Print this page and take it to your pharmacy with your prescription.
You can also call 1-866-398-0833 for prescription
coverage assistance or to enroll in a program
that provides prescription refill reminders
and the ability to refill Oxtellar XR®
prescriptions via text message.
TERMS & CONDITIONS
This card is provided to you as a service by your doctor and Supernus Pharmaceuticals, Inc. The patient must present a valid prescription for Oxtellar XR® (oxcarbazepine) extended-release tablets when redeeming this card. Prescriber ID# required on prescription. This card is valid towards out-of-pocket expenses for Oxtellar XR®. If the patient’s total cost per prescription is more than $0, this program will cover the amount above $0 (up to a maximum of $250 per prescription) on each of the next 12 prescriptions for up to a 30-day supply of Oxtellar XR® of any dosage strength filled. Patients with questions please call 1-866-398-0833.
Pharmacist instructions for a patient with an Eligible Third Party: 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.
- Submit transaction to McKesson Corporation using BIN #610524.
- If primary commercial prescription insurance 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 Oxtellar XR® program are subject to the LoyaltyScript® program Terms and Conditions posted at www.mckesson.com/mprstnc.
- Patient is 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 and where prohibited by law.
- For questions regarding setup, claim transmission, patient eligibility or other issues, call the LoyaltyScript® for Oxtellar XR® program at 877-264-2440 (8:00 AM-8:00 PM EST, Monday-Friday).
Supernus reserves the right to rescind, revoke, or amend this offer without notice at any time.
Oxtellar XR® (oxcarbazepine) extended-release tablets for oral use
Important Safety Information
Do not take Oxtellar XR if you are allergic to oxcarbazepine or any of the other ingredients in Oxtellar XR.
Oxtellar XR can cause serious side effects, including a low level of sodium in your blood. Symptoms of low blood sodium include nausea, tiredness, lack of energy, headache, confusion, and more frequent or more severe seizures. Similar symptoms that are not related to low sodium may occur from taking Oxtellar XR. Other serious side effects include seizures happening more often or becoming worse, trouble concentrating, problems with your speech and language, feeling confused, feeling sleepy and tired, and trouble walking and with coordination. The most common side effects include dizziness, sleepiness, headache, problems with walking and coordination (unsteadiness), shakiness, nausea, vomiting, double vision, weakness, and tiredness. These are not all of the possible side effects of Oxtellar XR. For more information, ask your healthcare provider or pharmacist.
Like other antiepileptic drugs, Oxtellar XR may cause suicidal thoughts or actions in a very small number of people, about 1 in 500. Before you take Oxtellar XR, tell your healthcare provider if you have or have had depression, mood problems, or suicidal thoughts or behavior. Call a healthcare provider right away if you have thoughts about suicide or dying, attempts to commit suicide, have new or worse depression or new or worse anxiety, feel agitated or restless, experience panic attacks, trouble sleeping (insomnia), or new or worse irritability, feel or act more aggressive, angry, or violent, act on dangerous impulses, have an extreme increase in activity and talking (mania), or experience other unusual changes in behavior or mood.
Oxtellar XR may also cause allergic reactions or serious problems which may affect organs and other parts of your body like the liver or blood cells. You may or may not have a rash with these types of reactions. Call your healthcare provider right away if you have any of the following: swelling of your face, eyes, lips, or tongue, trouble swallowing or breathing, a skin rash, hives, fever, swollen glands, or sore throat that does not go away or comes and goes, painful sores in the mouth or around your eyes, yellowing of your skin or eyes, unusual bruising or bleeding, severe fatigue or weakness, severe muscle pain, frequent infections, or infections that do not go away. Many people who are allergic to carbamazepine are also allergic to Oxtellar XR. Tell your healthcare provider if you are allergic to carbamazepine.
Before taking Oxtellar XR, tell your healthcare provider about all your medical conditions, including if you have or have had suicidal thoughts or actions, depression or mood problems, have liver problems, have kidney problems, use birth control medicine, are pregnant or plan to become pregnant, or are breastfeeding or plan to breastfeed. Oxtellar XR passes into breast milk. You and your healthcare provider should discuss whether you should take Oxtellar XR or breastfeed. You should not do both.
Oxtellar XR may harm your unborn baby. Tell your healthcare provider right away if you become pregnant while taking Oxtellar XR. If you use birth control medicine, Oxtellar XR may cause your birth control medicine to be less effective.
Tell your healthcare provider about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Taking Oxtellar XR with certain other medicines may cause side effects or affect how well they work. Do not start or stop other medicines without talking to your healthcare provider. Especially tell your healthcare provider if you take: carbamazepine, phenobarbital, phenytoin, or birth control medicine.
Do not stop taking Oxtellar XR without talking to your healthcare provider. Stopping Oxtellar XR suddenly can cause serious problems, including seizures that will not stop. Take Oxtellar XR exactly as prescribed.
Do not drive, operate heavy machinery, or do other dangerous activities until you know how Oxtellar XR affects you. Oxtellar XR may slow your thinking and motor skills.