The support program designed
for people taking AMPYRA—
"The Walking Pill®"
MyAmpyra™ is here to create a supportive community for both patients and physicians.
MyAmpyra provides
Tips on taking your
AMPYRA prescription
Personal Walking Assessment
to share with your doctor
Useful information about AMPYRA and walking
Refill reminders by e-mail
Coverage and co-pay assistance
Now that your doctor has prescribed AMPYRA, we're here to provide personalized service to help you every step of the way. We created MyAmpyra to make getting AMPYRA as simple as possible by confirming your eligibility for insurance coverage and enrollment in our co-pay assistance program.*
To help make getting started with AMPYRA a seamless experience, MyAmpyra can also help:
Arrange for a specialty pharmacy to deliver AMPYRA right to your door
Ensure that you work with the same representative every step of the way
* Patients who participate in Medicaid, Medicare, or any other federal healthcare program are not eligible to receive co-pay assistance. See full Terms & Conditions.
Co-pay assistance may be available
If you have commercial insurance
(employer-sponsored or individual), you may be eligible for
co-pay assistance where allowed by law.
This co-pay assistance may lower the
amount you pay for your AMPYRA prescription to as little as
In many cases, AMPYRA out of pocket costs may be less than generic dalfampridine.
Patients must:
- Be 18 years of age or older
- Be prescribed AMPYRA for an FDA-approved indication
- Have commercial health insurance
- Not covered by any federal, state, or government-funded healthcare program, such as Medicare, Medicare Advantage, Medicare Part D, Veterans Affairs, Department of Defense, or TRICARE
This offer is valid only in the United States, excluding where it's otherwise prohibited by law. Patients residing in the states of Massachusetts and Rhode Island are eligible for drug co-payment assistance only and are not eligible for other types of co-payment assistance, including but not limited to costs related to administration of the drug.
Patients who move from commercial to federally funded or state funded insurance will no longer be eligible for the program. Proof required for receiving payment for out-of-pocket drug costs includes a valid explanation of benefits (EOB) or specialty pharmacy invoice, which must be submitted within 180 days after each treatment.
Patient/Guardian may not and agrees not to seek reimbursement for value received from the Program from any third-party payers, including flexible spending accounts or healthcare savings accounts. If at any time patient begins receiving coverage under any federal, state, or government-funded healthcare program, Patient is no longer eligible to participate in the Program and must call 1-855-866-9255 between 8am – 8pm ET to stop participation. Restrictions may apply. This is not health insurance.
Patient/Guardian and pharmacist are responsible for notifying insurance carriers or any other third party who pays for or reimburses any part of the prescription filled using the Program as may be required by the insurance carrier' s terms and conditions and applicable law.
Once a patient is successfully enrolled into the Program, they will be automatically re-enrolled annually, for as long as your patient remains eligible. The patient is obligated to notify the program within thirty (30) days of any change in information provided in patient's enrollment form. The patient may notify the Program at any time to terminate participation in the Program. The patient may submit a new enrollment form to make changes to any Program elections. This offer may not be combined with any other coupon, discount, prescription savings card, free trial, or other offer for AMPYRA.
This is a limited time offer, and Merz reserves the right to rescind, revoke, amend, or terminate this offer, or the program in its entirety, at any time without notice.
Patient Assistance Program
If you have trouble affording your Prescription call 1-855-866-9255.
Have more questions?
Monday through Friday, from 8 AM to 8 PM ET
Are you a healthcare provider?
Get more information on the AMPYRA
healthcare professionals website
INDICATION
AMPYRA® (dalfampridine) is a prescription medicine indicated to help improve walking in adults with multiple sclerosis (MS). This was demonstrated by an increase in walking speed.
IMPORTANT SAFETY INFORMATION
Do not take AMPYRA if you have ever had a seizure, have certain types of kidney problems, or are allergic to dalfampridine (4-aminopyridine), the active ingredient in AMPYRA.
INDICATION & IMPORTANT SAFETY INFORMATION
Indication: AMPYRA (dalfampridine) is a prescription medicine indicated to help improve walking in adults with multiple sclerosis (MS). This was demonstrated by an increase in walking speed.
Important Safety Information
Do not take AMPYRA if you:
- have ever had a seizure,
- have certain types of kidney problems, or
- are allergic to dalfampridine (4-aminopyridine), the active ingredient in AMPYRA.
Take AMPYRA exactly as prescribed by your doctor.
Before taking AMPYRA, tell your doctor if you:
- have any other medical conditions
- are taking compounded 4-aminopyridine
- are taking any other prescription or OTC medicines, such as cimetidine
- are pregnant or plan to become pregnant. It is not known if AMPYRA will harm your unborn baby.
- are breastfeeding or plan to breastfeed. It is not known if AMPYRA passes into your breast milk. Talk with your healthcare provider about the best way to feed your baby if you take AMPYRA.
Stop taking AMPYRA and call your doctor right away if you have a seizure while taking AMPYRA. You could have a seizure even if you never had a seizure before. Your chance of having a seizure is higher if you take too much AMPYRA or if your kidneys have a mild decrease of function, which is common after age 50. Your doctor may do a blood test to check how well your kidneys are working before you start AMPYRA.
AMPYRA should not be taken with other forms of 4-aminopyridine (4-AP, fampridine), since the active ingredient is the same.
AMPYRA may cause dizziness or vertigo. If you have these symptoms do not drive, operate machinery or do other dangerous activities.
AMPYRA may cause serious side effects, including severe allergic reactions. Stop taking AMPYRA and call your doctor right away or get emergency medical help if you have shortness of breath or trouble breathing, swelling of your throat or tongue, or hives.
The most common side effects for AMPYRA in MS patients were urinary tract infection; trouble sleeping; dizziness; headache; nausea; weakness; back pain; problems with balance; multiple sclerosis relapse; burning, tingling, or itching of your skin; irritation in your nose and throat; constipation; indigestion; and pain in your throat.
Please see the Patient Medication Guide.