Get a FLOMAX Savings Coupon worth up to $10 now and sign up to receive additional savings



Please see Terms and Conditions

Please fill out the form below to sign up for Matter of FACT™ basics and receive a series of $10 coupons for your FLOMAX prescriptions over the next three months—up to $30 savings. Please note that if you are already enrolled in Matter of FACT™ basics, you are not eligible to sign up again or to receive an additional series of $10 coupons.

Required Information *

First Name *
Last Name *
Address *
City *
State *
ZIP Code *
Date Of Birth *
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Email
Phone

(e.g. 999-999-9999)

Please answer the following few questions so we can start sending you pertinent information and money-saving offers.

  1. When did you start taking your FLOMAX prescription?

    / /

  2. How would you like to receive future communications?

    Email Direct Mail

This information is being collected by Boehringer Ingelheim Pharmaceuticals, Inc. so that we may advertise our products to you and provide you with information about them.

Boehringer Ingelheim Pharmaceuticals, Inc. respects your right to have personal and medical information kept confidential. Boehringer Ingelheim and companies working with Boehringer Ingelheim will use the information you provide, as well as the information obtained about you from the pharmacy, to fulfill your request, and to help develop products, services, and programs. It will not be shared with any other third parties (such as mailing lists).

By checking here and clicking "Sign Up" below, you indicate that you agree to the above and want us to use the information you have provided to send you information and offers relating to BPH and FLOMAX from time to time.
By checking here and clicking "Sign Up" below, you indicate that you agree to the above and allow us to use your information to advertise BPH-related and other products to you. Boehringer Ingelheim may also provide you with useful materials and contact you about health-related topics.

If you do not check either box, we will fill just this one-time request.

You are about to submit the following information. Please click "Sign Up" to verify that all answers are correct. If you need to make changes, click 'Clear Form' to do so.

Important Safety Information
FLOMAX is approved to treat male urinary symptoms due to BPH, also called an enlarged prostate. Only your doctor can tell if you have BPH, not a more serious condition like prostate cancer. Avoid driving or hazardous tasks for 12 hours after your first dose or increase in dose, as a sudden drop in blood pressure may occur, rarely resulting in fainting. If considering cataract surgery, tell your eye surgeon you’ve taken FLOMAX. Common side effects are runny nose, dizziness and decrease in semen.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

Before taking FLOMAX capsules, please see the full Prescribing Information and Patient Information.

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