Free Trial Voucher
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To redeem your offer:

  • 1. Print your free trial voucher.
  • 2. Ask your doctor if BENICAR or BENICAR HCT is right for you.
  • 3. Present your voucher at the pharmacy together with a valid prescription for BENICAR or BENICAR HCT.
  • 1. Ask your doctor if BENICAR or BENICAR HCT is right for you.
  • 2. Present this voucher at the pharmacy together with a valid prescription for BENICAR or BENICAR HCT.
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*Terms and conditions apply.
Pharmacist: Limit One TrialScript® voucher per patient. Redeem for product only when accompanied by a valid, signed prescription form for BENICAR or BENICAR HCT. Submit claim to McKesson Corporation using BIN #610524. For pharmacy processing questions, please call the Help Desk at 1-800-657-7613.

Expiration Date: 06/30/2014

See important restrictions and eligibility requirements on next page.
RxBIN: 610524
RxPCN: 1016
RxGRP: 40025646
ISSUER: (80840)
ID:
XXXXX
WARNING: DO NOT TAKE BENICAR OR BENICAR HCT DURING PREGNANCY
  • BENICAR and BENICAR HCT can cause harm or death to an unborn baby
  • Talk with your doctor about other ways to lower your blood pressure if you become pregnant
  • If you get pregnant while taking BENICAR or BENICAR HCT, tell your doctor immediately
Please see the WARNINGS AND PRECAUTIONS section of the Full Product Information about Fetal Toxicity.

Please see Important Safety Information below. Please see Important Safety Information on pages 2-5.
Please see Full Prescribing Information for BENICAR and BENICAR HCT, including Boxed WARNING regarding Fetal Toxicity, on www.BENICAR.com.

 

To the Patient:

It is illegal for any person to sell, purchase, or trade; or to offer to sell, purchase, or trade or to counterfeit this voucher. This voucher is valid for redemption at retail outpatient pharmacies only. This voucher must be accompanied by a valid prescription for BENICAR or BENICAR HCT. No purchase required. Product dispensed pursuant to terms of voucher shall not be submitted to any third-party payer, public (eg, Medicaid, Medicare, Veterans Administration, Tricare/Champus or any other similar federal or state healthcare program) or private, for reimbursement. Not valid if reproduced or submitted to other payer. Offer good only in the United States. Offer cannot be combined with any other free trial, coupon, rebate, or similar offer. Daiichi Sankyo reserves the right to rescind, revoke, or amend this voucher program without notice. Void where prohibited by law.


To the Pharmacist:

Please dispense 14 tablets of one of the following medications, as applicable: BENICAR 5 mg, BENICAR 20 mg, BENICAR 40 mg, BENICAR HCT 20/12.5 mg, BENICAR HCT 40/12.5 mg, or BENICAR HCT 40/25 mg when accompanied by a valid prescription at no co-pay or cost to the patient. Not to be used in lieu of patient co-payment for another prescription. This voucher is valid for BENICAR and BENICAR HCT sample use only—no substitutions permitted. Product dispensed pursuant to terms of card shall not be submitted to any third-party payer, public (eg, Medicaid, Medicare, Veterans Administration, Tricare/Champus or any other similar federal or state healthcare program) or private, for reimbursement. Lifetime limit of one voucher per patient. Refills are not permitted with this voucher. Please remove this identification number from the patient profile after the claim is processed. For assistance in filing this claim, please call the Help Desk 1-800-657-7613. Product dispensed pursuant to terms of voucher shall only be submitted to McKesson for payment. Void where prohibited by law.


Daiichi Sankyo reserves the right to rescind, revoke, or amend this voucher program without notice. Void where prohibited by law.


INDICATIONS

BENICAR and BENICAR HCT are prescription medicines used to lower high blood pressure (hypertension). They may be used alone or with other medicines used to treat high blood pressure. BENICAR HCT is not for use as the first medicine to treat high blood pressure.


BENICAR® and BENICAR HCT® Important Safety Information

WARNING: DO NOT TAKE BENICAR OR BENICAR HCT DURING PREGNANCY
  • BENICAR and BENICAR HCT can cause harm or death to an unborn baby
  • Talk with your doctor about other ways to lower your blood pressure if you become pregnant
  • If you get pregnant while taking BENICAR or BENICAR HCT, tell your doctor immediately
Please see the WARNINGS AND PRECAUTIONS section of the Full Product Information about Fetal Toxicity.

Please see Full Prescribing Information for BENICAR and BENICAR HCT, including Boxed WARNING regarding Fetal Toxicity, on www.BENICAR.com.

Benicar

 

Children that are less than 1 year of age must not receive BENICAR for high blood pressure.


Before taking BENICAR or BENICAR HCT, tell your doctor if you are pregnant or plan to become pregnant. Also tell your doctor if you are breast-feeding or plan to breast-feed. A medicine in BENICAR HCT can pass into your breast milk. This may harm your baby. You and your doctor should decide if you will take BENICAR or BENICAR HCT or breast-feed. You should not do both.


Do not take BENICAR or BENICAR HCT if you:

Do not take BENICAR HCT if you:

Let your doctor know about any health conditions you may have


Tell your doctor if you are allergic to any of the ingredients in BENICAR or BENICAR HCT (see Full Product Information for a list of the ingredients in BENICAR and BENICAR HCT). Also let your doctor know if you have any of the health conditions listed below:

Before you take these medicines:

Let your doctor know if you have these, or any other, medical conditions:

BENICAR

  • Kidney problems
  • A lot of diarrhea or are vomiting

BENICAR HCT

  • Kidney or liver problems
  • Lupus
  • A lot of diarrhea or are vomiting

Please see Full Prescribing Information for BENICAR and BENICAR HCT, including Boxed WARNING regarding Fetal Toxicity, on www.BENICAR.com.

Benicar

 

Tell your doctor about all the medicines you take


Some of your other medicines and BENICAR or BENICAR HCT could affect each other. This may cause serious side effects.

These medicines may include prescription and nonprescription medicines, vitamins, and herbal supplements:

If you take BENICAR, tell your doctor if you also take:

  • Water pills (diuretics)
  • Other medicines for high blood pressure or a heart problem
  • Potassium supplements or a salt substitute that contains potassium
  • Pain or arthritis medicines, such as aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Welchol® (colesevelam hydrochloride)

If you take BENICAR HCT, tell your doctor if you also take:

  • Water pills (diuretics)
  • Other medicines for high blood pressure or a heart problem
  • Potassium supplements or a salt substitute that contains potassium
  • Pain or arthritis medicines, such as aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Diabetes medicine, including insulin
  • Narcotic pain medicine
  • Sleeping pills and antiseizure medicines called barbiturates
  • Lithium for certain types of depression
  • Steroids
  • Cholesterol-lowering medicines
  • Welchol® (colesevelam hydrochloride)

Please see Full Prescribing Information for BENICAR and BENICAR HCT, including Boxed WARNING regarding Fetal Toxicity, on www.BENICAR.com.

Benicar

 

About alcohol and other drug interactions


If you are taking BENICAR HCT, do not drink alcohol. Your blood pressure may become too low if you drink alcohol.

Some of your other medicines and BENICAR or BENICAR HCT could affect each other. This may cause serious side effects. Take BENICAR or BENICAR HCT as prescribed by your doctor. Talk with your doctor before you stop taking BENICAR or BENICAR HCT.


Know about possible side effects of BENICAR and BENICAR HCT


BENICAR and BENICAR HCT may cause serious side effects. These may include injury or death to an unborn baby; low blood pressure (hypotension), which may cause you to feel faint or dizzy; and kidney problems, which may get worse in people with kidney disease. If you have kidney problems, you may need blood tests, and your doctor may need to lower your dose. Tell your doctor if you get swelling in your feet, ankles, or hands, or have unexplained weight gain. These may be signs of kidney problems. If you have heart failure, your doctor should also check your kidney function before prescribing these medicines.

Because of the thiazide diuretic (water pill), an ingredient in BENICAR HCT, other serious side effects may include allergic reactions and changes in body salts (such as sodium and potassium) and fluids. Tell your doctor if you have these signs and symptoms: dry mouth, thirst, weakness, tiredness or sleepiness, restlessness, confusion, seizures, muscle pains or cramps, muscle tiredness, dizziness or fainting, having little or no urine output, fast heartbeat, or nausea and vomiting.

The thiazide diuretic in BENICAR HCT can also cause eye problems, which may lead to vision loss. Symptoms can happen within hours to weeks of starting BENICAR HCT. Tell your doctor if you have a decrease in vision or eye pain.

The most common side effect of BENICAR and BENICAR HCT was dizziness. Other side effects of BENICAR HCT included upper respiratory tract infections, more uric acid in the blood, and nausea.

Tell your doctor if you have any side effect that bothers you or does not go away. These are not all the possible side effects of BENICAR and BENICAR HCT. For more information, talk with your doctor or pharmacist. Call your doctor for medical advice about side effects.

To report side effects, contact Daiichi Sankyo, Inc., at 1-877-437-7763 or the FDA at 1-800-332-1088 or www.fda.gov/medwatch.


Please see Full Prescribing Information for BENICAR and BENICAR HCT, including Boxed WARNING regarding Fetal Toxicity, on www.BENICAR.com.

Benicar