Prescribing Information
SAFETY INFORMATION
Gout Smart Know-how for living with gout
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请使用本资料来探索您的各种
治疗选项 请立即下载您的副本，
以便下次赴约时可与您的医疗护
理专业人员讨论您的治疗计划。
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English 中文 Hmoob Tagalog
Saib daim ntawv no kom paub tias muaj puas tsawg txoj kev kho mob rau koj xaiv. Rub daim ntawv no los siv tam sim no ces mam li mus nrog koj tus kws kho mob tham txog txoj kev npaj kho koj tus mob thaum koj rov mus ntsib nws dua.
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About the Saving Card
About GoutSmart
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Prescription Assistance

SIGN & UP

Register to enroll in GoutSmart and get your ULORIC Savings Card

Contact Information

Please note that all information is required unless noted as optional.

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Please note that this program is open to U.S. residents only.

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If you are enrolling on behalf of someone else, we will still provide you with important and useful information about gout as well as information especially for friends and family.




 

Have you been diagnosed with gout?

 

Approximately how long have you been diagnosed?


 

Approximately how many gout attacks do you suffer from in a year?



 

How would you rate the severity of your attacks?


 

Are you currently using ULORIC for your gout?

 

Are you currently using any of the following prescription medicines to treat your gout? [Check all that apply]



 

Have you previously used, and stopped using, any of the following to treat your gout? [Check all that apply]



 

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You will be able to print your ULORIC Savings Card directly from this site as soon as you complete this registration.

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By clicking the "Submit" button below you will be enrolled in GoutSmart, an educational program developed to help you learn more about gout. However, you are not eligible for a ULORIC Savings Card at this time.

Terms and Agreement

By clicking the “Submit” button below, I certify that I am not covered by:

  • Any federal or state healthcare program such as Medicare, Medicaid, Veterans Administration, TriCARE, etc., including state medical or pharmaceutical assistance programs;
  • The Medicare Prescription Drug Program (Part D), or I am not currently covered in the coverage gap;
  • Insurance that is paying the entire cost of the prescription;
  • An insurer or other Third Party Payor in Massachusetts.

Your Privacy

By clicking the “Submit” button below, I understand that I am giving Takeda Pharmaceuticals U.S.A., Inc., its affiliates and business partners, permission to use my personal information to provide me with information and offers related to gout and related treatment options. I understand I may revoke my permission at any time. To learn how Takeda will use and protect your personal information, click here to view our Privacy Policy.


Eligibility Requirements

This offer cannot be used if any part of your prescription is covered by: (i) any federal or state healthcare program (Medicare, Medicaid, VA, TriCARE, etc.), including a state medical or pharmaceutical assistance program, (ii) the Medicare Prescription Drug Program (Part D), or if you are currently in the coverage gap, (iii) insurance that is paying the entire cost of the prescription, or (iv) an insurer or other Third Party Payor in Massachusetts.

Terms and Conditions

You must meet Eligibility Requirements. You agree to report your use of this card to any Third Party that reimburses you or pays for any part of the prescription price. You additionally agree that you will not submit the cost of any portion of the product dispensed pursuant to this card to a federal or state healthcare program for purposes of counting it toward your out-of-pocket expenses (such as TrOOP under Medicare Part D). This offer covers out-of-pocket expenses greater than $35, up to $100 benefit per prescription. This card is not valid with any other program, discount, or incentive involving ULORIC. Offer Expires 3/31/2013. This offer may be rescinded, revoked, or amended without notice. No reproductions. This card is void where prohibited by law, taxed, or restricted. Limit one card per purchase. Cash value of 1/100 of 1¢. For questions about this card, call The Customer Service Center at
1-877-747-5972.

Use of ULORIC

ULORIC is a prescription medicine used to lower blood uric acid levels in adults with gout. ULORIC is not for the treatment of high uric acid without a history of gout.

Individual results may vary.

Important Safety Information

Do not take ULORIC if you are taking Azathioprine or Mercaptopurine.

Your gout may flare up when you start taking ULORIC; do not stop taking your ULORIC even if you have a flare. Your healthcare provider may give you other medicines to help prevent your gout flares.

A small number of heart attacks, strokes, and heart-related deaths were seen in clinical studies. It is not certain that ULORIC caused these events.

Tell your healthcare professional about liver or kidney problems or a history of heart disease or stroke.

Your healthcare professional may do blood tests to check your liver function while you are taking ULORIC.

The most common side effects of ULORIC are liver problems, nausea, gout flares, joint pain, and rash.

Please see the complete Prescribing Information and talk to your healthcare professional.

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.

ULORIC is a trademark of Teijin Pharma Limited registered with the U.S. Patent and Trademark Office and used under license by Takeda Pharmaceuticals America, Inc.
©2012 Takeda Pharmaceuticals U.S.A., Inc.

This site is intended for use by US residents only. TXF-01608 03/12

 

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