$20 Rebate Offer

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Full Prescribing Information

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About LUMIGAN^®

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Full Prescribing Information

Home > Tools and Resources > $20 Rebate

$20 Rebate

Allergan (the maker of LUMIGAN

) is offering a $20 rebate to all patients who have just started taking LUMIGAN

ophthalmic solution. If you're taking LUMIGAN

, please complete our online survey in order to print out the $20 rebate form.

E-mail

First Name

Last Name

1.	When did you learn you (or your friend/loved one) had elevated intraocular pressure (IOP)?

Less than a year ago
2 to 5 years ago
Over 5 years ago
I have not been diagnosed with IOP

2.	What medication(s) are you (or your friend/loved one) currently taking?

LUMIGAN® (bimatoprost ophthalmic solution) 0.03%

Xalatan® (latanoprost ophthalmic solution ) 0.005%

Travatan® (travoprost ophthalmic solution) 0.0004% sterile

Timolol® 0.25% and 0.5% (Timolol maleate ophthalmic solution)

ALPHAGAN®P (brimonidine tartrate ophthalmic solution) 0.15% or 0.10%

None of the above

3.	How long have you (or your friend/loved one) been treating elevated intraocular pressure (IOP) with LUMIGAN®?

I am not taking LUMIGAN®
Less than 1 month
1 to 2 months
3 to 4 months
5 months or more

4.	After visiting this website and learning about LUMIGAN®, when do you (or your friend/loved one) plan to ask your doctor about starting LUMIGAN® therapy?

I am currently taking LUMIGAN®
Within the next week
Within the next month
Within the next 6 months
I have no plans to speak with him/her

5.	What is your (or your friend/loved ones) typical co-payment for brand-name medications at a retail pharmacy?

Less than or equal to $10
Between $11 and $20
Greater than $20
No prescription drug benefit
Not sure

6.	Have you (or your friend/loved one) signed up to receive the LUMIGAN® refill reminder, daily treatment reminder, and/or new patient e-mail notice(s)?

Yes
No

Xalatan is a registered trademark owned by Pfizer Inc.

Travatan is a registered trademark owned by Alcon Laboratories, Inc.

Timoptic, Timoptic-XE, and Cosopt are registered trademarks owned by Merck & Co., Inc.

LUMIGAN (bimatoprost ophthalmic solution) 0.03% is for the treatment of high eye pressure, also called intraocular pressure (IOP), in people with open-angle glaucoma or ocular hypertension.

Important Safety Information
LUMIGAN (bimatoprost ophthalmic solution) 0.03% has been reported to cause darkening (pigmentation) of eye color, eyelid skin and eyelashes, as well as increased growth of eyelashes. Pigmentation changes can increase as long as LUMIGAN is used. After stopping LUMIGAN, darkening of eye color is likely to be permanent while darkening of the eyelid skin and eyelash changes may be reversible. The effects of increased darkening beyond 5 years are not known.

The most common side effects are eye redness, growth of eyelashes, and itchy eyes.