Before beginning a submission, make sure you have your patient's insurance card ready.
Log in to the ARESTIN Rx Access Portal to print a pre-filled Prescription Form and download a Copay Assistance Patient Eligibility Form.
Call the dedicated service center: 1-855-684-7481, 8 am-8 pm ET, Monday-Friday and a pre-filled Prescription Form and a Copay Assistance Patient Eligibility Form will be faxed to you.
Print and fill out a Prescription Form and a Copay Assistance Patient Eligibility Form.
Don’t forget, the Prescription Form requires a dentist’s signature, and the Copay Assistance Patient Eligibility Form requires a patient’s signature.
to learn how to submit a prescription to ARESTIN Rx Access
to learn the simple steps of the prior authorization process.
*Login required. Visit RxAccessPortal.com to create an account for the ARESTIN Rx Access Online Portal.
ARESTIN® (minocycline HCl) Microspheres, 1mg is indicated as an adjunct to scaling and root planing (SRP) procedures for reduction of pocket depth in patients with adult periodontitis. ARESTIN® may be used as part of a periodontal maintenance program, which includes good oral hygiene and SRP.
IMPORTANT SAFETY INFORMATION
To report SUSPECTED ADVERSE REACTIONS, contact Valeant Pharmaceuticals North America LLC at 1-800-321-4576 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
Click here for full Prescribing Information.
Click here for IMPORTANT SAFETY INFORMATION