Keppra XR Patient Savings Program

With this Patient Savings Coupon, you pay the first $25 of your Keppra XR® or Keppra® co-pay, and we pay the remaining out-of-pocket expense up to $30. This coupon is good for one use only, limited to one coupon per month, per patient. A minimum 30-day supply is required in your purchase. See eligibility rules. Restrictions may apply. Simply click below to print your coupon!

Patient Instructions
To participate in the Keppra XR® or Keppra® Patient Savings Program, print this page and present it to the pharmacist along with your prescription. If you have any questions regarding your eligibility or benefits, call the Keppra XR®/Keppra® Patient Savings Program at 1-800-664-6864.

INDICATION

KEPPRA XR (levetiracetam) is a prescription medicine taken by mouth that is used with other medicines to treat partial onset seizures in people 12 years of age and older with epilepsy. KEPPRA XR is available in two dosage strengths: 500mg and 750mg tablets.

KEPPRA (levetiracetam) is a prescription medicine taken by mouth that is used with other medicines to treat primary generalized tonic-clonic seizures in people 6 years of age and older with certain types of generalized epilepsy, myoclonic seizures in people 12 years of age and older with juvenile myoclonic epilepsy, and partial onset seizures in people 1 month of age and older with epilepsy. KEPPRA is available in tablet strengths of 250mg, 500mg, 750mg, and 1000mg, and 100mg of levetiracetam per mL oral solution.

IMPORTANT SAFETY INFORMATION

KEPPRA and KEPPRA XR may not be for everyone. Ask your healthcare provider if KEPPRA or KEPPRA XR is right for you.

Warnings and Precautions

Antiepileptic drugs, including KEPPRA and KEPPRA XR, may cause suicidal thoughts or actions in a very small number of people, about 1 in 500. Call your healthcare provider right away if you have new or worsening symptoms of depression, any unusual changes in mood or behavior, or suicidal thoughts, behavior, or thoughts about self harm that you have never had before or may be worse than before. KEPPRA and KEPPRA XR may cause extreme sleepiness, tiredness, and weakness, and problems with muscle coordination. You should not drive, operate machinery or do other dangerous activities until you know how KEPPRA or KEPPRA XR affects you. Call your healthcare provider right away if you have a skin rash. Serious skin rashes can happen after you start taking KEPPRA and KEPPRA XR. There is no way to tell if a mild rash will become a serious reaction. Do not stop taking KEPPRA or KEPPRA XR unless instructed by your healthcare provider. Stopping a seizure medication all at once can cause seizures that will not stop, a very serious problem.

Common Adverse Reactions

In clinical trials, the most common side effects seen with KEPPRA XR and other formulations of KEPPRA include sleepiness, weakness, dizziness, and infection.

In clinical trials, the most common side effects seen in people who take KEPPRA include sleepiness, weakness, dizziness, and infection. In addition to those previously listed, the most common side effects seen in children who take KEPPRA include tiredness, acting aggressive, nasal congestion, decreased appetite, and irritability.

Talk to your healthcare provider about other possible side effects with KEPPRA or KEPPRA XR. 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. Please see additional patient information in the KEPPRA Patient Medication Guide and KEPPRA XR Patient Medication Guide at the end of the full prescribing information. This information does not take the place of talking with your healthcare provider about your condition or your treatment.

This coupon must be accompanied by a valid, signed prescription. Not valid for any prescriptions reimbursed, in whole or part, under any federal healthcare plan, including Medicare (including Medicare Part D), Medicaid, similar federal- or state-funded programs (including any state prescription drug assistance programs and the Government Health Insurance Plan available in Puerto Rico), or where otherwise prohibited by law. Not valid for Medicare eligible patients enrolled in an employer-sponsored health plan or employer sponsored prescription drug benefit for retirees.

Product dispensed pursuant to program rules and federal and state laws. Patients and pharmacists are responsible for notifying insurance carriers or other third party who pays for or reimburses any part of the prescription filled using this coupon as may be required by the insurance carriers’ terms and conditions and applicable law. This coupon may not be reproduced and has no cash value. Offer expires on .

UCB reserves the right to amend or end this program at any time without notice.