Important additional information for Allegra-D 12 Hour.
Important additional information for Allegra-D 24 Hour.
*Some restrictions may apply. See below for details.
Important additional information for Allegra-D 24 Hour.
*Some restrictions may apply. See below for details.
Side effects with Allegra-D 12 Hour and Allegra-D 24 Hour were similar to Allegra 60 mg alone (headache, insomnia or nausea)
and Allegra 180 mg alone (headache, cold or backache) respectively. Due to the decongestant (pseudoephedrine) component in
both Allegra-D 12 Hour and Allegra-D 24 Hour, these products must not be used if you: are taking an MAO inhibitor (a medication
for depression) or have stopped taking an MAO inhibitor within 14 days; retain urine; have narrow-angle glaucoma; have
severe high blood pressure or severe heart disease. Side effects with pseudoephedrine may include nervousness, restlessness,
dizziness, or insomnia. Headache, drowsiness, increased heart rate, palpitations, increased blood pressure, and abnormal
heart rhythms have been reported. You should also tell your doctor if you have high blood pressure, diabetes, heart disease,
glaucoma, thyroid disease, impaired kidney function, or symptoms of an enlarged prostate such as difficulty urinating.
*Rebate offer is for up to $24 per prescription off your out-of-pocket payment when you purchase Allegra-D 12 Hour or Allegra-D 24 Hour and send in rebate certificate with original pharmacy receipt. Offer not valid for Allegra (fexofenadine HCI) 30 mg, 60 mg, or 180 mg or Oral Suspension 30 mg/5mL. Offer not valid for prescriptions reimbursed or paid under Medicare, Medicaid, or any similar federal or state health care program, including any state medical or pharmaceutical assistance programs. Void in Massachusetts if any insurer or other third-party payer reimburses you or pays for any part of the prescription price. Offer also void where prohibited by law, taxed, or restricted. Amount of rebate for the purchase of Allegra-D 12 Hour or Allegra-D 24 Hour product will not exceed amount of copay or $24 per prescription—whichever is less. This certificate may not be reproduced and must accompany your request. Offer good only for Allegra-D 12 Hour & Allegra-D 24 Hour and only in the USA. Offer expires 12/31/07. Sanofi-aventis U.S. reserves the right to rescind, revoke, or amend this offer without notice. You are responsible for reporting receipt of a rebate to any private insurer that pays for or reimburses you for any part of the prescription filled. Limit of 12 rebates per calendar year (up to $288).
*Rebate offer is for up to $24 per prescription off your out-of-pocket payment when you purchase Allegra-D 12 Hour or Allegra-D 24 Hour and send in rebate certificate with original pharmacy receipt. Offer not valid for Allegra (fexofenadine HCI) 30 mg, 60 mg, or 180 mg or Oral Suspension 30 mg/5mL. Offer not valid for prescriptions reimbursed or paid under Medicare, Medicaid, or any similar federal or state health care program, including any state medical or pharmaceutical assistance programs. Void in Massachusetts if any insurer or other third-party payer reimburses you or pays for any part of the prescription price. Offer also void where prohibited by law, taxed, or restricted. Amount of rebate for the purchase of Allegra-D 12 Hour or Allegra-D 24 Hour product will not exceed amount of copay or $24 per prescription—whichever is less. This certificate may not be reproduced and must accompany your request. Offer good only for Allegra-D 12 Hour & Allegra-D 24 Hour and only in the USA. Offer expires 12/31/07. Sanofi-aventis U.S. reserves the right to rescind, revoke, or amend this offer without notice. You are responsible for reporting receipt of a rebate to any private insurer that pays for or reimburses you for any part of the prescription filled. Limit of 12 rebates per calendar year (up to $288).
© 2007 sanofi-aventis U.S. LLC
US.FEX.07.03.013
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Important - you MUST sign here in order to qualify for this
rebate.
Please sign here to certify that you understand, accept, and are complying with all the requirements and restrictions listed on this form. This also certifies that redeeming this certificate is consistent with the requirements of your health plan.
Please sign here to certify that you understand, accept, and are complying with all the requirements and restrictions listed on this form. This also certifies that redeeming this certificate is consistent with the requirements of your health plan.
