TEVA Patient Assistance Program Covered Medications

TEVA Patient Assistance Program Covered Medications List

This is a complete list of medications that you may be able to receive for free from TEVA is you qualify for the TEVA Patient Assistance Program

  1. Cyclosporine CapsulesModified
  2. Cyclosporine Oral Solution Modified
  3. GALZIN (zinc acetate) Capsules
  4. ORAP (pimozide) Tablets
  5. ProAir HFA (albuterol sulfate) Inhalation Aerosol
  6. Proglycem (diazoxide, USP) Oral Suspension
  7. PURINETHOL (mercaptopurine) Tablets **
  8. QNASL (beclomethasone diproprionate) Nasal Aerosol
  9. QVAR (beclomethasone dipropionate HFA)
  10. Vivactil(protriptyline HCI) Tablets, USP

** Existing PAP patients only; not accepting new Purinethol enrollments effective July 2006

About TEVA Patient Assistance Program

The TEVA PAP is a program brought to you by TEVA Respiratory.  Teva Respiratory helps those with asthma, COPD, and EIB (exercise induced bronchospasm) afford their medications.  You must meet the requirements to qualify for this program:


  • Be a resident of the United States, Puerto Rico, or the U.S. Virgin Islands
  • Not be eligible for any prescription drug benefits through any private or public insurer/payer/program
  • Have a total family annual income of 200%—or less—of the federal poverty level for your state
  • Have a prescription for one or more of the Teva medicines listed on the application


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