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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. The cost for Elmiron oral capsule 100 mg is around $990 for a supply of 100 capsules, depending on the pharmacy you visit. 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.

Oral Capsule

100 mg Elmiron oral capsule
from $990.44 for 100 capsule
Quantity Per unit Price
100 $9.90 $990.44

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

Print Now

The free Discount Card works like a coupon and 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. Valid at all major chains including Walgreens, CVS Pharmacy, Target, WalMart Pharmacy, Duane Reade and 65,000 pharmacies nationwide.

Elmiron 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: Eligible commercially/private insured patients may pay an initial $5 per fill for a maximum savings of $200 per length of program; for additional information contact the program at 800-526-7736.

Applies to:Elmiron
Number of uses:4 times

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. Must have no prescription coverage for needed medication
  2. Varies. **See below for details
  3. Medication must be for outpatient use only
  4. The patient must also be permanently residing in the US or US territories.
  5. *Some Medicare Part D patients who cannot afford their medicines, and who meet certain financial criteria, may also be eligible for assistance. Please Contact the program for more information (1-800-652-6227). **Please call 1-800-652-6227 or visit Program website for specific FPL income requirements.

Applicable drugs:

  • Elmiron (pentosan polysulfate sodium) Capsule