Are you a health care professional?
Please visit our practitioners’ site

Fill your first RESTASIS^® Ophthalmic Emulsion prescription to receive THREE great offers!

Up to $20 RESTASIS^® rebate
A FREE RESTASIS^® Advantage Patient Support Pack: the information in this kit can help you talk with your doctor to decide if a RESTASIS^® prescription is right for you
Plus, a FREE subscription to Your Health In Sight^®: Allergan’s quarterly newsletter

Register here today, and print out your rebate. Then, just send it back to us with your pharmacy receipt when you fill a prescription for RESTASIS^®. It’s that simple!

Please note that—according to federal and state laws—this offer is not available to patients enrolled in Medicare, Medicaid, any other government health program, or residents of Massachusetts.

Read the rebate offer terms and conditions.

A NOTE ABOUT PRIVACY

Your answers to the survey questions, along with the answers of other individuals, may be shared in an anonymous fashion with other third parties or governmental agencies for research purposes.

Once your information has been released to Allergan, Inc., it will continue to be protected by Allergan’s privacy policy. It will not, however, have the protections of the federal privacy regulations.

You are responsible for reporting delivery of a rebate to any private insurer that pays for, or reimburses you for, any part of the prescription filled.

To receive your rebate and special offers, please fill out the information below.

Sign up Now!

*Required information

*First name: *Last name: *Address: *City:

*State:

*ZIP:

*E-mail address: *Confirm e-mail address: Allergan, Inc. will never make your e-mail address available to third parties.

	*I am not currently enrolled or plan to enroll in Medicare, Medicaid, or any other government healthcare program.

	*Yes, I would like to receive future communications from RESTASIS^®.

	*Yes, I would like to receive future communications from Allergan, Inc.

Indication:

RESTASIS^® Ophthalmic Emulsion helps increase your eyes’ natural ability to produce tears, which may be reduced by inflammation due to Chronic Dry Eye. RESTASIS^® did not increase tear production in patients using anti-inflammatory eye drops or tear duct plugs.

Important Safety Information:

RESTASIS^® Ophthalmic Emulsion should not be used by patients with active eye infections and has not been studied in patients with a history of herpes viral infections of the eye. RESTASIS^® should not be used while wearing contact lenses. If contact lenses are worn, they should be removed prior to use.

The most common side effect is a temporary burning sensation. Other side effects include eye redness, discharge, watery eyes, eye pain, foreign body sensation, itching, stinging, and blurred vision.

Please see product information for RESTASIS^® Ophthalmic Emulsion.

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.

E-mail this page