• Present the Ryzolt^® Prescription Savings Card with a valid prescription for Ryzolt^® to your retail pharmacist.

• Eligible patients will receive up to $35 off out-of-pocket expenses for each eligible Ryzolt^® prescription during the program period
  (expiration 12/31/2011) after the patient pays an initial out-of-pocket payment of $10.

• The Prescription Savings Card can only be used every 24 days and only when accompanied by a valid prescription for Ryzolt^®.

• Once activated, the card is retained by the patient and can only be used by the same patient.

Rules and Restrictions

• The Ryzolt^® Prescription Savings Card is accepted at participating retail pharmacies only. Ask your pharmacy about participation.

• The Ryzolt^® Prescription Savings Card cannot be bought, transferred, or sold.

• Limit of one card per patient.

• You are responsible for reporting the use of this card to any private insurer that pays or reimburses for any part of the prescription filled.

Important Ryzolt^® Value Card Limitations

• This Value Card is not an insurance card.

• Eligibility Criteria/Restrictions: The prescription savings offer is not valid for prescriptions covered in whole or in part by Medicaid/Medicare (including the coverage gap), government-funded health programs, states that have an “all payer” anti-kickback law, or private indemnity or HMO insurance plans which reimburse you for the entire cost of your prescription drugs. This offer is valid in Massachusetts for cash-paying patients only (i.e., those who do not have any prescription coverage). This offer is only good in the U.S. at participating pharmacies, cannot be redeemed at government-subsidized clinics, and is not valid if prohibited by any state or local laws.

• Limit one Ryzolt^® Prescription Savings Card per patient.

• Cannot be combined with any other offer.

• Purdue Pharma L.P. reserves the right to rescind, revoke, or amend this offer without notice.

• Patients with questions please call 1-866-917-9747, 9:00am–5:00pm EST Mon.–Fri.

• Retain your Ryzolt^® Prescription Savings Card–valid for use with eligible prescriptions throughout the program period (expiration 12/31/2011).

• Before you print this Ryzolt^® PRESCRIPTION SAVINGS CARD please review the Important Safety Information and the
  Ryzolt^® Full Prescribing Information.

I have read the Important Safety Information about Ryzolt^®.