SYMBICORT

SAVINGS OFFER

You Could Get Your Prescription
FREE* for up to One Year

*Subject to eligibility rules; restrictions apply.

This SYMBICORT savings offer is brought to you by AZ Helps logo.

For eligible commercially insured patients

You could get your SYMBICORT prescription filled FREE* for up to 12 months.

For Medicare/Medicaid/ Uninsured patients

You could get your first SYMBICORT prescription (one inhaler) FREE!* Just present the free prescription offer to your pharmacist along with a valid prescription for SYMBICORT.

*Subject to eligibility rules; restrictions apply.

Eligibility

To sign up for the SYMBICORT Savings Offer, you must meet the eligibility requirements.

*Eligibility Requirements

All fields are required unless indicated as optional. After completing the short form below, you can start using your card right away.

Symbicort-copd-registration

Your Information

 

Note: You must be 18 or older to enroll.

 
MALE FEMALE PREFER NOT TO SAY

About You

 
Asthma COPD, Emphysema, or Chronic Bronchitis
 
 
YES NO
 
 
Commercially insured Uninsured or use Medicare/Medicaid
 

If you would like to receive your savings card through text message, please provide your mobile number to enroll in AZhelps for SYMBICORT.

Message & data rates may apply.
YES NO
 001
 
 

Symbicort-copd-registration

Your Information

 

Note: You must be 18 or older to enroll.

 
MALE FEMALE PREFER NOT TO SAY

About You

 
Asthma COPD, Emphysema, or Chronic Bronchitis
 
 
YES NO
 
 
Commercially insured Uninsured or use Medicare/Medicaid
 

If you would like to receive your savings card through text message, please provide your mobile number to enroll in AZhelps for SYMBICORT.

Message & data rates may apply.
YES NO
 001
 001
 
 

 

Important Safety Information

  • SYMBICORT combines an ICS, budesonide and a LABA medicine, formoterol. LABA medicines, such as formoterol, when used alone can increase the risk of hospitalizations and death from asthma problems. When an ICS and LABA are used together, this risk is not significantly increased
  • Do not use SYMBICORT for sudden severe symptoms of COPD or asthma
  • Before you use SYMBICORT, tell your healthcare provider about all of your medical conditions, including if you have heart conditions or high blood pressure, and all the medicines you may be taking. Some patients taking SYMBICORT may experience increased blood pressure, heart rate, or change in heart rhythm
  • Do not use SYMBICORT more often than prescribed. SYMBICORT should be taken as 2 puffs 2 times each day
  • While taking SYMBICORT, do not use another medicine containing a LABA for any reason. Ask your healthcare provider or pharmacist if any of your other medicines are LABA medicines
  • Call your healthcare provider or get medical care right away if:
    • Your breathing problems worsen
    • You need to use your rescue inhaler more often than usual or your rescue inhaler doesn’t work as well at relieving symptoms
  • SYMBICORT may cause serious side effects, including:
    • Using too much of a LABA medicine may cause chest pain, fast and irregular heartbeat, tremor, increased blood pressure, headache or nervousness
    • Fungal infection in your mouth or throat (thrush). Rinse your mouth with water without swallowing after using SYMBICORT to help reduce your chance of getting thrush
    • Pneumonia and other lower respiratory tract infections. People with COPD may have a higher chance of pneumonia and other lung infections. ICS may increase the chance of getting pneumonia. Call your healthcare provider if you notice any of the following symptoms: increase in mucus production or change in color, fever, increased cough, chills, or increased breathing problems
    • Immune system effects and a higher chance for infections. Tell your healthcare provider about any signs of infection such as: fever, body aches, feeling tired, vomiting, pain, chills, or nausea
    • Adrenal insufficiency. This can happen when you stop taking oral corticosteroid medicines and start inhaled corticosteroid medicine
    • Increased wheezing right after taking SYMBICORT. Always have a rescue inhaler with you to treat sudden wheezing
    • Serious allergic reactions including rash, hives, swelling of the face, mouth, and tongue, and breathing problems. Call your healthcare provider or get emergency medical care if you get any symptoms of a serious allergic reaction
    • Lower bone mineral density can happen in people who have a high chance for low bone mineral density (osteoporosis)
    • Slowed growth in children. A child’s growth should be checked regularly while using SYMBICORT
    • Eye problems including glaucoma and cataracts. You should have regular eye exams while using SYMBICORT
    • Swelling of blood vessels. This can happen in people with asthma. Tell your healthcare provider right away if you have: a feeling of pins and needles or numbness of arms or legs, rash, flu like symptoms, or pain and swelling of the sinuses
    • Decreases in blood potassium levels (hypokalemia)
    • Increases in blood sugar levels (hyperglycemia)
  • The most common side effects of SYMBICORT include:
    • COPD: throat irritation, thrush in the mouth and throat, bronchitis, sinusitis, and upper respiratory tract infection
    • Asthma: throat irritation, headache, upper respiratory tract infection, throat pain, sinusitis, flu, back pain, nasal congestion, stomach discomfort, vomiting, and thrush in the mouth and throat

Approved Uses

COPD: SYMBICORT 160/4.5 mcg is used long-term to improve symptoms of chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema, for better breathing and fewer flare-ups.

Asthma: SYMBICORT is for the treatment of asthma in patients 6 years and older whose asthma is not well-controlled with an asthma-control medicine such as an inhaled corticosteroid (ICS) or whose asthma warrants treatment with both an ICS and a long-acting beta2-adrenergic agonist (LABA).

SYMBICORT is not used to relieve sudden breathing problems and will not replace a rescue inhaler.

Please see full Prescribing Information and Patient Information, and discuss with your doctor.

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