Request Relistor Samples

Get appropriate patients started on RELISTOR tablets in just a few simple steps.

Copay Savings Card

For RELISTOR tablets and subcutaneous injection, many eligible commercially insured patients may pay as little as $0 with our copay card.

Eligibility criteria may apply.

Request Access Support

Request assistance with RELISTOR prescriptions for patients who require reimbursement support.

RELISTOR prescription considerations

When it is time to prescribe RELISTOR for your eligible and commercially insured patients, please refer to the following ICD-10 information:

  • ICD-10-CM code*

  • K59.03

  • Drug-induced
    constipation

ICD-10-CM, International Classification of Diseases, Tenth Revision, Clinical Modification.

*The ICD-10-CM code and all other patient access–related information are provided for informational purposes only. It is the treating physician’s responsibility to determine the proper diagnosis, treatment, and applicable ICD-10-CM code. Salix Pharmaceuticals does not guarantee coverage or reimbursement for the product.

TAKE A PROACTIVE APPROACH TO OIC
WITH RELISTOR

Learn more

RELISTOR® is for adult patients with opioid-induced constipation (OIC) and chronic non-cancer pain.