Important Safety Information
Side effects with Allegra® Oral Suspension 30 mg/5mL (6 mg/mL) are low and may include vomiting, fever, cough, ear infection and diarrhea.

Important additional information
*Some restrictions may apply. See below for details.
*Rebate offer is for up to $10 per prescription off your out-of-pocket payment when you purchase Allegra Oral Suspension and send in rebate certificate with original pharmacy receipt. 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 void where prohibited by law, taxed, or restricted. Amount of rebate for the purchase of Allegra Oral Suspension will not exceed amount of copay or $10 per prescription—whichever is less. This certificate may not be reproduced and must accompany your request. Offer good only for Allegra Oral Suspension and only in the USA. Offer expires 12/31/07. Sanofi-aventis U.S. LLC 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 $120).
US.AOS.07.03.011
Save up to $10 per prescription on your out-of-pocket costs*
FREE important information on managing your child's seasonal allergy symptoms
Yes! I would like to receive additional information regarding allergies and sanofi-aventis U.S. therapies.
By checking the box above, you agree that sanofi-aventis and others working on our behalf in connection with the Rebate Program may use your information for marketing purposes, including sending you materials such as tips and rebate offers and developing additional products and services to serve you better. Sanofi-aventis U.S. respects your interest in keeping your personal health information private. We will not sell or rent your information to any third party or outside mailing lists. For more information, see our Privacy Policy at http://www.privacypolicy.sanofi-aventis.us/. To be removed from our mailing list, please visit http://unsubscribe.sanofi-aventis.us/ or call 1-800-207-8049.

 Out of the 365 days in a year, how many days do you take medication for your seasonal allergies?
 0-30 days (1 mo.)
 31-60 days (2 mos.)
 61-90 days (3 mos.)
 91-120 days (4 mos.)
 121-180 days (6 mos.)
 181-240 days (8 mos.)
 241-300 days (10 mos.)
 301-365 days (year round)
 Which medications are you currently taking for your allergies?(check all that apply)
 Alavert® Children Syrup
 Benadryl®
 Claritin® Syrup
 Clarinex® Reditabs
 Clarinex® Syrup
 Singulair®
 Sudafed®
 Zyrtec® Chewable Tablets
 Zyrtec® Syrup
Name
Address
CityStateZIP
Sign here:
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.
IMPORTANT:
MAIL YOUR ORIGINAL PHARMACY RECEIPT AND THIS COMPLETED ORIGINAL FORM TO:
sanofi-aventis U.S.
400 Pennington Avenue
P.O. Box 12029
Dept 4553
Trenton, NJ 08650

Please allow 6 to 8 weeks for processing of your rebate request.
*Some restrictions may apply. Offer expires 12/31/07
US.AOS.07.03.011 Last Update: March 2007