by this proposed modification: REMS Document, Xywav Prescription Form, Xyrem Prescription Form, and Prescriber Brochure, and REMS Website. The pharmacy requirements were changed to verify and document the patient has no other active prescriptions for oxybate products before dispensing Xywav and Xyrem by reviewing
Prescription Form of GHB. In July 2024 the U.S. Food and Drug Administration (FDA) approved Xyrem, a Schedule III prescription form of GHB, for treating
explaining the risks and proper use of Lumryz, Xyrem and Xywav, and the required prescription form. (b) sodium oxybate [Xyrem authorized
Xyrem Rems Program Form PDF Details. The Xyrem REMS Program Form is a document that provides information on the steps required to enroll in and participate in the Xyrem REMS Program. The form must be completed and signed by both the patient and their prescriber before they can receive Xyrem.
side influence, CNS depression, misuse. Xyrem Prescription Form to your patients, including one XYWAV and XYREM REMS Prescription
to complete and send back. Xyrem Prescription Form a neurotransmitter continues to be studied. For more information, please
XYWAV and XYREM are central nervous system depressants for narcolepsy and idiopathic hypersomnia. To prescribe or dispense them, you need to enroll in the XYWAV and XYREM REMS program and download the prescription forms from the website.
XYREM PRESCRIPTION FORM XYREM (sodium oxybate) oral solution 0.5 g/mL Form available online at www.XYWAVXYREMREMS.com. Print, sign, and: Fax to XYWAV and XYREM REMS: (toll free) OR mail to XYWAV and XYREM REMS, PO Box , St. Louis, MO . For more information, call the XYWAV and XYREM REMS at (toll free)
XYREMREMS PROGRAM. PRESCRIBER ENROLLMENT FORM. XYREM (sodium oxybate) oral solution 0.5 g/mL. Fax completed form to XYREM REMS Program at (toll
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