OTOVEL PATIENT SAVINGS AND SUPPORT

AFFORDABILITY

Eligible patients may pay no more than $20* for OTOVEL

*Savings Card Terms and Conditions

Patient: If your co-pay for OTOVEL® (ciprofloxacin and fluocinolone acetonide) exceeds $20 (insured patients), present this card to the pharmacist for instant rebate. Benefit limitations apply. Cash-paying patients will receive a discount of $188 per box. Patient is responsible for the remaining balance after benefit limits are reached. For questions regarding your eligibility or benefits or if you wish to discontinue your participation, call 877-264-2440 (8:00 AM-8:00 PM EST, Monday-Firday).

Pharmacist: Benefit limitations apply. When you use this card, you are certifying that you have not submitted and will not submit a claim for reimbursement under any federal, state, or other governmental programs for this prescription. By redeeming this coupon, you agree that you understand and will abide by the terms and conditions of this offer, posted at www.mckesson.com/mprstnc.

  • Submit transaction to McKesson Corporation using BIN #610524.

  • Patient not eligible if prescriptions are paid in part or full by any state or federally funded programs, including but not limited to, Medicare or Medicaid, Medigap, VA, DOD, or TriCare. This program is not valid where prohibited by law.

  • If primary coverage exists, input card information as secondary coverage and transmit using the COB segment of the NCPDP transaction. Applicable discounts will be displayed in the transaction response.

  • Acceptance of this card and your submission of claims for the OTOVEL Savings Program are subject to the OTOVEL Savings Program Terms and Conditions posted at www.mckesson.com/mprstnc.

    - LoyaltyScript® is not an insurance card.

  • For questions regarding setup, claim transmission, patient eligibility, or other issues, call 877-264-2440 (8:00 AM-8:00 PM EST, Monday-Friday).

Not intended for use by health care providers in the state of Vermont.

IMPORTANT SAFETY INFORMATION

Contraindications
OTOVEL is contraindicated in:

  • Patients with known hypersensitivity to fluocinolone acetonide or other corticosteroids, ciprofloxacin or other quinolones, or to any other components of OTOVEL.

  • Viral infections of the external ear canal, including varicella and herpes simplex infections and fungal otic infections.

INDICATIONS

OTOVEL® (ciprofloxacin and fluocinolone acetonide) is indicated for the treatment of acute otitis media with tympanostomy tubes (AOMT) in pediatric patients (aged 6 months and older) due to S. aureus, S. pneumoniae, H. influenzae, M. catarrhalis, and P. aeruginosa.

IMPORTANT SAFETY INFORMATION

Contraindications
OTOVEL is contraindicated in:

  • Patients with known hypersensitivity to fluocinolone acetonide or other corticosteroids, ciprofloxacin or other quinolones, or to any other components of OTOVEL.

  • Viral infections of the external ear canal, including varicella and herpes simplex infections and fungal otic infections.

Warnings and Precautions
Hypersensitivity Reactions - OTOVEL should be discontinued at the first appearance of a skin rash or any other sign of hypersensitivity. Serious and occasionally fatal hypersensitivity (anaphylactic) reactions, some following the first dose, have been reported in patients receiving systemic quinolones. Some reactions were accompanied by cardiovascular collapse, loss of consciousness, angioedema (including laryngeal, pharyngeal or facial edema), airway obstruction, dyspnea, urticaria and itching. Serious acute hypersensitivity reactions may require immediate emergency treatment.

Potential for Microbial Overgrowth with Prolonged Use - Prolonged use of OTOVEL may result in overgrowth of non-susceptible bacteria and fungi. If the infection is not improved after one week of treatment, cultures should be obtained to guide further treatment. If such infections occur, discontinue use and institute alternative therapy.

Continued or Recurrent Otorrhea - If otorrhea persists after a full course of therapy, or if two or more episodes of otorrhea occur within 6 months, further evaluation is recommended to exclude an underlying condition such as cholesteatoma, foreign body, or a tumor.

Adverse Reactions
The most common adverse reactions that occurred in 1 or more of the patients are otorrhea, excessive granulation tissue, ear infection, ear pruritus, tympanic membrane disorder, auricular swelling, and balance disorder.

For additional safety information, consult the Otovel full Prescribing Information.

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.