Your eye doctor and/or pharmacist has decided which treatment is best for your eyes. It's up to YOU to decide whether or not you want to save as you stay on this therapy! Here's how it works.
Program Information for RESTASIS® 30-Day Prescription Users
Each time you are ready to fill/refill your RESTASIS® (cyclosporine ophthalmic emulsion) 0.05% prescription, follow these 5 easy steps:
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Have your prescription for RESTASIS® filled at your pharmacy.
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Make sure you get 2 trays (30-day supply—60 vials total) when you get your prescription for RESTASIS®
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Circle your out-of-pocket purchase price on the receipt.
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To receive your personal organizer, send your original pharmacy receipt (proof of purchase)—along with your full name, address, and telephone number—to
RESTASIS® My Tears, My Rewards® Program
P.O. Box 6513
West Caldwell, NJ 07007 -
Once you send your original pharmacy receipt, we will send your personal organizer to the address your provided within 6 to 8 weeks. Turn to Tab 2 (Rebates and Rewards) to learn how to continue saving.
Program Information for RESTASIS® 90-Day Prescription Users
For enrollees with a 3-month (90-day supply) prescription refill:
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Mail in your first preprinted certificate self-mailer along with your original 3-month (90-day supply) mail order receipt (proof of purchase) to
RESTASIS® My Tears, My Rewards® Program
P.O. Box 6513
West Caldwell, NJ 07007 -
Mail the receipt for your second 3-month (90-day) supply using the self-mailer for month #4 (skip the self-mailers for months 2 and 3)
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Mail the receipt for your third 3-month (90-day) supply using the self-mailer for month #7 (skip the self-mailers for months 5 and 6)
We'll credit your 3-month receipt toward your earned rewards for that 3-month period.
For REFRESH® Brand Lubricant Eye Drop Users
If you are currently taking an artificial tear:-
Send 3 box tops from any artificial tear box (proof of purchase) to
REFRESH® Brand Lubricant Eye Drops
My Tears, My Rewards® Program
P.O. Box 6513
West Caldwell, NJ 07007 -
In 3 to 4 weeks, you'll receive
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Your My Tears, My Rewards® Program personal organizer
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A $3 coupon toward any REFRESH® Brand Lubricant Eye Drop product
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Important eye care information
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Want to learn more about the rewards you can earn?
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.
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 product information for RESTASIS® Ophthalmic Emulsion.