Savings

Lower out-of-pocket costs with the QBREXZA Copay Card

  • *This offer is not valid for patients without commercial insurance or whose prescription claims are eligible to be reimbursed, in whole or in part, by any government program. Please see full terms and conditions at QBREXZA.com/copayterms.

Activate the copay card at
QBREXZA.com/activate

Streamline the access process with CoverMyMeds

Prior Authorization (PA) and Medical Exception (ME) criteria

For those insurance plans that require a Prior Authorization (PA) or Medical Exception (ME),
save time by completing a simple form through CoverMyMeds.com

A pharmacy can also initiate the PA or ME through CoverMyMeds. In this case, you will receive
a fax with a keycode, or you can check your CoverMyMeds portal to complete the process

Health plans commonly require the following criteria to be met prior to providing coverage for
QBREXZA to ensure use in the appropriate patient population:

  • Patient is 9 years of age or older
  • Diagnosis of primary avillary hyperhidrosis ICD-10 Code: L74.510
  • Trial of 20% aluminum chloride (over-the-counter clinical-strength or prescription-strength) antiperspirant and rationale for failure/discontinuation. Indicate which products the patient has tried and failed
  • Physician attestation to significant impairment of the patient’s participation in daily activities

For insurance plans that require a PA or ME you can:

This resource is informational only and not intended to be directive or a guarantee of coverage.

CoverMyMeds tutorial video

Learn how
CoverMyMeds can
streamline the access
process



Understand your patient’s insurance coverage

DermiraConnect helps verify insurance coverage and
provides information on out-of-pocket cost.

Speak with a DermiraConnect
support specialist at
1-877-DERMIRA
(1-877-337-6472)
(Monday-Friday, 8 am-8 pm ET)

Samples of QBREXZA are available at no cost to licensed healthcare
professionals and their patients through our partnership with MySampleCloset.

You can order QBREXZA samples at
MySampleCloset.com


Raise awareness of primary axillary hyperhidrosis within your practice

QBREXZA offers a variety of helpful tools for your
practice to help your patients stay on track
throughout their treatment.

  • QBREXZA Digital Display
  • Sweat Assessment Tool
  • Social Media Kit
  • Sample Letter of Medical Necessity
  • Sample Letter of Appeal
  • QBREXZA Samples

Discover office resources

INDICATION AND IMPORTANT
SAFETY INFORMATION
INDICATION

QBREXZA is an anticholinergic indicated for topical treatment of primary axillary hyperhidrosis in adult and pediatric patients 9 years of age and older.

IMPORTANT SAFETY INFORMATION

Contraindications: QBREXZA is contraindicated in patients with medical conditions that can be exacerbated by the anticholinergic effect of QBREXZA (e.g., glaucoma, paralytic ileus, unstable cardiovascular status in acute hemorrhage, severe ulcerative colitis, toxic megacolon complicating ulcerative colitis, myasthenia gravis, Sjogren’s syndrome).

INDICATION

QBREXZA is an anticholinergic indicated for topical treatment of primary axillary hyperhidrosis in adult and pediatric patients 9 years of age and older.

IMPORTANT SAFETY INFORMATION

Contraindications: QBREXZA is contraindicated in patients with medical conditions that can be exacerbated by the anticholinergic effect of QBREXZA (e.g., glaucoma, paralytic ileus, unstable cardiovascular status in acute hemorrhage, severe ulcerative colitis, toxic megacolon complicating ulcerative colitis, myasthenia gravis, Sjogren’s syndrome).

WARNINGS AND PRECAUTIONS

Worsening of Urinary Retention: QBREXZA should be used with caution in patients with a history or presence of documented urinary retention. Prescribers and patients should be alert for signs and symptoms of urinary retention (e.g., difficulty passing urine, distended bladder), especially in patients with prostatic hypertrophy or bladder-neck obstruction. Instruct patients to discontinue use immediately and consult a physician should any of these signs or symptoms develop. Patients with a history of urinary retention were not included in the clinical studies.

Control of Body Temperature: In the presence of high ambient temperature, heat illness (hyperpyrexia and heat stroke due to decreased sweating) can occur with the use of anticholinergic drugs such as QBREXZA. Advise patients using QBREXZA to watch for generalized lack of sweating when in hot or very warm environmental temperatures and to avoid use if not sweating under these conditions.

Operating Machinery or an Automobile: Transient blurred vision may occur with use of QBREXZA. If blurred vision occurs, the patient should discontinue use until symptoms resolve. Patients should be warned not to engage in activities that require clear vision such as operating a motor vehicle or other machinery, or performing hazardous work until the symptoms have resolved.

ADVERSE REACTIONS

The most common adverse reactions seen in ≥2% of subjects treated with QBREXZA were dry mouth (24.2%), mydriasis (6.8%), oropharyngeal pain (5.7%), headache (5.0%), urinary hesitation (3.5%), vision blurred (3.5%), nasal dryness (2.6%), dry throat (2.6%), dry eye (2.4%), dry skin (2.2%) and constipation (2.0%). Local skin reactions, including erythema (17.0%), burning/stinging (14.1%) and pruritus (8.1%) were also common.

DRUG INTERACTIONS

Anticholinergics: Coadministration of QBREXZA with anticholinergic medications may result in additive interaction leading to an increase in anticholinergic adverse effects. Avoid coadministration of QBREXZA with other anticholinergic-containing drugs.

INSTRUCTIONS FOR ADMINISTERING QBREXZA

Instruct patients to use one cloth to apply QBREXZA to both axillae by wiping the cloth across one underarm, ONE TIME. Using the same cloth, apply the medication to the other underarm, ONE TIME. Inform patients that QBREXZA can cause temporary dilation of the pupils and blurred vision if it comes in contact with the eyes.

Instruct patients to wash their hands with soap and water immediately after discarding the used cloth.

USE IN SPECIFIC POPULATIONS

Pregnancy: There are no available data on QBREXZA use in pregnant women to inform a drug-associated risk for adverse developmental outcomes.

Lactation: There are no data on the presence of glycopyrrolate or its metabolites in human milk, the effects on the breastfed infant, or the effects on milk production. The developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for QBREXZA and any potential adverse effects on the breastfed infant from QBREXZA or from the underlying maternal condition.

Renal Impairment: The elimination of glycopyrronium is severely impaired in patients with renal failure.