Skip directly to content
Answering your questions.
Helping you get the most from your LYRICA experience.

Activate your LYRICA Co-Pay Savings Card

A A A
Text Size

Activate your LYRICA Co-Pay Savings Card

 

Please fill out the form below to activate your LYRICA Co-Pay Savings Card. If you do not currently have a LYRICA Co-Pay Savings Card, please talk to your doctor.

  1. Activate your card by filling out the form below.
  2. Bring your LYRICA prescription and card to your pharmacy.
  3. Keep your card in your wallet and use it for up to 12 months.
 

 

 

*Required field.

 

*Do you purchase your prescription medication through Medicaid, Medicare, or a federal or state prescription drug program?
We're sorry, you're not eligible for this offer.
 

 

*Are you over the age of 18?
We're sorry, you're not eligible for this offer.
 

 


 
 

Terms and conditions apply. Card will be accepted only at participating pharmacies. This card is not health insurance. No membership fees. For more information, call
1-800-578-7076 or contact Pfizer at PO Box 29387, Shawnee Mission, KS 66201, or visit www.pfizer.com.

 

Are you new to LYRICA? LYRICA ANSWERS is designed just for you

As you begin your treatment, LYRICA ANSWERS will help you know what to expect and how to best partner with your doctor.

 

And when you sign up for LYRICA ANSWERS, you’ll get a specifically tailored
e-mail each week in your first month of treatment to help you as you start taking LYRICA.

 

To sign up, you just need to fill out a few extra questions.

 

Yes! I want to join LYRICA ANSWERS. When you check this box, the submit button will become inactive until you fill out the remaining few questions.

 
 
 
 
 
 
 
 
 
GenderMaleFemale
*Are you requesting this information for you or someone else?
MyselfA family member
 
YesNoI haven’t filled my script yet
  
 

 

Privacy is important to us. To learn more about our use of your information and your rights, please consult our Privacy Policy.

 

Privacy Statement

Pfizer understands that your personal and health information is private. The information you provide will only be used by Pfizer and parties acting on its behalf to send you the materials you requested and other helpful information and updates on LYRICA, as well as related treatments, products, offers, and services.
In addition, we would like to request that Pfizer or companies acting on its behalf be able to send you materials about other health conditions, use your information to develop or improve products and services, or contact you in the future about health-related topics.
 
OFFER TERMS:
By using the LYRICA Co-Pay Savings Card, you acknowledge that you currently meet the eligibility criteria and will comply with the following terms and conditions: The Card is not valid for prescriptions that are eligible to be reimbursed, in whole or in part, by Medicaid, Medicare (including Medicare Part D), or other federal or state healthcare programs (including any state prescription drug assistance programs and the Government Health Insurance Plan available in Puerto Rico [formerly known as “La Reforma de Salud”]). The Card is not valid for prescriptions that are eligible to be reimbursed by private indemnity or HMO insurance plans or other health or pharmacy benefit programs which reimburse you for the entire cost of your prescription drugs. Use of the Card will allow the consumer to pay a $25 out-of-pocket maximum per prescription, once a month for up to 12 months during offering period. To qualify for this offer, the patient’s out-of-pocket expense must be a minimum of $25 per prescription. Depending on individual’s co-pay, savings may be up to $70 per prescription. You must deduct the value received under this program from any reimbursement request submitted to your insurance plan, either directly by you or on your behalf. Cannot be combined with any other rebate/coupon, free trial, or similar offer for the specified prescription. The Card will be accepted only at participating pharmacies. This Card is not health insurance. Offer good only in the US and Puerto Rico. The Card is limited to 1 per person during this offering period and is not transferable. Pfizer reserves the right to rescind, revoke, or amend the program without notice. For expiration date, please refer to the Co-Pay Savings Card.

For reimbursement when using a non-participating pharmacy/mail order: Pay for LYRICA prescription, and mail copy of original pharmacy receipt (cash register receipt NOT valid) with product name, date, and amount circled to: LYRICA Co-Pay Savings Card, 14001 Weston Parkway, Suite 103, Cary, NC 27513.

Be sure to include a copy of the front of your Co-Pay Savings Card, your name and mailing address.

page isi

IMPORTANT SAFETY INFORMATION & INDICATIONS

LYRICA is not for everyone. LYRICA may cause serious, even life threatening, allergic reactions. Stop taking LYRICA and call your doctor right away if you have any signs of a serious allergic reaction. Some signs are swelling of your face, mouth, lips, gums, tongue, throat or neck or if you have any trouble breathing, or have a rash, hives or blisters.

Drugs used to treat seizures increase the risk of suicidal thoughts or behavior. LYRICA may cause suicidal thoughts or actions in a very small number of people, about 1 in 500. Patients, family members or caregivers should call the doctor right away if they notice suicidal thoughts or actions, thoughts of self harm, or any unusual changes in mood or behavior. These changes may include new or worsening depression, anxiety, restlessness, trouble sleeping, panic attacks, anger, irritability, agitation, aggression, dangerous impulses or violence, or extreme increases in activity or talking. If you have suicidal thoughts or actions, do not stop LYRICA without first talking to your doctor.

LYRICA may cause swelling of your hands, legs and feet, which can be serious for people with heart problems. LYRICA may cause dizziness and sleepiness. You should not drive or work with machines until you know how LYRICA affects you. Also, tell your doctor right away about muscle pain or problems along with feeling sick and feverish, or any changes in your eyesight including blurry vision, or if you have any kidney problems or get dialysis.

Some of the most common side effects of LYRICA are dizziness, blurry vision, weight gain, sleepiness, trouble concentrating, swelling of your hands and feet, dry mouth, and feeling “high.” If you have diabetes, tell your doctor about any skin sores.

You may have a higher chance for swelling and hives if you are also taking angiotensin converting enzyme (ACE) inhibitors so tell your doctor if you are taking these medications. You may have a higher chance of swelling of your hands or feet or gaining weight if you are also taking certain diabetes medicines. Do not drink alcohol while on LYRICA. You may have a higher chance for dizziness and sleepiness if you take LYRICA with alcohol, narcotic pain medicines, or medicines for anxiety.

Before you start LYRICA, tell your doctor if you are planning to father a child, or if you are pregnant, plan to become pregnant, or are breast-feeding. If you have had a drug or alcohol problem, you may be more likely to misuse LYRICA. In studies, a specific type of blood vessel tumor was seen in mice, but not in rats. The meaning of these findings in humans is not known.

Do not stop taking LYRICA without talking to your doctor. If you stop suddenly you may have headaches, nausea, diarrhea, trouble sleeping, increased sweating, or you may feel anxious. If you have epilepsy, you may have seizures more often.

INDICATIONS

LYRICA is indicated to treat fibromyalgia, diabetic nerve pain, spinal cord injury nerve pain, and pain after shingles. LYRICA is also indicated to treat partial onset seizures in adults with epilepsy who take 1 or more drugs for seizures.

View the Medication Guide
View the Full Prescribing Information

 
▲ EXPAND
▼ COLLAPSE