Patient
Assistance Program
Eligible patients may receive a 30-day supply of ZELNORM for up to six (6) months. Patients will need to reapply for continued support at the end of each six (6) months of coverage.

Eligibility and Requirements

What does my income have to be in order to qualify for this program?

Your income will need to meet a fraction of the Federal Poverty Level guidelines.

Is US residency required to qualify?

Yes, patients must be legal US citizens and reside in one of the 50 US states, the District of Columbia, or Puerto Rico.

Am I eligible if I have Medicare coverage?

No, all government healthcare patients are excluded.

Eligibility for the ZELNORM Patient Assistance Program is subject to approval by the ZELNORM Patient Program Administrator. Submitting an application to the ZELNORM Patient Assistance Program does not guarantee program approval. The ZELNORM Patient Assistance Program can be changed, rescinded or revoked at any time without prior notice.

Application Information

How do I apply?

Download and complete the application form. Call (267) 214-9644 if you need assistance.

How do I submit the application?

The completed application can be submitted by fax (908-926-2652), mail (ZELNORM Patient Assistance, 2325 Heritage Center Drive, Furlong, PA 18925), email (zelnormpap@marketsharemovers.com).

How will I know if I am approved?

Patients will be notified by email provided at the time of enrollment.

How long will the approval process take?

Patients will be notified of approval/denial within one week after the application is received and determined to be complete.

Alfasigma USA, Inc. holds the highest respect for its customers and guarantees our firm commitment to your privacy. We do not sell any of the information provided by you to any other institutions.

Medication Details

How much medication can I receive?

Approved patients will receive a voucher good for up to six(6) monthly fills of ZELNORM.

Where will I receive my voucher?

Approved patients will receive their voucher at the address on the application.

How long will it take for me to receive my voucher?

Approved patients will receive their voucher for ZELNORM within one week after the application is received and approved.

How long will I qualify for this program if I am approved?

Once approved, patients will receive up to six months of ZELNORM and patients will need to reapply for continued support at the end of each six month period.

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Indication and Important
Safety Information

What is ZELNORM?

ZELNORMTM (tegaserod) is a prescription medicine used to treat adult women less than 65 years of age with irritable bowel syndrome with constipation (IBS-C).

Important Safety Information

ZELNORM is for use in adult women under 65 years of age who do not have a history of ischemic cardiovascular disease and who have no more than one risk factor for cardiovascular disease. Cardiovascular disease risk factors include active smoking, high blood pressure or history of being treated with medicines that lower blood pressure, high cholesterol or are taking medicine to lower your blood cholesterol levels, history of diabetes, age 55 years or over, or obesity. Talk to your healthcare provider about risk factors you may have for a major cardiovascular event before you start taking ZELNORM.

What is ZELNORM?

ZELNORMTM (tegaserod) is a prescription medicine used to treat adult women less than 65 years of age with irritable bowel syndrome with constipation (IBS-C).

Do not take ZELNORM if you:

  • have had a heart attack, stroke, transient ischemic attack (TIA) or angina.
  • have severe kidney problems or end-stage kidney disease, or moderate or severe liver problems.
  • have or have had inflammation and injury of the intestines caused by reduced blood flow to the intestines (ischemic colitis), intestinal blockage (bowel obstruction), gallbladder problems that caused symptoms, or scar tissue that formed between the tissues and other organs in the abdomen; have or may have had a problem with the muscular valve that controls the flow of digestive juices to the first part of your intestine (sphincter of Oddi).
  • are allergic to ZELNORM.
What are the possible side effects of ZELNORM?

ZELNORM can cause serious side effects, including:

  • Major cardiovascular events, such as stroke, heart attack, and death have happened in adults taking ZELNORM who had an increased risk of a cardiovascular event. Talk to your healthcare provider about cardiovascular risk factors you may have before you start taking ZELNORM, and get emergency medical help right away if you have signs or symptoms of a heart attack, stroke, mini stroke (TIA), or angina (chest pain caused by your heart not getting enough oxygen).
  • Ischemic colitis and other problems of the intestines caused by reduced blood flow to the intestines, that sometimes require hospitalization, have happened in some people taking ZELNORM. Stop taking ZELNORM and get medical help if you have symptoms such as rectal bleeding, bloody diarrhea, or new or worsening stomach-area (abdominal) pain.
  • Diarrhea is a common side effect of ZELNORM, and it can sometimes be severe. Stop taking ZELNORM and call your healthcare provider right away if you have severe diarrhea, especially if you also feel lightheaded or dizzy, or if you faint.
  • ZELNORM may increase the risk of suicidal thoughts and behavior. You, your caregiver, and your family should monitor you for changes in behavior. If you have any new or worsening symptoms of depression, unusual changes in mood or behavior, begin to have suicidal thoughts or behavior, or thoughts of self-harm, stop taking ZELNORM right away and tell your healthcare provider.

The most common side effects of ZELNORM are headache, stomach-area (abdominal) pain, nausea, diarrhea, gas, indigestion, and dizziness.

Before you take ZELNORM, tell your healthcare provider:
  • if you are pregnant or plan to become pregnant. It is not known if ZELNORM will harm your unborn baby.
  • if you are breastfeeding or plan to breastfeed. It is not known if ZELNORM passes into breast milk. You should not breastfeed if you take ZELNORM.
  • if you are an active smoker.
  • if you have or have had high blood pressure or are taking medicine to lower your blood pressure.
  • if you have or have had high blood cholesterol levels or are taking medicine to lower your blood cholesterol levels.
  • if you have or have had diabetes.
  • if you are having diarrhea or have diarrhea often.

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

To report possible adverse reactions, contact Alfasigma USA at 1-855-697-9232. You may also report possible adverse reactions to the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

Please also see the Medication Guide within the full Prescribing Information.

Distributed by: Alfasigma USA, Inc. Covington, LA 70433 © 2019 Alfasigma USA, Inc. ZELNORM is a trademark of Alfasigma USA, Inc. All rights reserved. ALUSA-00069

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