLORIDE) UP TO $100 OFF
Mail in form ONGLYZA 5MG (SAXAGLIPTIN HYDROCHLORIDE) UP TO $100 OFF
Mail in form ORACEA 40MG (DOSYCYCLINE MONOHYDRATE) UP TO $25 OFF
Mail in form ORENCIA 250MG (ABATACEPT/MALTOSE) UP TO $100 OFF CO-PAY
Mail in form ORENCIA 125 MG/ML (ABATACEPT)
Mail in form OXCARBAZEPINE 150MG (OXCARBAZEPINE) UP TO $10 OFF
Mail in form OXCARBAZEPINE 300MG (OXCARBAZEPINE) UP TO $10 OFF
Mail in form OXCARBAZEPINE 600MG (OXCARBAZEPINE) UP TO $10 OFF


P

You can apply online or you may choose to print an online prescription form to take to your physician. Click on Medication Name for the Monograph.
Mail in form PENNSAID 1.5% (DICLOFENAC SODIUM) UP TO $60 OFF
Mail in form PEXEVA 10MG (PAROXETINE MESYLATE) UP TO $50 OFF
Mail in form PEXEVA 20MG (PAROXETINE MESYLATE) UP TO $50 OFF
Mail in form PEXEVA 30MG (PAROXETINE MESYLATE) UP TO $50 OFF
Mail in form PEXEVA 40MG (PAROXETINE MESYLATE) UP TO $50 OFF
Mail in form PLAVIX 75MG (CLOPIDOGREL BISULFATE) Up to $100 off
Mail in form PRADAXA 150MG (DABIGATRAN ETEXILATE MES) UP TO $100 OFF
Mail in form PRADAXA 75MG (DABIGATRAN ETEXILATE MES) UP TO $100 OFF
Mail in form PRASUGREL HCL ORAL TABLET 10 MG (EFFIENT) UP TO $25 OFF
Mail in form PRASUGREL HCL ORAL TABLET 5 MG (EFFIENT) UP TO $25 OFF
Mail in form PREMARIN 0.3MG (ESTROGENS CONJUGATED) $25 OFF
Mail in form PREMARIN 0.45MG (ESTROGENS CONJ) $25 OFF
Mail in form PREMARIN 0.625MG (ESTROGENS CONJUGATED) $25 OFF
Mail in form PREMARIN 0.9MG (ESTROGENS CONJUGATED) $25 OFF
Mail in form PREMARIN 1.25MG (ESTROGENS CONJUGATED) $25 OFF
Mail in form PREMARIN VAG 0.625MG/GM (ESTROGENS CONJUGATED) UP TO $50 OFF
Mail in form PREZISTA 400 MG (DARUNAVIR ETHANOLATE) Up to $100 off Co-pay
Mail in form PREZISTA 600 MG (DARUNAVIR ETHANOLATE) Up to $100 off Co-pay
Mail in form PREZISTA DS 150 MG (DARUNAVIR ETHANOLATE) Up to $100 off Co-pay
Mail in form PREZISTA DS 75 MG (DARUNAVIR ETHANOLATE) Up to $100 off Co-pay
Mail in form PRISTIQ 50MG (DESVENLAFAXINE SUCCIN 24H) $15 OFF
Mail in form PROGRAF 0.5MG (TACROLIMUS ANH) UP TO $200 OFF
Mail in form PROGRAF 1MG (TACROLIMUS ANH) UP TO $200 OFF
Mail in form PROGRAF 5MG (TACROLIMUS ANH) UP TO $200 OFF
Mail in form PROGRAF 5MG/ML (TACROLIMUS ANH) UP TO $200 OFF
Mail in form PROLIA 60MG/ML (DENOSUMAB) UP TO $75 OFF
Mail in form PROVENTIL HFA 90 MCG (ALBUTEROL SULFATE CFE/FRE) UP TO $15 OFF
Mail in form PULMOZYME 1MG/ML (DEOXYRIBONUCLEASE ALFA) COPAY ASSISTANCE
Mail in form PYLERA 125-140-125MG (BISMUTH/METRONID/TETRACYC) UP TO $45 OFF


Q

You can apply online or you may choose to print an online prescription form to take to your physician. Click on Medication Name for the Monograph.

R

You can apply online or you may choose to print an online prescription form to take to your physician. Click on Medication Name for the Monograph.
Mail in form RANEXA 1000MG (RANOLAZINE 12HR) UP TO $60 OFF
Mail in form RANEXA 500MG (RANOLAZINE 12HR) UP TO $60 OFF
Mail in form RAPAFLO 4MG (SILODOSIN) UP TO $50 OFF
Mail in form RAPAFLO 8MG (SILODOSIN) UP TO $50 OFF
Mail in form RAPAMUNE 1MG (SIROLIMUS) UP TO $100 OFF
Mail in form RAPAMUNE 1MG/ML (SIROLIMUS) UP TO $100 OFF
Mail in form RAPAMUNE 2MG (SIROLIMUS) UP TO $100 OFF
Mail in form RELPAX 20MG (ELETRIPTAN HCL) UP TO $100 OFF
Mail in form RELPAX 40MG (ELETRIPTAN HCL) UP TO $100 OFF
Mail in form REMICADE 100 MG (INFLIXIMAB) Up to $550 off
Mail in form RENVELA 800MG (SEVELAMER CARBONATE) UP TO $155 OFF
Mail in form RENVELA 800MG (SEVELAMER CARBONATE) UP TO $155 OFF
Mail in form RENVELA NOT AVAILABLE (SEVELAMER CARBONATE) UP TO $155 OFF
Mail in form RESCRIPTOR 200MG (DELAVIRDINE MESYLATE) UP TO $100 OFF
Mail in form RETROVIR 100MG (ZIDOVUDINE) UP TO $100 OFF
Mail in form REYATAZ 100MG (ATAZANAVIR SULFATE) UP TO $200 OFF
Mail in form REYATAZ 150MG (ATAZANAVIR SULFATE) UP TO $200 OFF
Mail in form REYATAZ 200MG (ATAZANAVIR SULFATE) UP TO $200 OFF
Mail in form REYATAZ 300MG (ATAZANAVIR SULFATE) UP TO $200 OFF
Mail in form RISPERIDONE 0.25MG (RISPERIDONE) UP TO $10 OFF CO-PAY
Mail in form RISPERIDONE 0.5MG (RISPERIDONE) UP TO $10 OFF CO-PAY
Mail in form RISPERIDONE 1MG (RISPERIDONE) UP TO $10 OFF CO-PAY
Mail in form RISPERIDONE 1MG/ML (RISPERIDONE) Up to $10 off co-pay
Mail in form RISPERIDONE 2MG (RISPERIDONE) UP TO $10 OFF CO-PAY
Mail in form RISPERIDONE 3MG (RISPERIDONE) UP TO $10 OFF CO-PAY
Mail in form RISPERIDONE 4MG (RISPERIDONE) UP TO $10 OFF CO-PAY
Mail in form RYBIX ODT 50MG (TRAMADOL HCL ODT) UP TO $85 OFF
Mail in form RYZOLT ER 100MG (TRAMADOL HCL) UP TO $35 OFF
Mail in form RYZOLT ER 200MG (TRAMADOL HCL) UP TO $35 OFF
Mail in form RYZOLT ER 300MG (TRAMADOL HCL) UP TO $35 OFF


S

You can apply online or you may choose to print an online prescription form to take to your physician. Click on Medication Name for the Monograph.
Mail in form SAFYRAL 3-0.03-0.451MG (DROSPIR/ETH ESTRA/LEVOMEF) UP TO $25 OFF
Mail in form SAIZEN 5MG (SOMATROPIN) UP TO $50 OFF CO-PAY
Mail in form SAIZEN 8.8MG (SOMATROPIN) UP TO $50 OFF CO-PAY
Mail in form SANCTURA XR 60MG (TROSPIUM CHLORIDE SR 24H) UP TO $30 OFF CO-PAY
Mail in form SAPHRIS BLK 10MG (ASENAPINE) UP TO $100 OFF
Mail in form SAPHRIS BLK 5MG (ASENAPINE) UP TO $100 OFF
Mail in form SEASONIQUE (NORGESTIMATE/ETHINYL EST) UP TO $25 OFF
Mail in form SELZENTRY 150MG (MARAVIROC) UP TO $100 OFF
Mail in form SELZENTRY 300MG (MARAVIROC) UP TO $100 OFF
Mail in form SENSIPAR 30MG (CINACALCET HCL) UP TO $300 OFF
Mail in form SENSIPAR 60MG (CINACALCET HCL) UP TO $300 OFF
Mail in form SENSIPAR 90MG (CINACALCET HCL) UP TO $300 OFF
Mail in form SEROQUEL 25 MG (QUETIAPINE FUMARATE)
Mail in form SEROQUEL 50 MG (QUETIAPINE FUMARATE)
Mail in form SEROQUEL 200 MG (QUETIAPINE FUMARATE)
Mail in form SEROQUEL 100 MG (QUETIAPINE FUMARATE)
Mail in form SEROQUEL XR 150MG (QUETIAPINE FUMARATE) Up to $75 off
Mail in form SEROQUEL XR 200MG (QUETIAPINE FUMARATE 24H) Up to $75 off
Mail in form SEROQUEL XR 300MG (QUETIAPINE FUMARATE 24H) Up to $75 off
Mail in form SEROQUEL XR 400MG (QUETIAPINE FUMARATE 24H) Up to $75 off
Mail in form SEROQUEL XR 50MG (QUETIAPINE FUMARATE) Up to $75 off
Mail in form SILENOR 3MG (DOXEPIN HCL) UP TO $25 OFF
Mail in form SILENOR 6MG (DOXEPIN HCL) UP TO $25 OFF
Mail in form SIMPONI 50MG (GOLIMUMAB) UP TO $200 OFF
Mail in form SIMPONI SJ 50MG (GOLIMUMAB) UP TO $200 OFF
Mail in form SINGULAIR 4MG (MONTELUKAST SODIUM CHEW) UP TO $20 OFF
Mail in form SINGULAIR CHW 5MG (MONTELUKAST SODIUM CHEW) UP TO $20 OFF
Mail in form SOLODYN ER 115MG (MINOCYCLINE HCL) UP TO $50 OFF
Mail in form SOLODYN ER 65MG (MINOCYCLINE HCL) UP TO $50 OFF
Mail in form STALEVO 31.25-125-200MG (CARBIDOPA/LEVODOP/ENTACAP) UP TO $100 OFF
Mail in form STALEVO 50-200-200MG (CARBIDOPA/LEVODOP/ENTACAP) UP TO $100 OFF
Mail in form STALEVO 100 25-100-200MG (CARBIDOPA/LEVODOP/ENTACAP) UP TO $100 OFF
Mail in form STALEVO-150 37.5-150-200MG (CARBIDOPA/LEVODOP/ENTACAP) UP TO $100 OFF
Mail in form STALEVO-50 12.5-50-200MG (CARBIDOPA/LEVODOP/ENTACAP) UP TO $100 OFF
Mail in form STAVZOR 250MG (VALPROIC ACID) UP TO $50 OFF
Mail in form STAVZOR 500MG (VALPROIC ACID) UP TO $50 OFF
Mail in form STAVZOR DS 125 MG (VALPROIC ACID)
Mail in form STELARA 45MG (USTEKINUMAB) UP TO $3000.00 OFF
Mail in form STELARA 90MG (USTEKINUMAB) UP TO $3000.00 OFF
Mail in form SUBOXONE 2-0.5MG (BUPRENORPHINE/NALOXONE) BOX OF 30
Mail in form SUBOXONE 8-2MG (BUPRENORPHINE/NALOXONE) BOX OF 30
Mail in form SUMAVEL DOSE 6MG/0.5ML (SUMATRIPTAN SUCCINATE) UP TO $200 OFF
Mail in form SUSTIVA 200MG (EFAVIRENZ) UP TO $200 OFF
Mail in form SUSTIVA 200 MG (EFAVIRENZ) UP TO $200 OFF
Mail in form SUSTIVA 600MG (EFAVIRENZ) UP TO $200 OFF
Mail in form SYMBICORT 120 160-4.5MCG (BUDESONIDE/FORMOTEROL FUM) UP TO $20 OFF
Mail in form SYMBICORT 120 80-4.5MCG (BUDESONIDE/FORMOTEROL FUM) UP TO $20 OFF
Mail in form SYMLIN 120 1000MCG/ML (PRAMLINTIDE ACETATE) UP TO $30 OFF
Mail in form SYMLIN 60 1000MCG/ML (PRAMLINTIDE ACETATE) UP TO $30 OFF


T

You can apply online or you may choose to print an online prescription form to take to your physician. Click on Medication Name for the Monograph.
Mail in form TACLONEX 0.005-0.064% (BETAMET DIPROP/CALCIPOTRN) UP TO $100 0FF
Mail in form TACLONEX 0.005-0.064% (BETAMET DIPROP/CALCIPOTRN) UP TO $100 0FF
Mail in form TAFLUPROST/PF OPHTHALMIC (ZIOPTAN) Up to $70 off
Mail in form TARKA 2-240MG (TRANDOLAPRIL/VERAP M-PHAS) $10 OFF
Mail in form TARKA 2-180MG (TRANDOLAPRIL/VERAP M-PHAS) $10 OFF
Mail in form TARKA 2-240MG (TRANDOLAPRIL/VERAP M-PHAS) $10 OFF
Mail in form TARKA 4-240MG (TRANDOLAPRIL/VERAP M-PHAS) $10 OFF
Mail in form TEKTURNA 150MG (ALISKIREN HEMIFUMARATE) UP TO $25 OFF
Mail in form TEKTURNA 300MG (ALISKIREN HEMIFUMARATE) UP TO $25 OFF
Mail in form TEKTURNA HCT 150-12.5MG (ALISKIREN/HCTZ) UP TO $25 OFF
Mail in form TEKTURNA HCT 150-25MG (ALISKIREN/HCTZ) UP TO $25 OFF
Mail in form TEKTURNA HCT 300-12.5MG (ALISKIREN/HCTZ) UP TO $25 OFF
Mail in form TEKTURNA HCT 300-25MG (ALISKIREN/HCTZ) UP TO $25 OFF
Mail in form TESTIM 1% 1% (TESTOSTERONE) CO-PAY COVERAGE
Mail in form TOVIAZ 4MG (FESOTERODINE FUM) UP TO $25 OFF
Mail in form TOVIAZ 8MG (FESOTERODINE FUM) UP TO $25 OFF
Mail in form TRADJENTA 5MG (LINAGLIPTIN) UP TO $150 OFF
Mail in form TRAVATAN Z 0.004% (TRAVOPROST) UP TO $20 OFF
Mail in form TRAVATAN Z 0.004% (TRAVOPROST) UP TO $20 OFF
Mail in form TRETIN-X 0.05% (TRETINOIN/EMOL CMB9/CLN1) UP TO $100 OFF
Mail in form TREXIMET 85-500MG (SUMATRIPTAN/NAPROXEN) UP TO $50 OFF
Mail in form TRIBENZOR 10-40-12.5MG (OLMESARTAN MED/AMLOD/HCTZ) UP TO $50 OFF
Mail in form TRIBENZOR 10-40-25MG (OLMESARTAN MED/AMLOD/HCTZ) UP TO $50 OFF
Mail in form TRIBENZOR 5-20-12.5MG (OLMESARTAN MED/AMLOD/HCTZ) UP TO $50 OFF
Mail in form TRIBENZOR 5-40-12.5MG (OLMESARTAN MED/AMLOD/HCTZ) UP TO $50 OFF
Mail in form TRIBENZOR 5-40-25MG (OLMESARTAN MED/AMLOD/HCTZ) UP TO $50 OFF
Mail in form TRILIPIX 135MG (FENOFIBRIC ACID) UP TO $15 OFF
Mail in form TRILIPIX 45MG (FENOFIBRIC ACID) UP TO $15 OFF
Mail in form TRIZIVIR 300-150-300MG (ZIDOVUDINE/LAMIVUD/ABAC) UP TO $100 OFF
Mail in form TRUSOPT PLUS 2% (DORZOLAMIDE HCL) UP TO $10 OFF
Mail in form TRUVADA 200-300MG (EMTRICITABINE/TENOFOVIR) UP TO $50 OFF
Mail in form TUSSIONEX 10-8MG/5ML (HYDROCODONE/CPM PSX SR)


U

You can apply online or you may choose to print an online prescription form to take to your physician. Click on Medication Name for the Monograph.

V

You can apply online or you may choose to print an online prescription form to take to your physician. Click on Medication Name for the Monograph.
Mail in form VAGIFEM 10MCG (ESTRADIOL) UP TO $10 0FF
Mail in form VALSARTAN ORAL TABLET 160 160 MG (DIOVAN) UP TO $25 OFF
Mail in form VALSARTAN ORAL TABLET 80 80 MG (DIOVAN) UP TO $25 OFF
Mail in form VALSARTAN/HYDROCHLOROTHIA 160/12.5MG (DIOVAN HCT) UP TO $25 OFF
Mail in form VALSARTAN/HYDROCHLOROTHIA 320/12.5MG (DIOVAN HCT) UP TO $25 OFF
Mail in form VALSARTAN/HYDROCHLOROTHIA 320/25MG (DIOVAN HCT) UP TO $25 OFF
Mail in form VANIQA 13.9% (EFLORNITHINE HCL) UP TO $25 OFF
Mail in form VANOS 0.1% (FLUOCINONIDE) UP TO $50 OFF
Mail in form VANOS 0.1% (FLUOCINONIDE) UP TO $50 OFF
Mail in form VANOS 0.1% (FLUOCINONIDE) UP TO $50 OFF
Mail in form VAPRISOL 20MG/100ML (CONIVAPTAN HCL/D5W) UP TO $50 OFF
Mail in form VARENICLINE TARTRATE ORAL 0.5 MG (CHANTIX) $30 OFF
Mail in form VECTICAL (CALCITRIOL) UP TO $25 OFF
Mail in form VELTIN 1.2-0.025% (CLINDAMYCIN/TRETINOIN) UP TO $50 OFF
Mail in form VERAMYST 27.5MCG (FLUTICASONE FUROATE) UP TO $25 OFF
Mail in form VERDESO 0.05% (DESONIDE) UP TO $20 OFF
Mail in form VERDESO 0.05 % (DESONIDE) UP TO $20 OFF
Mail in form VESICARE 10MG (SOLIFENACIN SUCCINATE) UP TO $25 OFF
Mail in form VESICARE 5MG (SOLIFENACIN SUCCINATE) UP TO $25 OFF
Mail in form VICTOZA PEN 6MG/ML (LIRAGLUTIDE) UP TO $25 OFF
Mail in form VICTOZA PEN 6MG/ML (LIRAGLUTIDE) UP TO $25 OFF
Mail in form VICTRELIS 200MG (BOCEPREVIR) UP TO $200 OFF
Mail in form VIMOVO (NAPROXEN/ESOMEPRAZOLE MAG) UP TO $100 OFF
Mail in form VIMOVO 375-20MG (NAPROXEN/ESOMEPRAZOLE MAG) UP TO $100 OFF
Mail in form VIMPAT 100MG (LACOSAMIDE) Up to $60 off
Mail in form VIMPAT 150MG (LACOSAMIDE) Up to $60 off
Mail in form VIMPAT 200MG (LACOSAMIDE) Up to $60 off
Mail in form VIMPAT 50MG (LACOSAMIDE) Up to $60 off
Mail in form VIRACEPT 250MG (NELFINAVIR MESYLATE) UP TO $100 OFF
Mail in form VIRACEPT 625MG (NELFINAVIR MESYLATE) UP TO $100 OFF
Mail in form VIREAD 300MG (TENOFOVIR DISPROXIL FUM) UP TO $50 OFF
Mail in form VIVITROL 380MG (NALTREXONE MICROSPHERES) UP TO $500 OFF
Mail in form VYTORIN 10-10MG (EZETIMIBE/SIMVASTATIN) UP TO $20 OFF
Mail in form VYTORIN 10-20MG (EZETIMIBE/SIMVASTATIN) UP TO $20 OFF
Mail in form VYTORIN 10-40MG (EZETIMIBE/SIMVASTATIN) UP TO $20 OFF
Mail in form VYTORIN 10-80MG (EZETIMIBE/SIMVASTATIN) UP TO $20 OFF


W

You can apply online or you may choose to print an online prescription form to take to your physician. Click on Medication Name for the Monograph.

X

You can apply online or you may choose to print an online prescription form to take to your physician. Click on Medication Name for the Monograph.

Y

You can apply online or you may choose to print an online prescription form to take to your physician. Click on Medication Name for the Monograph.

Z

You can apply online or you may choose to print an online prescription form to take to your physician. Click on Medication Name for the Monograph.
Mail in form ZANAFLEX 2MG (TIZANIDINE HCL) UP TO $25 OFF
Mail in form ZANAFLEX 4MG (TIZANIDINE HCL) UP TO $25 OFF
Mail in form ZANAFLEX 6MG (TIZANIDINE HCL) UP TO $25 OFF
Mail in form ZEGERID 20-1100MG (OMEPRAZOLE/SOD BICARB) UP TO $30 OFF
Mail in form ZEGERID 40-1100MG (OMEPRAZOLE/SOD BICARB) UP TO $30 OFF
Mail in form ZEGERID ORAL 40-1680MG (OMEPRAZOLE/SOD BICARB) UP TO $30 OFF
Mail in form ZELAPAR 1.25MG (SELEGILINE HCL) UP TO $40 OFF
Mail in form ZEMPLAR 1MCG (PARICALCITOL) UP TO $100 OFF
Mail in form ZEMPLAR 2MCG (PARICALCITOL) UP TO $100 OFF
Mail in form ZEMPLAR 4MCG (PARICALCITOL) UP TO $100 OFF
Mail in form ZENPEP 25000U (LIPASE/PROTEASE/AMYLASE) UP TO $50 OFF
Mail in form ZENPEP 3000U (LIPASE/PROTEASE/AMYLASE) UP TO $50 OFF
Mail in form ZENPEP 10000U (AMYLASE/LIPASE/PROTEASE) UP TO $50 OFF
Mail in form ZENPEP 15000U (AMYLASE/LIPASE/PROTEASE) UP TO $50 OFF
Mail in form ZENPEP 20000U (AMYLASE/LIPASE/PROTEASE) UP TO $50 OFF
Mail in form ZENPEP 5000U (AMYLASE/LIPASE/PROTEASE) UP TO $50 OFF
Mail in form ZETIA 10MG (EZETIMIBE) UP TO $20 OFF
Mail in form ZIAGEN 20MG/ML (ABACAVIR SULFATE) UP TO $100 OFF
Mail in form ZIAGEN 300 MG (ABACAVIR SULFATE)
Mail in form ZIANA 1.2-0.025% (CLINDAMYCIN/TRETINOIN) UP TO $50 OFF
Mail in form ZIANA 1.2-0.025% (CLINDAMYCIN/TRETINOIN) UP TO $50 OFF
Mail in form ZIOPTAN 0.0015 % (TAFLUPROST/PF) Up to $70 off
Mail in form ZOLOFT 100MG (SERTRALINE) UP TO $50 OFF
Mail in form ZOLOFT 25 MG (SERTRALINE) UP TO $50 OFF
Mail in form ZOLOFT 50MG (SERTRALINE) UP TO $50 OFF
Mail in form ZOMIG B/P 2.5MG (ZOLMITRIPTAN) UP TO $35 OFF
Mail in form ZOMIG B/P 5MG (ZOLMITRIPTAN) UP TO $35 OFF
Mail in form ZOMIG NASAL 5MG (ZOLMITRIPTAN NASAL) UP TO $35 OFF
Mail in form ZOMIG-ZMT 2.5MG (ZOLMITRIPTAN DISP) UP TO $35 OFF
Mail in form ZOMIG-ZMT 5MG (ZOLMITRIPTAN DISP) UP TO $35 OFF
Mail in form ZYFLO CR 600MG (ZILEUTON 12H) UP TO $40 OFF


* Availability subject to change without prior notice

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Copyright © 2013 Xubex Pharmacy. All Rights Reserved. Privacy Statement

Xubex Patient Assistance Program is not insurance.

This online pharmacy is obligated to comply fully with the Controlled Substances Act and DEA regulations. As part of this obligation, this online pharmacy has applied for a modified DEA registration authorizing it to operate as an online pharmacy. In addition, this online pharmacy will only dispense a controlled substance to a person who has a valid prescription issued for a legitimate medical purpose based upon a medical relationship with a prescribing practitioner. This includes at least one prior in-person medical evaluation in accordance with section 309 of the Controlled Substances Act (21 U.S.C. 829) or a medical evaluation via telemedicine in accordance with section 102(54) of the Controlled Substances Act (21 U.S.C. 802(54)).

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.