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As low as $0* co-pay for each prescription filled

OTREXUP TOTAL CARE CO-PAY ASSISTANCE PROGRAM

To receive co-pay assistance of up to $250 for each prescription filled, please accurately answer the questions below:

Please see Important Safety Information, including Boxed Warning and full Prescribing Information, at https://www.otrexup.com/.

Are you using this medication to treat any of the following?

To insure each patient is benefiting from the Otrexup Total Care Co-Pay Assistance Program, Antares Pharma, Inc. would like to notify you about updates to the program by email. Please see Important Safety Information when the coupon is printed.