For eligible patients

The ZUPLENZ patient ASSISTANCE Program from Fortovia Direct Rx

All eligible patients pay $25 out-of-pocket costs*

A streamlined Patient Assistance Program is also available for uninsured, underinsured, Medicare, Medicaid, and indigent patients.

Patients can receive free, 24-48 hour home delivery of product when healthcare professionals order directly from a specialty pharmacy within the Fortovia Direct Rx network.

Important information for patients:

  1. Pharmacy will contact patients directly to verify insurance coverage and address.
  2. Patients must confirm their insurance information with pharmacy before prescription is shipped.
  3. Patients must provide credit/debit card information.

*Terms and Conditions: Certain patients in Federal programs may not qualify. Qualified patients will pay $25 per ZUPLENZ prescription. After a maximum reimbursement allowance, any remaining costs will be the responsibility of the patient. Co-pay assistance is not valid for prescriptions reimbursed, in whole or in part, under Medicaid, Medicare, including Medicare Advantage and Part D prescription drug plans, or any other federal or state program (including state pharmaceutical assistance programs) or where prohibited, taxed, or otherwise restricted. Fortovia Therapeutics Inc. reserves the right to rescind, revoke, or amend this offer without notice. Patients understand and agree to comply with the terms and conditions of this offer as set forth here.

Helpful Resources for Coping with Nausea During CANCER THERAPY

Use these helpful resources to learn more about what causes nausea and vomiting, and how it can be prevented or treated

American Cancer Society

National Cancer Institute

Nausea and vomiting are common side effects of chemotherapy and radiation

Learn More

ZUPLENZ is a medicine to help prevent nausea and vomiting in patients receiving chemotherapy, radiation therapy, or surgery

Learn More

Helpful resources for coping with nausea and vomiting during cancer treatment

Learn More

IMPORTANT SAFETY INFORMATION

  • Do not take ZUPLENZ if you: take apomorphine hydrochloride (eg, Apokyn®), have had an allergic reaction to ZUPLENZ or ondansetron or are allergic to any of its ingredients. See the last page of the full Patient Information.
  • ZUPLENZ may cause serious side effects, including severe allergic reactions. Stop taking ZUPLENZ and get medical help right away if you have any of these signs or symptoms of an allergic reaction to ZUPLENZ: rash, hives, itching, trouble breathing, chest tightness or chest pain, swelling of your mouth, face, lips, or tongue.
  • Before you take ZUPLENZ, tell your healthcare provider if you: have any heart problems, including a condition called "congenital long QT syndrome" or take a medicine that causes heart problems (QT prolongation), have liver problems.
  • Patients with severe hepatic impairment (Child-Pugh score of 10 or greater) should not receive more than 8mg of ZUPLENZ per day due to a reduction in drug clearance.
  • The most common side effects of ZUPLENZ include: headache, tiredness and body discomfort, constipation, diarrhea. These are not all the possible side effects of ZUPLENZ. For more information, ask your doctor or pharmacist.
  • Taking ZUPLENZ with certain other medicines may cause serious side effects. Tell your doctor about all prescription and over-the-counter medications and supplements you take, including apomorphine (for Parkinson's/movement disorders), tramadol hydrochloride (for pain), medicines for depression and migraine, and any other medicine for nausea and vomiting.

You are encouraged to report negative side effects of prescription medical products to the FDA.
Visit www.fda.gov/safety/medwatch, or call Fortovia at 1-855-273-0468.

Please see full Prescribing Information.

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IMPORTANT SAFETY INFORMATION

  • Do not take ZUPLENZ if you: take apomorphine hydrochloride (eg, Apokyn®), have had an allergic reaction to ZUPLENZ or ondansetron or are allergic to any of its ingredients. See the last page of the full Patient Information.
  • ZUPLENZ may cause serious side effects, including severe allergic reactions. Stop taking ZUPLENZ and get medical help right away if you have any of these signs or symptoms of an allergic reaction to ZUPLENZ: rash, hives, itching, trouble breathing, chest tightness or chest pain, swelling of your mouth, face, lips, or tongue.
  • Before you take ZUPLENZ, tell your healthcare provider if you: have any heart problems, including a condition called "congenital long QT syndrome" or take a medicine that causes heart problems (QT prolongation), have liver problems.
  • Patients with severe hepatic impairment (Child-Pugh score of 10 or greater) should not receive more than 8mg of ZUPLENZ per day due to a reduction in drug clearance.
  • The most common side effects of ZUPLENZ include: headache, tiredness and body discomfort, constipation, diarrhea. These are not all the possible side effects of ZUPLENZ. For more information, ask your doctor or pharmacist.
  • Taking ZUPLENZ with certain other medicines may cause serious side effects. Tell your doctor about all prescription and over-the-counter medications and supplements you take, including apomorphine (for Parkinson's/movement disorders), tramadol hydrochloride (for pain), medicines for depression and migraine, and any other medicine for nausea and vomiting.

You are encouraged to report negative side effects of prescription medical products to the FDA.
Visit www.fda.gov/safety/medwatch, or call Fortovia at 1-855-273-0468.

Please see full Prescribing Information.