Restrictions and Conditions of Use

Savings Card

Good toward the purchase of prescriptions for BELVIQ® (lorcaserin HCI) CIV or BELVIQ XR® (lorcaserin HCI) CIV for up to 13 uses per year. Limited to 1 prescription per patient for any 30-day period. For patients with commercial insurance that covers the product, the patient pays the first $30 for BELVIQ XR or $40 for BELVIQ, and then Eisai Inc. will provide no more than $160 off the patient's out-of-pocket costs per commercially insured, covered prescription. For patients paying cash who have commercial insurance that does not cover the product, Medicare Part D, TRICARE, or are uninsured, Eisai will provide no more than $195 off the patient's cash price per 30 day fill.Save this card to reuse each month up to the expiration date or program discontinuation. No substitutions permitted.

  • Must be 18 years of age or older.
  • Not available to individuals eligible for federal healthcare programs that may cover prescription drugs, including Medicaid, CHAMPVA, the Department of Veterans Affairs healthcare program, or the Puerto Rico Government Health Insurance Plan, or any similar state or federal healthcare programs.
  • Medicare Part D and TRICARE patients whose insurance does NOT cover BELVIQ® or BELVIQ XR® may use this card if paying the full cash price for a prescription covered by this card and no claim is submitted to Medicare or TRICARE, or any other federal, state, or other governmental program. Out-of-pocket expenses incurred using this card cannot be applied towards Medicare Part D true out-of-pocket (TrOOP) expenses or TRICARE catastrophic cap.
  • Not valid for prescriptions for BELVIQ or BELVIQ XR reimbursed in full by any third-party payer.
  • Patients and pharmacies are responsible for disclosing to insurance carriers the redemption and value of the card and complying with any other conditions imposed by insurance carriers, third-party payers, or applicable law.
  • May not be combined with any other coupon, discount, prescription savings card, free trial, or other offer. 
  • The value of this card is not contingent on any prior or future purchases.
  • The card is solely intended to provide savings on any purchase of BELVIQ or BELVIQ XR. Use of the card for any single purchase does not obligate the patient to make future purchases of BELVIQ or BELVIQ XR or any other product.
  • Void outside the USA, including US territories and where prohibited by law.
  • This card expires 08/31/2018.
  • This card is not an insurance program.
  • This card may not be accepted at all pharmacies.
  • Federal law prohibits the selling, purchasing, trading, or counterfeiting of this savings card; such activities may result in imprisonment of 10 years, fines of $250,000, or both.
  • Eisai Inc. reserves the right to rescind, revoke, or amend this offer without notice at any time.
  • Other restrictions apply.

If you have any questions about the program rules or require additional information, please call 1-855-BELVIQ1 (1-855-235-8471). Questions about coverage? Call 1-866-61-EISAI (1-866-613-4724).

Financial assistance is available. For more about our Patient Assistance Program for those in financial need, click here.

 

INDICATION

BELVIQ/BELVIQ XR is indicated as an adjunct to a reduced-calorie diet and increased physical activity for chronic weight management in adults with an initial body mass index (BMI) of 30 kg/m2 or greater (obese), or 27 kg/m2 or greater (overweight) in the presence of at least one weight-related comorbid condition (e.g., hypertension, dyslipidemia, type 2 diabetes).

Limitations of Use:

  • The safety and efficacy of coadministration of BELVIQ/BELVIQ XR with other products intended for weight loss, including prescription drugs (e.g., phentermine), over-the-counter drugs, and herbal preparations, have not been established.
  • The effect of BELVIQ/BELVIQ XR on cardiovascular morbidity and mortality has not been established.

IMPORTANT SAFETY INFORMATION

Contraindications

  • Pregnancy: BELVIQ/BELVIQ XR should not be taken during pregnancy or by women who are planning to become pregnant.
  • Hypersensitivity: Patients with prior hypersensitivity reactions to lorcaserin or to any of the product components should not take BELVIQ/BELVIQ XR. Hypersensitivity reactions have been reported.

Warnings and Precautions

  • Serotonin Syndrome or Neuroleptic Malignant Syndrome (NMS)- like reactions: BELVIQ/BELVIQ XR is a serotonergic drug. The development of potentially life-threatening serotonin syndrome or Neuroleptic Malignant Syndrome (NMS)-like reactions have been reported during use of serotonergic drugs, including, but not limited to, selective serotonin-norepinephrine reuptake inhibitors, and selective serotonin reuptake inhibitors, tricyclic antidepressants, bupropion, triptans, dietary supplements such as St. John's Wort and tryptophan, drugs that impair metabolism of serotonin (including monoamine oxidase inhibitors), dextromethorphan, lithium, tramadol, antipsychotics or other dopamine antagonists, particularly when used in combination. Patients should be monitored for the emergence of serotonin syndrome symptoms or NMS-like reactions, including agitation, hallucinations, coma, tachycardia, labile blood pressure, hyperthermia, hyperreflexia, incoordination, nausea, vomiting, diarrhea, and muscle rigidity. Treatment with BELVIQ/BELVIQ XR and any concomitant serotonergic or antidopaminergic agents should be discontinued immediately if the above events occur and supportive symptomatic treatment should be initiated.
  • Valvular heart disease: Patients should not take BELVIQ/BELVIQ XR in combination with potent 5-HT2B receptor agonists that have been associated with regurgitant valvular heart disease (e.g., cabergoline). In clinical trials, 2.4% of patients taking BELVIQ and 2.0% of patients taking placebo developed valvular regurgitation: none of these patients were symptomatic. BELVIQ/BELVIQ XR should be used with caution in patients with congestive heart failure (CHF). Patients who develop signs and symptoms of valvular heart disease, including dyspnea, dependent edema, CHF, or a new cardiac murmur, should be evaluated and discontinuation of BELVIQ/BELVIQ XR should be considered.
  • Cognitive impairment: Impairment in attention, memory, somnolence, confusion, and fatigue have been reported in patients taking BELVIQ. Patients should not drive a car or operate heavy machinery until they know how BELVIQ/BELVIQ XR affects them.
  • Psychiatric disorders: The recommended daily dose should not be exceeded, as higher doses may cause euphoria, hallucination, and dissociation. Monitor patients for the development or worsening of depression, suicidal thoughts or behaviors, and/or any changes in mood. Discontinue BELVIQ/BELVIQ XR in patients who develop suicidal thoughts or behaviors.
  • Hypoglycemia: Weight loss may increase the risk of hypoglycemia in patients with type 2 diabetes mellitus who are being treated with antidiabetic medications, so measurement of blood sugar levels before and during treatment with BELVIQ/BELVIQ XR is recommended. Decreases in doses of antidiabetic medications or changes in medication regimen should be considered.
  • Priapism: Men who experience priapism should immediately discontinue BELVIQ/BELVIQ XR and seek emergency medical attention. BELVIQ/BELVIQ XR should be used with caution with erectile dysfunction medications. BELVIQ/BELVIQ XR should be used with caution in men who have conditions that might predispose them to priapism (e.g., sickle cell anemia, multiple myeloma, or leukemia), or in men with anatomical deformation of the penis (e.g., angulation, cavernosal fibrosis, or Peyronie's disease).
  • Heart rate decreases: Because BELVIQ/BELVIQ XR may cause a slow heartbeat, it should be used with caution in patients with a history of bradycardia or heart block greater than first degree.
  • Monitoring Considerations: Consider monitoring for CBC changes, signs and symptoms of prolactin excess, and pulmonary hypertension.

Most Common Adverse Reactions for BELVIQ®

  • In patients without diabetes: headache (17%), dizziness (9%), fatigue (7%), nausea (8%), dry mouth (5%), and constipation (6%).
  • In patients with diabetes: hypoglycemia (29%), headache (15%), back pain (12%), cough (8%), and fatigue (7%).

Most Common Adverse Reactions for BELVIQ XR®

  • Common side effects in patients on BELVIQ XR were similar to those seen in patients on BELVIQ.

Nursing Mothers

  • BELVIQ/BELVIQ XR should not be taken by women who are nursing.

BELVIQ®/BELVIQ XR® is a federally controlled substance (CIV) because it may be abused or lead to dependence.
For more information about BELVIQ®/BELVIQ XR®, see full Prescribing Information.