xermelo.copaysavingsprogram.com
Open in
urlscan Pro
3.212.242.37
Public Scan
URL:
https://xermelo.copaysavingsprogram.com/
Submission: On February 24 via api from US — Scanned from US
Submission: On February 24 via api from US — Scanned from US
Form analysis
0 forms found in the DOMText Content
* Important Safety Information * Full Prescribing Information * For Healthcare Professionals * Return to XERMELO Patient Website * Return to XERMELO Patient Website GET STARTED WITH XERMELO STEP 1: PATIENT INFORMATION First name* Please enter your first name. Last name* Please enter your last name. Email Address Invalid email address format. Mailing Address* Please enter your mailing address. Mailing Address 2 (optional) City* Please enter your city. State* None selectedALABAMAALASKAARIZONAARKANSASCALIFORNIACOLORADOCONNECTICUTDELAWAREDISTRICT OF COLUMBIAFLORIDAGEORGIAHAWAIIIDAHOILLINOISINDIANAIOWAKANSASKENTUCKYLOUISIANAMAINEMARYLANDMASSACHUSETTSMICHIGANMINNESOTAMISSISSIPPIMISSOURIMONTANANEBRASKANEVADANEW HAMPSHIRENEW JERSEYNEW MEXICONEW YORKNORTH CAROLINANORTH DAKOTAOHIOOKLAHOMAOREGONPENNSYLVANIAPUERTO RICORHODE ISLANDSOUTH CAROLINASOUTH DAKOTATENNESSEETEXASUTAHVERMONTVIRGINIAWASHINGTONWEST VIRGINIAWISCONSINWYOMING Please enter your state. ZIP Code* Please enter your ZIP code. Phone Number* Please enter your phone number. *Required field STEP 2: ELIGIBILITY QUESTION What type of prescription drug insurance do you have?* Please select. Commercial prescription drug insurance through an employer-sponsored or private health plan or the Federal Employee Health Benefit Plan. Prescription insurance coverage through a state or federal healthcare program, including but not limited to Medicare Part D, Medicaid, Medigap, Veterans Affairs (VA) or Department of Defense (DOD) programs. I am not covered by prescription drug insurance. To learn how TerSera Therapeutics will use and protect your personal information, click here to view our Privacy Policy. IMPORTANT SAFETY INFORMATION AND INDICATION IMPORTANT SAFETY INFORMATION * Do not take XERMELO if you have a history of hypersensitivity to telotristat or any of the ingredients in XERMELO. * XERMELO may cause constipation which can be serious. You should stop taking XERMELO if severe constipation or severe, persistent, or worsening abdominal pain develops. Talk to your doctor if you have these symptoms. * The most common side effects of XERMELO include nausea, headache, increase in liver enzymes, depression, flatulence, decreased appetite, swelling of your hands and feet, fever, abdominal pain, and constipation. * Talk to your doctor about all medications you are taking as some may interact with XERMELO. * XERMELO is not recommended if you have moderate or severe liver impairment. INDICATION XERMELO is a prescription pill, used along with somatostatin analog (SSA) therapy, for Carcinoid Syndrome diarrhea in adults who are not adequately controlled by SSA therapy. Please see Full Prescribing Information. You are encouraged to report negative side effects of prescription drugs to the FDA. To report suspected adverse reactions, contact the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch. You may also contact TerSera Therapeutics at 1-844-334-4035 or medicalinformation@tersera.com. * About TerSera * Terms of Use * Contact Us * Site Map Xermelo is a registered trademark of TerSera Therapeutics LLC or its affiliates. ©2022 TerSera Therapeutics LLC. All rights reserved. XER-P-0266 V2 (10/2022) THANK YOU FOR YOUR INTEREST IN XERMELO Based on the information provided, this patient is not eligible for the program. The XERMELO Co-pay Program is only available to commercially insured patients who reside in the United States and US territories. If you have questions or need further assistance, please call the support team at 1-844-539-7427. IMPORTANT SAFETY INFORMATION AND INDICATION IMPORTANT SAFETY INFORMATION * Do not take XERMELO if you have a history of hypersensitivity to telotristat or any of the ingredients in XERMELO. * XERMELO may cause constipation which can be serious. You should stop taking XERMELO if severe constipation or severe, persistent, or worsening abdominal pain develops. Talk to your doctor if you have these symptoms. * The most common side effects of XERMELO include nausea, headache, increase in liver enzymes, depression, flatulence, decreased appetite, swelling of your hands and feet, fever, abdominal pain, and constipation. ×