PEXEVA®

To save your patients up to $25 on every Pexeva® prescription please provide the following information.

First Name*:

Last Name*:

Email Address*:

If you have questions about the Pexeva Co-Pay Benefit Program,
please call 800-773-0116.

Please read the information below before you submit your request.
Concerning Confidentiality: Noven respects your right to have personal and medical information kept confidential. Noven, and companies working with Noven, will not share your personal and medical information with any third parties (such as outside mailing lists).

	Check here if you also agree that Noven and companies working with Noven may use your information to help develop new Noven products, services and programs, provide you in the future with materials you may find useful, and contact you about health-related topics.
	Check here if you also agree that Noven may contact you from time to time about special offers and updates on Pexeva and related health issues.

Important Safety Information

Suicidal thoughts or behavior and antidepressant drugs
Short-term studies have shown that antidepressants increased the risk compared to placebo of suicidal thinking and behavior (suicidality) in children, adolescents, and young adults. When deciding to use PEXEVA® or any other antidepressant in these age groups, people must balance the risk with the potential benefit to the patient. Short-term studies did not show an increased risk of suicidality with antidepressants compared to placebo in adults beyond age 24; the risk decreased in adults aged 65 and older. Depression and certain other psychiatric disorders are themselves associated with increases in the risk of suicide. Patients of all ages who are started on antidepressant therapy should be monitored by their doctor and watched closely to see if their condition worsens, if they have suicidal thoughts or behavior or if they exhibit any unusual changes in behavior. Families and caregivers need to understand that they should watch the patient closely and tell the doctor if they have any concerns. PEXEVA® is not approved for use in pediatric patients.

The most common side effects that have been reported with PEXEVA® include nausea, dry mouth, constipation, decreased appetite, infection, drowsiness, tremor, sweating, muscle weakness, trouble sleeping, abnormal ejaculation, impotence and other male genital disorders, and female genital disorders.

Please see Important Safety Information, including Black Boxed Warning. Please see accompanying full Prescribing Information including use in Pregnancy. (See WARNINGS-Clinical Worsening and Suicide Risk and Usage in Pregnancy: Teratogenic and Nonteratogenic Effects).

You are encouraged to report negative side effects of prescription drugs to the FDA.
Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.


Copyright © 2008 Noven Therapeutics, LLC All rights reserved. For U.S. Audience Only
Visit Noven Therapeutics