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With the Patient Assistance Program from HealthWell Foundation, contact the program to see how they can financially help you out.

| Dosage | Quantity | Retail price | GoodRx price |
|---|
| Dosage | Quantity | Retail price | GoodRx price |
|---|
| Dosage | Quantity | Retail price | GoodRx price |
|---|
| 30 vials of 0.4ml | 2 packages | $697.65 | $62.46 |
| 60 vials of 0.4ml | 1 package | $698.02 | $62.46 |
| 5ml of 50mg/ ml | 1 ampule | N/A | $21.23 |
| 25mg | 30 capsules | $125.08 | $35.48 |
| 100mg | 60 capsules | $911.11 | $198.05 |

GoodRx coupon prices last updated on 04/20/26.