Patients

The First and Only FDA-Approved Lisinopril Oral Solution for Pediatric Patients Age 6 Years and Older


QBRELIS (lisinopril) is a prescription medicine for the:
  • treatment of high blood pressure in pediatric patients age 6 years and older, as well as adults.
  • treatment of heart failure.
  • treatment of acute myocardial infarction (heart attack); usually taken with other standard treatments, such as thrombolytics, aspirin, and beta blockers.
It’s the first and only FDA-approved oral liquid form of a medicine called lisinopril. Because it’s FDA-approved, you can be sure it’s a high-quality product.

Qbrelis Dosing Information

Your doctor will tell you how much Qbrelis that you or the patient should take. Do not change the dose of Qbrelis unless your doctor tells you to do so.
  • Qbrelis should be taken at the same time every day.
  • Always carefully measure the prescribed dose of Qbrelis before you or the patient takes it.
  • Make sure that you or the patient swallows the entire dose of Qbrelis.
  • If you have questions about Qbrelis, ask your doctor or your pharmacist.
  • Consult your doctor before making any changes to the medication.

Missed a dose of Qbrelis?
If you or the patient misses a dose of Qbrelis, the next dose should be taken at the regular time. Use the normal amount. Do not use more medicine than your doctor has prescribed.

Qbrelis may cause side effects. See additional Important Safety Information below.

Patients May Pay No More Than $30 For Qbrelis*

If you have commercial insurance, you’ll pay no more than $30 for your prescription with the Qbrelis co-pay programs. The automatic savings is instantly applied to your co-pay at the pharmacy. It’s completely paperless, so there are no cards, coupons, or forms.

For eVoucherRx™ questions, please call: 800‐388‐2316 Relay Pharmacy Help Desk/Customer Support.* Or to see a list of participating pharmacies for eVoucherRx, visit http://evoucherrx.relayhealth.com/storelookup.

For Voucher On Demand™ questions, please call: 866-379-6389 Change Healthcare Help Desk/Customer Support.*

See Qbrelis co-pay programs eligibility restrictions, terms, and conditions.
How do I use the Qbrelis co-pay programs?
It’s easy. You don’t need any cards or coupons. Take your Qbrelis prescription to one of many participating pharmacies nationwide. When you pick up your prescription, you’ll get an automatic co-pay reduction that ensures you’ll pay no more than $30 for Qbrelis if your co-pay is $230 or less.

How much money will I save?
Qualifying patients will pay no more than $30 for a Qbrelis prescription. Your savings depends on the amount of your co‐pay above $30.*

*Eligibility Restrictions, Terms, and Conditions

By participating in this savings program, participants understand and agree that the information provided, as well as non-personally identifiable information obtained from the pharmacy, will be shared with the manufacturer and with any companies working with the manufacturer. Participants also affirm that they will not submit, and have not had submitted on their behalf, a claim for reimbursement or coverage for items purchased with this card under Medicaid, Medicare, TRICARE, or any other federal or state government healthcare program, or where prohibited by state law.

  • Offer applies to out‐of‐pocket expenses (co‐pay) greater than $30. Out‐of‐pocket expenses greater than $30 will be covered up to $230 per prescription. If your total out‐of‐pocket cost exceeds $230, you will be responsible for a $30 co‐pay plus any additional amount over $230. If your co‐pay is already $30 or less, this offer does not apply.
  • Offer applies only to Qbrelis patients and associated refills.
  • This offer is not valid for prescriptions paid in part or in full by any federally or state‐funded program, including but not limited to Medicaid, Medicare, Department of Veterans Affairs, Department of Defense, or TRICARE, and where prohibited by law.
  • For questions about eVoucherRx™, please call: 800‐388‐2316 Relay Pharmacy Help Desk/Customer Support.
  • For questions about Voucher On Demand™, please call: 866‐379‐6389 Change Healthcare Help Desk/Customer Support.
  • This savings program cannot be combined with any other coupon, certificate, voucher, or similar offer.
  • Offer good only in the USA at participating retail pharmacies and cannot be redeemed at government‐subsidized clinics. Void where taxed, restricted, or prohibited by law.
  • Offer not extended to clubs, groups, or organizations.
  • Participation in this program must comply with all applicable laws and contractual or other obligations as a pharmacy provider.
  • This is not an insurance program.
  • Participating patients and pharmacists understand and agree to comply with the Terms and Conditions of this offer as set forth herein.
  • Any step‐edits or prior authorizations required by the insurance plan still apply.
  • Silvergate Pharmaceuticals, Inc. reserves the right to modify or cancel this program at any time.
  • eVoucherRx™ and Voucher On Demand™ are not extended on prescriptions for patients:
    • who are cash‐paying customers.
    • using institution-based pharmacies to fill their prescriptions, or who are recipients of federal or state government health care.
    • who are filling their prescriptions at nonparticipating pharmacies.
eVoucherRx™ is a trademark of RelayHealth.
Voucher On Demand™ is a trademark of Change Healthcare.