Copay Savings Program
*Zenzedi Copay Savings Program Terms and Conditions
To the Patient:
For eligible patients, if your copay exceeds $30 (insured patients) or $75 (noninsured patients), provide your
copay savings card information to the pharmacist for an instant discount. Patients may use the copay savings
card each time a prescription is filled for up to 360 days’ supply per year.
Copays are based on 30-tablet count prescriptions. Benefit limitations apply. Patient is responsible for the
remaining balance after benefit limits are reached. If you have any questions regarding your eligibility or
benefits, or if you wish to discontinue your participation, call +1-855-558-1630 (8:00 am–8:00 pm
EST, Monday–Friday). When you use this card, you are certifying that you understand the program rules,
regulations, and terms and conditions.
You are not eligible if prescriptions are paid by any state or other federally funded programs,
including, but not limited to, Medicare or Medicaid, Medigap, VA or DoD or TRICARE, or where prohibited
by law; and you will otherwise comply with the terms above. Not intended for distribution to healthcare
providers in VT.
To the Pharmacist:
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
- Acceptance of this card and your submission of claims for the Zenzedi® Copay Savings program
are subject to the LoyaltyScript® program Terms and Conditions posted at
- 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 or DoD or TRICARE, or where
prohibited by law
- For questions regarding setup, claim transmission, patient eligibility or other issues, call +1-855-558-1630(8:00 am–8:00 pm EST, Monday–Friday).
- Please see full Prescribing Information and Medication Guide for
Zenzedi, including Boxed Warning.
Arbor Pharmaceuticals, LLC reserves the right to rescind, revoke, cancel, or adjust this offer at any time.
It is a violation of federal law to buy, sell, or counterfeit this card.
Zenzedi (dextroamphetamine sulfate tablets, USP) is a prescription medicine for the treatment of narcolepsy.
Zenzedi is also indicated as a treatment for ADHD in pediatric patients ages 3 to 16 years as an integral part
of a total treatment program for ADHD that may include counseling or other therapies.
Zenzedi (dextroamphetamine sulfate tablets, USP) is a federally controlled
substance (CII) with a high risk of abuse or dependence. Keep in a safe place to prevent misuse and
abuse. Selling or sharing Zenzedi may harm others and is illegal.
- has a history of advanced heart disease or hardening of the arteries, moderate to severe high blood
pressure, hyperthyroidism, known hypersensitivity or other serious cardiac problems that may place you
or your child at increased vulnerability to the sympathomimetic effects of a stimulant drug, or glaucoma
- is very anxious, tense, or agitated
- has a history of drug abuse
- is taking or has taken within the past 14 days an anti-depression medicine called a monoamine oxidase
inhibitor or MAOI
- is sensitive to, allergic to, or had a reaction to other stimulant medicines
- sudden death in people who have heart problems or heart defects
- sudden death, stroke, and heart attack in adults
- increased blood pressure and heart rate
Tell your doctor if you or your child has any heart problems,
including heart defects, abnormal heart rhythm, high blood pressure, disease known as cardiomyopathy,
coronary artery disease, or a family history of these problems or sudden cardiac death.
Call your doctor right away if you or your child has any signs of heart problems such as chest pain,
shortness of breath, or fainting while taking Zenzedi.
- new or worsening behavior and thought problems
- new or worsening bipolar illness
- seeing things or hearing voices
- believing things that are not true
- being suspicious
Tell your doctor about any drug abuse, alcohol abuse or mental
problems that you or your child has had, or about a family history of suicide, bipolar illness, or
depression, new or worsening aggressive behavior or hostility.
Call your doctor right away if you or your child has any new or worsening mental symptoms or
problems while taking Zenzedi.
- fingers or toes may feel numb, cool, painful
- fingers or toes may change color from pale, to blue, to red
Tell your doctor if you or your child has any numbness, pain,
color change, or sensitivity to temperature in your fingers and toes or a family history of health
conditions including circulation problems in fingers and toes.
Call your doctor right away if you or your child has any signs of unexplained wounds appearing on
fingers and toes while taking Zenzedi.
- slowing of growth (height and weight) in children, seizures, eyesight changes or blurred vision, and
serotonin syndrome. Serotonin syndrome can be life threatening and happens when Zenzedi is taken with
certain medicines. Symptoms include agitation, hallucinations, coma or other changes in mental status,
problems controlling your movements or muscle twitching, fast heartbeat, high or low blood pressure,
sweating or fever, nausea or vomiting, diarrhea, and muscle stiffness or tightness
The most common side effects reported with Zenzedi treatment include: fast heartbeat, tremors,
trouble sleeping, stomach upset, dry mouth, decreased appetite, headache, dizziness, and weight
Talk to your doctor if you or your child have side effects that are bothersome or do not go away, if
you or your child is pregnant, plan on becoming pregnant, or are breast-feeding, about all health
conditions (or a family history of), and about the medicines you or your child take. Your doctor will
decide whether Zenzedi can be taken with other medicines and if Zenzedi is right for you or your
Please talk to your healthcare professional and see complete
Prescribing Information for Zenzedi.
You are encouraged to report side effects of prescription drugs to Arbor Pharmaceuticals, LLC
Information at 1‐866‐516‐4950 or to the FDA at
www.fda.gov/medwatch or call