Patient Assistance Program

The Valeant Patient Assistance Program is designed to offer free medicine to patients who are financially disadvantaged. This program is available to patients who:

  • Meet the household income guidelines for the program
  • Are legal residents of the 50 United States
  • Do not have prescription coverage
  • Do not have resources from government or private programs to pay for medicine

Applications must be completed and signed by the patient and the physician, and can be requested by calling (866) 268-7325. The Valeant Patient Assistance Program includes, but is not limited to, the following prescription medicines:


Ancobon Capsules® (flucytosine)
Cuprimine® (penicillamine) 250 mg
Demser® (metyrosine) 250mg
Diastat® AcuDial™ 10 mg (diazepam rectal gel)
Diastat® AcuDial™ 20 mg (diazepam rectal gel)
Diastat® Gel 2.5 mg (diazepam rectal gel) 
Edecrin® (ethacrynic acid), 25 mg
Elidel® (pimecrolimus) Cream
Lacrisert® (hydroxypropyl cellulose ophthalmic insert), 5 mg
Lodosyn® (carbidopa), 25 mg
Mephyton® (phytonadione), 5 mg
Mestinon® 60 mg Syrup (pyridostigmine bromide, USP)
Mestinon Timespan Tablets® 180 mg (pyridostigmine bromide, USP)
Migranal® (dihydroergotamine mesylate, USP) Nasal Spray
Mysoline (primidone) 50mg and 250mg 
Oxsoralen-Ultra® Capsules (Methoxsalen, USP, 10mg)
Prostigmin® Tablets, 15 mg (Neostigmine Bromide)
Syprine® (trientine hydrochloride), 250 mg
Tasmar® (Tolcapone) Tablets
Timoptic® Ocudose®, 0.25% and 0.50%
Zelapar® (Selegiline HCl) Orally Disintegrating Tablets
Zovirax® (acyclovir) Cream and Ointment