From the Maker of MIGRANAL® and Generic MIGRANAL® (dihydroergotamine mesylate, USP)
Migranal Banner
Migranal Banner
INDICATION

Migranal®(dihydroergotamine mesylate, USP) Nasal Spray is used to treat an active migraine headache with or without aura. Do not use it to try to prevent a migraine if you have no symptoms, to treat a common tension headache, or to treat a migraine that is not typical of your usual migraine.

IMPORTANT SAFETY INFORMATION
Serious or potentially life-threatening reductions in blood flow to the brain or extremities due to interactions between dihydroergotamine (the active ingredient in Migranal Nasal Spray) and protease inhibitors and macrolide antibiotics have been reported rarely. As a result, these medications should not be taken together.
Please click here for full Prescribing Information, including Boxed Warning and Patient Information.

1 Medication...
2 Simple Ways to Save.*

Answer the questions below and download your Savings Card!

Are you eligible for reimbursement of prescriptions (in whole or in part) under any federal, state or other governmental programs, including, but not limited to, Medicare (including Medicare Advantage and Part A, B and D plans), Medicaid, TRICARE, Veterans Administration or Department of Defense health coverage, CHAMPUS, the Puerto Rico Government Health Insurance Plan or any other federal or state healthcare programs?*

Do you live in Massachusetts and/or have insurance coverage for prescriptions in Massachusetts?*

Are you 18 years of age or older?*


To start receiving information, please provide your contact information below.
*
*
*
*
*
*

For Privacy Statement, please click here.
*Eligibility Criteria/Terms and Conditions:

By using the MIGRANAL coupon, you confirm that you understand and agree to comply with the following terms and conditions of this offer:

  • This offer is only valid for patients with commercial insurance.
  • This offer is not valid for any person eligible for reimbursement of prescriptions, in whole or in part, by any federal, state, or other governmental programs, including, but not limited to, Medicare (including Medicare Advantage and Part A, B, and D plans), Medicaid, TRICARE, Veterans Administration or Department of Defense health coverage, CHAMPUS, the Puerto Rico Government Health Insurance Plan or any other federal or state health care programs.
  • You agree not to seek reimbursement for all or any part of the benefit received through this offer and are responsible for making any required reports of your use of this offer to any insurer or other third party who pays any part of the prescription filled.
  • This offer is good only in the United States of America (including the District of Columbia, Puerto Rico and the U.S. Virgin Islands) at participating retail pharmacies.
  • You must be 18 years of age or older to redeem this offer.
  • You must present the coupon along with your prescription to participate in this program. You must activate the coupon before using by calling 1-855-330-3269 or by visiting www.migranal.com.
  • The coupon is good for use only with the products identified herein. No other purchase is necessary.
  • This offer cannot be redeemed at government-subsidized clinics.
  • The coupon is good for a maximum of 12 30-day prescription fills.
  • Patient is responsible for paying the first $5 for their MIGRANAL Generic prescription or the first $35 for their MIGRANAL prescription. Valeant Pharmaceuticals will be responsible to pay any remaining co-payment for each eligible prescription fill using the coupon up to a maximum amount of $250 per fill. Patient is responsible for all additional costs and expenses after maximum limits are reached.
  • The coupon and offer are not health insurance.
  • The selling, purchasing, trading, or counterfeiting of the coupon is prohibited by law. Void if reproduced.
  • This offer is not valid with other offers. The coupon has no cash value. No cash back.
  • Valeant Pharmaceuticals reserves the right to rescind, revoke, terminate, or amend this offer at any time, without notice.
  • You understand and agree to comply with the terms and conditions of this offer as set forth above.
  • This offer and coupon expire on 12/31/16.
  • For questions call: 1-844-247-3986.
Migranal Banner
SCROLL DOWN TO COMPLETE YOUR SAVINGS CARD DOWNLOAD!
IMPORTANT SAFETY INFORMATION (continued)
Do not use Migranal Nasal Spray if you:
  • Are taking certain anti-HIV medications known as protease inhibitors
  • Are taking a macrolide antibiotic such as troleandomycin, clarithromycin, or erythromycin
  • Are pregnant or nursing
  • Have any disease affecting your heart, arteries, or blood circulation
  • Have taken other medications for the treatment or prevention of migraine within the last 24 hours
  • Have severe liver or kidney disease
  • Experience hemiplegic or basilar migraines, which often cause paralysis or impairment of speech

The use of Migranal Nasal Spray should not exceed dosing guidelines and should not be used on a daily basis.

Serious cardiac (heart) events, including some that have been fatal, have occurred following use of injectable dihydroergotamine, the active ingredient in Migranal Nasal Spray, but are extremely rare.

You may experience some nasal congestion or irritation, altered sense of taste, sore throat, nausea, vomiting, dizziness, and fatigue after using Migranal Nasal Spray.

Contact your doctor immediately if you experience:
  • Numbness or tingling in your fingers and toes
  • Pain, tightness, or discomfort in your chest
  • Muscle pain or cramps in your arms and legs
  • Weakness in your legs
  • Temporary speeding or slowing of your heart rate
  • Swelling or itching
Please click here for full Prescribing Information, including Boxed Warning and Patient Information.

You are encouraged to report adverse side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.


BRING THIS COUPON TO YOUR PHARMACIST FOR CO-PAY SAVINGS
TO THE PATIENT
  • You must present this coupon along with your prescription to participate in this program. You must activate this coupon before using by calling 1-855-330-3269 or visiting www.migranal.com.
  • When you use this coupon you are certifying that you understand and agree to the program rules, regulations, eligibility requirements, and terms and conditions which can be found at www.migranal.com.
  • This offer is not valid for any person eligible for reimbursement of prescriptions, in whole or in part, by any federal, state, or other governmental programs, including, but not limited to, Medicare (including Medicare Advantage and Part A, B, and D plans), Medicaid, TRICARE, Veterans Administration or Department of Defense health coverage, CHAMPUS, the Puerto Rico Government Health Insurance Plan, or any other federal or state health care programs.
TO THE PHARMACIST:

When you use this coupon, you are certifying that you have not submitted and will not submit a claim for reimbursement under any federal, state, or other governmental programs for this prescription.

Pharmacist instructions for a patient with an Eligible Third-Party Payer
MIGRANAL Generic
  • Submit the claim to the primary Third-Party Payer first, then submit the balance due to Therapy First Plus as a Secondary Payer COB [coordination of benefits] with patient responsibility amount and a valid Other Coverage Code (eg, 8). The patient is responsible for the first $5 and the card pays up to the next $250. Reimbursement will be received from Therapy First Plus.
MIGRANAL
  • Submit the claim to the primary Third-Party Payer first, then submit the balance due to Therapy First Plus as a Secondary Payer COB [coordination of benefits] with patient responsibility amount and a valid Other Coverage Code (eg, 8). The patient is responsible for the first $35 and the card pays up to the next $250. Reimbursement will be received from Therapy First Plus.
  • Valid Other Coverage Code required. For any questions regarding Therapy First Plus. online processing, please call the Help Desk at 1-800-422-5604.
  • Submit transaction using BIN 004682.
  • This offer is only valid for patients with commercial insurance.
  • When you use this coupon you are certifying that you have not submitted and will not submit a claim for reimbursement under any federal, state, or other governmental programs, including, but not limited to, Medicare (including Medicare Advantage and Part A, B, and D plans), Medicaid, TRICARE, Veterans Administration or Department of Defense health coverage, CHAMPUS, the Puerto Rico Government Health Insurance Plan, or any other federal or state health care programs. This offer is not valid for any person eligible for reimbursement of prescriptions, in whole or in part, by any of these programs.
  • By accepting this coupon and submitting claims for any of the products specified herein you agree to the program terms and conditions, which are posted at www.migranal.com.
  • Participants must be 18 years of age or older.
  • This offer and coupon expire on 12/31/16.
  • For questions call: 1-844-247-3986.
  • Valeant Pharmaceuticals reserves the right to rescind, revoke, terminate, or amend this offer at any time, without notice.