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| Drug Information | |
| Drug | Cimetidine 300mg |
| Brand Equivalent | Cimetidine 300mg |
| Class | Histamine-2 Antagonist |
| Topic | Gastroenterology |
| Program Contact Info / Application Submission | |
| Program | Xubex Patient Assistance Program |
| Company | Xubex |
| Form | Download PDF |
| Address | PO Box 1244 Winter Park, Fl 32790-1244 |
| Phone | 866-699-8239 |
| Fax | 407-671-7960 |
| Website | http://www.xubex.com |
| Program Requirements | |
| Details | Insurance card required Drivers license required |
| Delivery of Medication | |
| Ship Time | 7 - 10 business days |
| Delivery Options | Can NOT be delivered directly to the patient Can NOT be delivered directly to the doctor Shipped as a voucher card |
| Application Process | |
| New Applications | New applications NOT accepted Patients can NOT apply directly to the program Doctors can NOT apply directly to the program Advocates can NOT apply directly to the program Can apply for a new application via phone Can NOT apply for a new application via fax Can NOT apply for a new application via mail |
| Refills | Refills NOT accepted Patients can NOT apply for refills Doctors can NOT apply for refills Advocates can NOT apply for refills Can NOT apply for refills via phone Can NOT apply for refills via fax Can NOT apply for refills via mail |
| Re-Applications | Re-Applications NOT accepted Patients can NOT apply for Re-Applications Doctors can NOT apply for Re-Applications Advocates can NOT apply for Re-Applications Can Re-Apply via phone Can NOT Re-Apply via fax Can NOT Re-Apply via mail |
| Appeals | Income Appeals accepted Patients can apply for Income Appeals Doctors can apply for Income Appeals Advocates can apply for Income Appeals Hardship Appeals accepted Patients can apply for Hardship Appeals Doctors can apply for Hardship Appeals Advocates can apply for Hardship Appeals Can apply for an appeal via phone Can apply via fax Can apply for an appeal via mail |
| Appeals | |
| Conditions | Appeals must be made after the patient has been denied |
| Other Medications | |
| Other Medications available in this program | |
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