Prescribing Information Important Risk Information

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Follow the LILETTA Patient Savings ProgramSM* application steps below:

STEP 1: Patient Information Release

In order to participate in the LILETTA Patient Savings ProgramSM,* you must meet certain eligibility criteria. During the enrollment process for the program, you will be asked to provide personal information, such as your name, address, phone number, email address, and information related to your insurance and treatment. The information pertaining to you that we collect will be used in accordance with the Allergan Privacy Statement, which can be found at


STEP 2: Confirm Eligibility
STEP 3: Review Terms and Conditions
STEP 4: Complete Enrollment
*Depending on insurance coverage, eligible patients may pay no more than $75 for LILETTA, up to a maximum savings limit of $500. Offer applies to product only, and does not apply to costs associated with medical examination or product administration. Check with pharmacist or healthcare provider for copay discount. Patient out-of-pocket expense may vary. Offer not valid for patients enrolled in Medicare, Medicaid, or other federal or state healthcare programs. Please see full LILETTA Patient Savings ProgramSM Terms and Conditions here.

LILETTA® (levonorgestrel-releasing intrauterine system) 52 mg is a hormone-releasing system placed in your uterus to prevent pregnancy for as long as you want for up to 4 years.

Important Risk Information About LILETTA

LILETTA does not protect against HIV or STDs.

Available by prescription only.

Please see full Prescribing Information.

Reference: 1. LILETTA (levonorgestrel-releasing intrauterine system) 52 mg [Prescribing Information]. Irvine, CA: Allergan and Medicines360; 2017.