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Elmiron Prices, Coupons and Patient Assistance Programs

Elmiron is available as a brand name drug only, a generic version is not yet available. See generic Elmiron availability.

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

The cost for Elmiron oral capsule 100 mg is around $1,118 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.

This Elmiron price guide is based on using the discount card which is accepted at most U.S. pharmacies.

Oral Capsule Printable Discount Card

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.

Print Free Discount Card

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, Copay Cards and Rebates

Elmiron offers may be in the form of a printable coupon, rebate, savings or copay 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 insured patients pay $5 per fill for a maximum savings of $150; maximum annual savings of $1800 per calendar year; for additional information contact the program at 800-526-7736.

Applies to:
Number of uses:
per prescription per calendar year

Form more information phone: 800-526-7736 or Visit website

Patient Assistance & Copay Programs for Elmiron

Patient assistance programs (PAPs) are usually sponsored by pharmaceutical companies and provide free or discounted medicines and copay programs 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

More information please phone: 800-652-6227 Visit Website