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NYS Medicaid Pharmacy Programs

oxazolidinone antibiotics (Sivextro®, Zyvox®)

oxazolidinone antibiotics (Sivextro®, Zyvox®)

Prior Authorization Call Line: 1-877-309-9493

Prior Authorization Fax Line: 1-800-268-2990

Prior authorization for oxazolidinone antibiotics (Sivextro®, Zyvox®) has been implemented to address potential misutilization and inappropriate prescribing, which could result in bacterial resistance adversely affecting the health of all New Yorkers. Requests for prior authorization of oxazolidinone antibiotics can be initiated by either prescribers or their authorized agents. An authorized agent is an employee of the prescribing practitioner and has access to the patient's medical records (i.e. nurse, medical assistant).

  • linezolid (Zyvox®)
  • tedizolid (Sivextro®)

Prior authorization requirements:

  • Please be prepared to respond to a series of questions that identify the prescriber, the patient and the reason for prescribing this drug.
  • Please be prepared to fax clinical documentation upon request.
  • The CDRP oxazolidinone antibiotics Worksheet provides step-by-step assistance in completing the prior authorization process.