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:
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ICD-10-CM code*
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K59.03
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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.