What is the Dymista Savings Card?
It's a savings offer that can reduce the amount of your out-of-pocket expense to $14 per 30-day prescription of Dymista through December 31, 2017. The Dymista Savings Card helps eligible patients save up to $100 per use on out-of-pocket costs for those who have commercial health insurance. You can print the savings offer from your computer or store it on your smartphone. Just present your card at the pharmacy each time you drop off or refill your prescription.
Use it again and again.
The Dymista Savings Card is reusable for up to twelve (12) times per calendar year.
See if you're eligible.
Fill out the following form to see if you are eligible. See below for Terms and Conditions Certain restrictions apply.

* = Required Fields

* Do you have:

If you do not have insurance, unfortunately you are not eligible to use the Dymista Savings Card.
Unfortunately we cannot provide you with a savings card online. Please call 800-796-9526 for more information.
If you are covered by Medicare, Medicaid, or any other state or federally funded benefit program, unfortunately you are not eligible to use the Dymista Savings Card.

* Your age:

If you are under 18 years of age, unfortunately you are unable to apply for the Dymista Savings Card online.

Congratulations! You are eligible to receive the Dymista Savings Card offer. Please complete the following fields and click "Submit" to receive your card.

Your Information




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Dymista Savings Card Terms and Conditions

This SAVINGS card can be used to reduce the amount of your out-of-pocket expense up to a maximum of $100 after you pay the first $14 per 30 day prescription. No other purchase is necessary. This offer can be used up to a total of 12 times per calendar year through December 31, 2017, with a benefit cap of $1,200 per calendar year. Valid prescription with Prescriber ID# required.

Eligibility Requirements: This SAVINGS card can be redeemed only by patients or patient guardians who are 18 years of age or older and who are residents of the United States and its territories. Patients must have commercial insurance. Not valid for uninsured patients (but may be used by commercially insured patients without coverage for Dymista) and patients who are covered by any state or federally funded healthcare program, including but not limited to any state pharmaceutical assistance program, Medicare (Part D or otherwise), Medicaid, Medigap, VA or DOD, or TriCare (regardless of whether Dymista is covered by such government program); not valid if the patient is Medicare eligible and enrolled in an employer-sponsored health plan or prescription benefit program for retirees; and not valid if the patient's insurance plan is paying the entire cost of this prescription. Void outside the US and its territories or where prohibited by law, taxed, or restricted. This program is valid in Massachusetts through June 30, 2019, unless otherwise amended or extended by Massachusetts.

This SAVINGS card is not health insurance. The SAVINGS card is not transferable and the amount of the benefit cannot exceed the patient's out-of-pocket expenses. Cannot be combined with any other rebate/coupon, free trial, or similar offer for the specified prescription. This SAVINGS card is not redeemable for cash. Mylan Specialty reserves the right to amend or end this program at any time without notice.

NOTICE: Data related to your use of this SAVINGS card may be collected, analyzed and shared with Mylan Specialty for market research and other purposes related to assessing coupon programs. Data shared with Mylan Specialty will be aggregated and de-identified, meaning it will be combined with data related to other SAVINGS card redemptions and will not identify you.

Patient Instructions: Present your SAVINGS card and prescription drug insurance card, along with a valid prescription for the Dymista By using this SAVINGS card, you acknowledge that you currently meet the eligibility criteria and that you understand and will comply with the following additional terms and conditions:

  • You have not submitted and will not submit a claim for reimbursement under any federal, state or other governmental programs for this prescription.
  • Your acceptance of this offer must be consistent with the terms of any drug benefit provided by your health insurer. You agree to report the use of this SAVINGS card to your insurer if required.

Pharmacist Instructions: When you use this SAVINGS card, you are certifying that you have received this SAVINGS card from an eligible patient; you have dispensed the product as indicated; you have not submitted and will not submit a claim for reimbursement under any federal, state or other governmental programs for this prescription; and you will otherwise comply with these terms and all applicable terms and conditions. You further certify that your participation in this program is consistent with all applicable state laws and any obligations, contractual or otherwise, that you have as a pharmacy provider, and that you will report the use of this SAVINGS card to the patient’s insurer if required.

  • Submit transaction to McKesson Corporation using BIN #610524
  • Patient must have primary coverage. Input SAVINGS card information as secondary coverage and transmit using the COB segment of the NCPDP transaction. Applicable discounts will be displayed in the transaction response.
  • Acceptance of this SAVINGS card and your submission of claims for the Dymista® program are subject to the Mylan Specialty SAVINGS card Terms and Conditions posted at www.dymista.com/copay.
  • Acceptance of this SAVINGS card and your submission of claims for the Dymista® program are subject to the LoyaltyScript® program Terms and Conditions posted at www.mckesson.com/mprstnc.
  • For questions regarding setup, claim transmission, patient eligibility or other issues, call the LoyaltyScript® for Dymista® program at 800-657-7613 (8:00 AM-8:00 PM EST, Monday-Friday).

Important Safety Information

  • DYMISTA can cause sleepiness or drowsiness. Do not drive, operate machinery, or do anything that needs you to be alert until you know how DYMISTA affects you.
  • Do not drink alcohol or take any other medicines that may cause you to feel sleepy while using DYMISTA. It can increase your chances of having serious side effects.

DYMISTA may cause serious side effects including:

  • Sleepiness or drowsiness
  • Nasal Problems. Symptoms of nasal problems may include: crusting in the nose, nosebleeds, runny nose, hole in the cartilage between your nose (nasal septal perforation). A whistling sound when you breathe may be a symptom of nasal septal perforation.
  • Slow wound healing. You should not use DYMISTA until your nose has healed if you have a sore in your nose, if you have had surgery on your nose, or if your nose has been injured.
  • Thrush (Candida), a fungal infection in your nose and throat. Tell your healthcare provider if you have any redness or white colored patches in your nose or mouth.
  • Eye problems, such as glaucoma or cataracts. Some people may have eye problems, including glaucoma and cataracts. You should have regular eye exams when using DYMISTA.
  • Immune system problems that may increase your risk of infections. DYMISTA may cause problems with the way your immune system protects your body against infection and increase your risk of infection. Avoid contact with people who have contagious diseases such as chickenpox or measles while you use DYMISTA. Symptoms of infection may include: fever, aches or pains, chills, feeling tired.
  • Adrenal Insufficiency. Adrenal insufficiency is a condition in which the adrenal glands do not make enough steroid hormones. Symptoms of adrenal insufficiency may include: tiredness, weakness, nausea, vomiting, low blood pressure.
  • Slowed or delayed growth in children. A child’s growth should be checked regularly while using DYMISTA.

Call your healthcare provider or get medical help right away if you have symptoms of any of the serious side effects listed above.

  • The most common side effects of DYMISTA include: changes in taste, nosebleeds, and headache.
  • Tell your healthcare provider if you have any side effect that bothers you or that does not go away. These are not all of the possible side effects of DYMISTA. For more information, ask your healthcare provider or pharmacist.

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. DYMISTA and other medicines may affect each other, causing side effects.

Especially tell your healthcare provider if you take:

  • ritonavir (Norvir) or medicines that contain ritonavir (commonly used to treat HIV infection or AIDS)
  • ketoconazole, fluconazole, or itraconazole (for fungal infections)

Before using DYMISTA tell your healthcare provider if you are pregnant or plan to become pregnant. It is not known if DYMISTA will harm your unborn baby.


Indications

DYMISTA is a prescription medicine used to treat symptoms of seasonal allergic rhinitis in people 6 years of age and older, who need treatment with both azelastine hydrochloride and fluticasone propionate. DYMISTA may help to reduce your nasal symptoms including stuffy nose, runny nose, itching, and sneezing.


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.