The Novo Nordisk Hormone Therapy Patient Assistance Program (PAP) embodies our commitment to our patients and the Novo Nordisk Triple Bottom Line. The Hormone Therapy Patient Assistance Program provides medicine to those who need it.
If you are a patient in need of assistance or know someone in need of assistance, please see the applicant instructions below. If approved, a free 90-day supply of medicine will be sent to the prescribing physician’s office. Patients can pick up their medicine at their physician’s office at their convenience.
In order to apply for a free supply of Vagifem® (estradiol vaginal inserts) 10 mcg:
Once completed, the form and any necessary documents should be submitted to Novo Nordisk by mail or fax:
Return by fax to: 1-888-868-9853
Return by mail to:
Novo Nordisk Patient Assistance Program
PO Box 181640
Louisville, KY 40261
Please call Novo Nordisk at 1-888-868-9852 if you have questions.
Indications and Usage:
Vagifem® (estradiol vaginal inserts) is used after menopause to treat menopausal changes in and around the vagina.
Important Safety Information:
Do not start using Vagifem® if you currently have or have had certain cancers. Estrogens may increase the chances of getting certain types of cancers, including cancer of the breast or uterus. Also, do not start using Vagifem® if you have unusual vaginal bleeding, had a stroke or heart attack, currently have or have had blood clots, currently have or have had liver problems, have been diagnosed with a bleeding disorder, are allergic to Vagifem® or any of its ingredients, or think you may be pregnant.
Vagifem® is only used in the vagina; however, the risks associated with oral estrogens should be taken into account.
The most commonly reported side effects of Vagifem® included: headache, breast pain, irregular vaginal bleeding or spotting, stomach/abdominal cramps, bloating, nausea and vomiting, hair loss, fluid retention, and vaginal yeast infection.
Estrogens should be used at the lowest dose possible for your treatment only as long as needed.
Please click here (PDF) for Vagifem® Prescribing Information.
Vagifem® is a prescription medication.
Talk to your doctor to see if Vagifem® is right for you.
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.
Novo Nordisk provides patient assistance for those who qualify. Please call 1-866-310-7549 to learn more about Novo Nordisk assistance programs.
Vagifem® is a registered trademark of Novo Nordisk Health Care AG.
Novo Nordisk is a registered trademark of Novo Nordisk A/S.
Novo Nordisk Inc., 800 Scudders Mill Road, Plainsboro, New Jersey 08536 U.S.A.
© 2017 Novo Nordisk All rights reserved. USA17BIO00017 February 2017