Proctofoam HC Patient assistance program
Complete a free online enrollment application to find out if you’re eligible to pay only $49 per month for your Proctofoam HC medication with our help.Get started today
- Secure: Your personal and medical information is safe with us
- Convenient: We manage the whole process and we’re here to assist you
- Ongoing refills: We request your medication refills on your behalf
NiceRx works with your healthcare provider to help you access affordable medications directly from U.S. pharmaceutical companies.
An introduction to NiceRx(01:52)
Next steps after qualifying(00:38)
Uploading documents and billing(00:50)
SSN & billing information(00:33)
Medication delivery time(00:41)
How it works
Get started by filling out the online enrollment application to find out if you are eligible.
NiceRx verifies your eligibility for medication assistance and notifies you if you are qualified. The pharmaceutical company provides your medication for free and you only pay our service fee.
You may be required to submit further information and documents required by the pharmaceutical company which can be securely uploaded online.
Your application is created and sent to your doctor for signature. At this stage, you will be billed $49 and will not be billed again until you receive your first medication delivery.
Your application is sent to the pharmaceutical company. You will be billed again once you receive your medication. We handle the entire ordering process including requesting ongoing refills.
Your monthly Proctofoam HC cost savings if eligible
If you are eligible for the Proctofoam HC patient assistance program you can receive your medication for free. Our monthly service fee of $49 per medication covers the cost of our services in applying for the program and requesting your ongoing refills on your behalf. If you obtain your Proctofoam HC through NiceRx, you will only pay $49 a month regardless of the retail price of your medication.
Am I eligible for the Proctofoam HC patient assistance program?
You could receive your Proctofoam HC without paying the full retail price if you meet the eligibility criteria for assistance. The eligibility requirements are set by the pharmaceutical companies that are providing assistance programs. At NiceRx, we review each application individually, although the main factors considered by most programs are:
- I am a permanent, legal resident of the United States or Puerto Rico
- I am uninsured or my insurance doesn’t cover my medication
- I meet certain income eligibility requirements
How do I apply for Proctofoam HC patient assistance?
We do everything that we can to take the hassle and stress out of applying for patient assistance programs. Simply start by filling in our enrollment application. We will ask for details about your healthcare provider, your insurance, and your household income. This information is required by the pharmaceutical companies you are applying to for assistance. We may also be able to help you access patient assistance for other medications that you have been prescribed, so be sure to tell us about any medications you are taking as well as Proctofoam HC.
NiceRx will review the information you have provided, and if we determine that you may be eligible for assistance, we will seek to enroll you in the Proctofoam HC patient assistance program. We will handle the enrollment process for you by working with your healthcare provider and preparing all the required paperwork for your doctor to sign. We will also request your Proctofoam HC medication refills on your behalf for up to 1 year once you are enrolled in the program.
Is NiceRx a Proctofoam HC coupons provider?
At NiceRx, we help eligible individuals access the Proctofoam HC patient assistance program. This means that we are not a Proctofoam HC coupon, a Proctofoam HC discount card, or a Proctofoam HC copay card provider. We do not offer any medication trial offers, or free Proctofoam HC samples.
Can NiceRx help me get Proctofoam HC if I have insurance?
We may be able to help you if you have insurance, including if your insurance company will not pay for your Proctofoam HC medication, or you have a high copay or coinsurance responsibility. We may even be able to assist if you do not have insurance. Please fill in our enrollment application to find out more.
How much does Proctofoam HC cost without insurance?
Proctofoam HC costs without insurance will vary depending on how much you buy and the retailer you buy it from. As a guide, Proctofoam HC rectal foam (1%-1%) will typically cost around $170 for 10 grams. If you obtain your medication through NiceRx, you will pay a flat monthly rate of $49 per medication regardless of its retail price.
How much does Proctofoam HC cost with insurance?
The copay of Proctofoam HC will vary in line with the specific terms of your healthcare plan. For further details about what you may need to pay, your insurance provider or pharmacist will be able to calculate the copay costs with your current insurance.
What is Proctofoam HC?
Proctofoam HC is an FDA (U.S. Food and Drug Administration) approved medication manufactured by Duchesnay. Proctofoam HC is a topical aerosol foam used to treat minor pain, itching, swelling, and discomfort caused by hemorrhoids and other problems of the anal area (anal fissures). This medication contains pramoxine, as a local anesthetic that works by temporarily numbing the area, and hydrocortisone, a corticosteroid (steroid) that acts as an anti-inflammatory agent that reduces redness, itching, and rectal irritation.
What doses of Proctofoam HC are available?
Proctofoam HC is available as a rectal foam, in the following doses: pramoxine hydrochloride 100mg in 10g, hydrocortisone acetate 100mg in 10g.
Shake well before use. Hold the aerosol upright to use. This medicine is for rectal use only. Do not take Proctofoam HC (pramoxine and hydrocortisone rectal foam) by mouth. Wash your hands before and after use. Use an applicator to put in rectal foam. Apply to the affected area 3 to 4 times daily. Do not put the applicator into the rectum. After each use, applicator parts should be pulled apart for thorough cleaning with warm water. Store upright at room temperature.
Please read the drug information leaflet and always speak with your healthcare professional for medical advice or about any changes to your dose so they can monitor and evaluate your condition.
Proctofoam HC active ingredients
Proctofoam HC contains hydrocortisone acetate or pramoxine hydrochloride as the active ingredients.
Proctofoam HC side effects
The most common side effects of Proctofoam HC in clinical trials include:
- Dry skin, burning, and itching
In rare instances, Proctofoam HC can cause more serious side effects. These can include:
- An allergic reaction, like rash, hives, itching, blistered, or peeling skin with or without fever, wheezing, tightness in the chest or throat, difficulty breathing, swallowing, or talking, swelling of the mouth, face, lips, tongue, or throat
- Vomiting, severe dizziness or feeling faint, muscle weakness, tiredness, mood changes, loss of appetite, or weight loss
- Cushing’s disease – weight gain in the upper back or belly, moon face, severe headache, or slow healing
- High blood sugar – confusion, drowsiness, increased thirst, increased appetite, passing urine more often, flushing, fast breathing, fruity odor to your breath
- Very bad bleeding from the rectum or rectal pain
Your doctor will assess the benefits of using Proctofoam HC against your risk of side effects. Patients are encouraged to report negative side effects or adverse reactions of Proctofoam HC to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.
Proctofoam HC drug interactions
There is currently no data available for Proctofoam HC interactions with other medications. Tell your healthcare provider about all the medicines you take, including prescription drugs and over-the-counter medicines, vitamins, and herbal supplements.
Proctofoam HC contraindications
You should not use Proctofoam HC if you:
- Are allergic to the active ingredients hydrocortisone acetate or pramoxine hydrochloride
- Are allergic to any of the other ingredients in Proctofoam HC
Talk to your doctor before using Proctofoam HC if you:
- Are taking any of the medications that could interact with Proctofoam HC
- Are a child – this medicine may affect growth in children and teens
- Are pregnant or are planning to become pregnant
- Are breastfeeding or are planning to breastfeed – it is not known if this medication passes into breast milk
Proctofoam HC generic
Proctofoam HC is the trademark brand name for hydrocortisone acetate and pramoxine hydrochloride manufactured by Duchesnay. A generic version of hydrocortisone acetate and pramoxine hydrochloride is available. Generic drugs are generally cheaper than brand-name drugs, but you can still find Proctofoam HC savings through NiceRx.
*Qualifying persons may obtain medications directly from patient assistance programs without any out-of-pocket cost (or for less than $49 per medication). However, our monthly flat rate of just $49 per medication spares you the hassle of tracking down the different programs and filling out all the required paperwork for each program.
Enrollees enjoy a full-service solution, as NiceRx assists them and their physicians with the entire process. We prepare all required documents for the physician to sign, help enrollees manage all prescription refills, monitor eligibility criteria, and maintain enrollment.
**If you do not receive medications because you were determined to be ineligible for the prescription assistance by the applicable pharmaceutical companies and you have a letter of denial, we will refund any fees you paid toward medications for which you did not qualify to receive prescription assistance (“Refund”).
To receive a refund, you must send the letter of denial to us by fax to 888-517-7444, or by e-mail to [email protected] within 30 days of your receipt of such letter. The Refund is your sole and exclusive remedy for any fees you may wish to dispute.
The content on this website is intended for information purposes only. It does not constitute medical advice. The information on this website should not be relied upon and is not a substitute for professional medical advice. You should always speak to your doctor regarding the risks and benefits of any treatment.