Sign up for the ORALAIR co-pay assistance program by filling out and submitting the form below. By signing up for a co-pay card, you can get savings to bring your ORALAIR prescription co-pay down to $15, with a maximum monthly benefit of $100. Eligibility restrictions, terms, and conditions apply

Please fill in the information below. Fields or questions marked with an asterisk (*) are required.

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Register for and activate my new ORALAIR co-pay card
Activate my ORALAIR co-pay card

By providing your information, including your personal contact and health information, you agree to allow GREER® and its agents to obtain and use the information you have provided to communicate with you in the future about your health and treatment with ORALAIR. Specifically, you agree that GREER and its agents may use this information to contact you by e-mail, mail, or phone (if you provide a phone number) and that such electronic or other written communications may include information about products, services, and your health. GREER and its agents will not sell, rent, or otherwise distribute your name and any personally identifiable information outside of GREER and its agents. GREER will use your information in accordance with the GREER Privacy Policy. To stop receiving these communications, you can unsubscribe at any time by following the instructions provided in the communications.





Eligibility restrictions, terms, and conditions

Co-pay card for patients with a valid prescription for ORALAIR.

Valid for most patients with commercial insurance, as well as for cash-paying patients.

  • Commercially insured patients may receive savings to reduce the co-pay amount to $15
  • Cash-paying patients may receive savings of up to $100

Card valid for 30-day prescriptions.
Card valid for 1 use per month, for up to 10 uses.
Card may be used only by eligible residents of the United States.
This offer is not valid for patients covered, in whole or in part, by any state or federally funded healthcare or pharmacy benefit programs, including but not limited to Medicare, Medicaid, VA, or TRICARE, or any qualified health plan purchased on a state-based, partnership, or federally facilitated exchange.
This offer is not an insurance benefit.
No other purchase is necessary.
Eligible patients may be responsible for deductibles or other out-of-pocket costs, depending on their specific healthcare benefits.
This offer will provide savings in patients' co-pay cost for ORALAIR only. It does not cover any other healthcare provider charges or any other treatment costs.
Patient, pharmacist, and prescriber agree not to seek reimbursement for all or any part of the benefit received by the patient through this offer.
Patient is responsible for reporting receipt of co-pay assistance to any insurer, health plan, or other third party who pays for or reimburses any part of the prescription filled using the co-pay card, as may be required.
This offer is nontransferable. No substitutions are permitted. This offer cannot be combined with any other coupon, rebate, free trial, discount, prescription savings card, or other offer.
It is illegal to sell, purchase, trade, or counterfeit, or offer to sell, purchase, trade, or counterfeit, the coupon. Void if reproduced. Void where prohibited by law, taxed, or restricted.
Stallergenes Greer reserves the right to rescind, revoke, amend, or terminate this offer or the program in its entirety at any time.

Important Safety Information

ORALAIR can cause severe allergic reactions that may be life-threatening. Symptoms of allergic reactions to ORALAIR include:

  • Trouble breathing
  • Throat tightness or swelling
  • Trouble swallowing or speaking
  • Dizziness or fainting
  • Rapid or weak heartbeat
  • Severe stomach cramps or pain, vomiting, or diarrhea
  • Severe flushing or itching of the skin

If any of these symptoms occur, stop taking ORALAIR and immediately seek medical care. For home administration of ORALAIR, your doctor should prescribe auto-injectable epinephrine for you to keep at home for treating a severe reaction, should one occur. Your doctor will train and instruct you on the proper use of auto-injectable epinephrine.

Do not take ORALAIR if you or your child:

  • Has severe, unstable, or uncontrolled asthma;
  • Had a severe allergic reaction in the past that included trouble breathing, dizziness or fainting, or rapid or weak heartbeat;
  • Has ever had difficulty with breathing due to swelling of the throat or upper airway after using any sublingual immunotherapy before;
  • Has ever been diagnosed with eosinophilic esophagitis; or
  • Is allergic to any of the inactive ingredients contained in ORALAIR.

Stop taking ORALAIR and contact your doctor if you or your child has any mouth surgery procedures (such as tooth removal), develops any mouth infections, ulcers or cuts in the mouth or throat, or has heartburn, difficulty swallowing, pain with swallowing, or chest pain that does not go away or worsens.

In children and adults, the most commonly reported side effects were itching of the mouth, lips, tongue or throat. These side effects, by themselves, are not dangerous or life-threatening.

You may report side effects to the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

Talk to your doctor before using ORALAIR while pregnant or breastfeeding.

Please see full Prescribing Information, including Boxed Warning and Medication Guide, for additional important safety information.

Important Safety Information

ORALAIR can cause severe allergic reactions that may be life-threatening. Symptoms of allergic reactions to ORALAIR include:

  • Trouble breathing
  • Throat tightness or swelling
  • Trouble swallowing or speaking
  • Dizziness or fainting
  • Rapid or weak heartbeat
  • Severe stomach cramps or pain, vomiting, or diarrhea
  • Severe flushing or itching of the skin

If any of these symptoms occur, stop taking ORALAIR and immediately seek medical care. For home administration of ORALAIR, your doctor should prescribe auto-injectable epinephrine for you to keep at home for treating a severe reaction, should one occur. Your doctor will train and instruct you on the proper use of auto-injectable epinephrine.

Do not take ORALAIR if you or your child:

  • Has severe, unstable, or uncontrolled asthma;
  • Had a severe allergic reaction in the past that included trouble breathing, dizziness or fainting, or rapid or weak heartbeat;
  • Has ever had difficulty with breathing due to swelling of the throat or upper airway after using any sublingual immunotherapy before;
  • Has ever been diagnosed with eosinophilic esophagitis; or
  • Is allergic to any of the inactive ingredients contained in ORALAIR.

Stop taking ORALAIR and contact your doctor if you or your child has any mouth surgery procedures (such as tooth removal), develops any mouth infections, ulcers or cuts in the mouth or throat, or has heartburn, difficulty swallowing, pain with swallowing, or chest pain that does not go away or worsens.

In children and adults, the most commonly reported side effects were itching of the mouth, lips, tongue or throat. These side effects, by themselves, are not dangerous or life-threatening.

You may report side effects to the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

Talk to your doctor before using ORALAIR while pregnant or breastfeeding.

Please see full Prescribing Information, including Boxed Warning and Medication Guide, for additional important safety information.

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ORALAIR® is a registered trademark of Stallergenes Greer or its affiliates.

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