Medication Guide App

Elmiron Prices, Coupons and Patient Assistance Programs

Elmiron (pentosan polysulfate sodium) is a member of the miscellaneous genitourinary tract agents drug class and is commonly used for Bladder Infection and Interstitial Cystitis.

Elmiron Prices

This Elmiron price guide is based on using the discount card which is accepted at most U.S. pharmacies. Prices are for cash paying customers only and are not valid with insurance plans.

Elmiron is available as a brand name drug only, a generic version is not yet available. For more information, read about generic Elmiron availability.


100 mg Elmiron capsule
from $480.55 for 100 capsule
Quantity Per unit Price
100 $4.81 – $7.26 $480.55 – $725.85

Important: When there is a range of pricing, consumers should normally expect to pay the lower price. However, due to stock shortages and other unknown variables we cannot provide any guarantee. Printable Discount Card

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The free Discount Card can save you up to 80% or more off the cost of prescription medicines, over-the-counter drugs and pet prescriptions.

Please note: This is a drug discount program, not an insurance plan.

Manufacturer Coupons and Rebates

Elmiron offers may be in the form of a printable coupon, rebate, savings card, trial offer, or free samples. Some offers may be printed right from a website, others require registration, completing a questionnaire, or obtaining a sample from the doctor's office.

Elmiron EarlyAssist Savings Card: Pay as little as $5 per month for up to 4 months; for additional information contact the program at 866-917-9748.

Applies to:Elmiron
Number of uses:4 times
ExpiresJune 30, 2015

Patient Assistance Programs for Elmiron

Patient assistance programs (PAPs) are usually sponsored by pharmaceutical companies and provide free or discounted medicines to low income or uninsured and under-insured people who meet specific guidelines. Eligibility requirements vary for each program.

Provider: Johnson & Johnson Patient Assistance Foundation, Inc. Patient Assistance Program

Elligibility requirements:

  1. The patient must have no prescription coverage for the requested medication and
  2. Meet income guidelines that are not disclosed.
  3. Medical diagnosis necessary for this program is not specified.
  4. US residency requirements are not specified.
  5. Medicare LIS (Low Income Subsidy) eligible patients are not eligible to receive assistance through this program. This Program participates in the CPAPA. This single common application allows uninsured HIV-positive individuals with low incomes to use one application to apply for multiple assistance programs. IMPORTANT: Send completed CPAPA to the corresponding addresses listed for each company. Contact program for Spanish application.

Applicable drugs:

  • Elmiron (pentosan polysulfate sodium) Capsule 100mg