NYRx, the Medicaid Pharmacy Program

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

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

Prior authorization for linezolid (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. Only prescribers, not their authorized agents, can initiate the prior authorization process for Zyvox®. An authorized agent is an employee of the prescribing practitioner and has access to the patient's medical records (i.e. nurse, medical assistant).

The following is general information about Zyvox® prior authorization requirements:

• All prescriptions for Zyvox® must be prior authorized as of November 1, 2000.
• Prescribers are required 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.
• Prescriptions for Zyvox® are limited to a maximum of a 28 tablet, 900 ml of suspension, or 8400 ml of intravenous solution for a 14-day supply. Continuation beyond 14 days of therapy will require a new prescription and a new prior authorization number.
• No refills for Zyvox® prescriptions are allowed. If additional Zyvox® is needed, the prescriber must write a new prescription and obtain a new prior authorization number.
• The CDRP linezolid (Zyvox®) Worksheet and Instructions provides step-by-step assistance in completing the prior authorization process.