Prescribing Information Important Risk Information
 
 
 

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Follow the LILETTA Patient Savings Program®* application steps below:

Step 1: Patient Information Release

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STEP 1: Patient Information Release

In order to participate in the LILETTA Patient Savings Program®, you must meet certain eligibility criteria. During the enrollment process for the program, you will be asked to provide personal information, such as your name, address, phone number, and information related to you insurance and treatment. The information pertaining to you that we collect will be used in accordance with the Allergan Privacy Statement, which can be found at www.allergan.com/privacy.

By enrolling in the LILETTA Patient Savings Program, you agree that you would like to receive and that Allergan and its affiliates and vendor partners may contact you with information related to LILETTA® and the LILETTA Patient Savings Program, including site updates, education, and other Allergan products, services, and programs. You may choose to be contacted by mail or fax. If you later wish to opt out of receiving this information, you may cancel your enrollment in this program at any time by calling 1-855-706-4508.

AGREE

DISAGREE

*Depending on insurance coverage, eligible patients pay $100, then save up to a maximum of $700, for the LILETTA® product. Offer applies to product only, and does not apply to costs associated with medical examination or product administration. Check with your pharmacist or healthcare provider for your copay discount. Patient out-of-pocket expense may vary. Offer not valid for patients enrolled in Medicare, Medicaid, or other federal or state healthcare programs. Program expires 10/31/19. Please see full LILETTA Patient Savings Program® Terms, Conditions, and Eligibility Criteria here.
Indication

LILETTA® (levonorgestrel-releasing intrauterine system) 52 mg is a hormone-releasing system placed in your uterus to prevent pregnancy for as long as you want for up to 5 years.

Important Risk Information About LILETTA

LILETTA does not protect against HIV or STDs.

Available by prescription only.

Please see full Prescribing Information.

Reference: 1. LILETTA (levonorgestrel-releasing intrauterine system) 52 mg [Prescribing Information]. Irvine, CA: Allergan and Medicines360; 2018.