XYWAV and XYREM REMS | |
A REMS (Risk Evaluation and Mitigation Strategy) is a program to manage known or potential serious risks associated with a drug product and is required by the FDA to ensure that the benefits of the drug outweigh its risks. This program ensures that XYWAV® (calcium, magnesium, potassium, and sodium oxybates) and XYREM® (sodium oxybate) are dispensed only from the Certified Pharmacy. The XYWAV and XYREM REMS is designed to ensure that prescribers and patients are educated on and understand the risks and safe use conditions of XYWAV and XYREM and agree to follow the requirements of the XYWAV and XYREM REMS. XYWAV and XYREM may only be dispensed to patients enrolled in the XYWAV and XYREM REMS. |
XYWAV and XYREM are central nervous system depressants.
| What are XYWAV and XYREM? XYWAV and XYREM are central nervous system depressants.
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To prescribe XYWAV or XYREM for patients XYWAV and XYREM Electronic Prescribing for Controlled Substances (EPCS) meets DEA requirements | ePrescribe Information |
Prescriber Resources Select the buttons below to view or download. | |||||
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XYWAV and XYREM Prescriber Brochure Download |
Patient/Caregiver Resources | |
What You Should Know
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XYWAV and XYREM REMS | |
A REMS (Risk Evaluation and Mitigation Strategy) is a program to manage known or potential serious risks associated with a drug product and is required by the FDA to ensure that the benefits of the drug outweigh its risks. This program ensures that XYWAV® (calcium, magnesium, potassium, and sodium oxybates) and XYREM® (sodium oxybate) are dispensed only from the Certified Pharmacy. The XYWAV and XYREM REMS is designed to ensure that prescribers and patients are educated on and understand the risks and safe use conditions of XYWAV and XYREM and agree to follow the requirements of the XYWAV and XYREM REMS. XYWAV and XYREM may only be dispensed to patients enrolled in the XYWAV and XYREM REMS. |
XYWAV and XYREM are central nervous system depressants.
| What are XYWAV and XYREM? XYWAV and XYREM are central nervous system depressants.
|
To prescribe XYWAV or XYREM for patients XYWAV and XYREM Electronic Prescribing for Controlled Substances (EPCS) meets DEA requirements | ePrescribe Information |
Prescriber Resources Select the buttons below to view or download. | |||||
| |||||
XYWAV and XYREM Prescriber Brochure Download |
Patient/Caregiver Resources | |
What You Should Know
|
***PLEASE BE AWARE***
that the XYWAV and XYREM Prescription Forms are available for prescribers from the XYWAV and XYREM REMS website within the “Prescribe XYWAV and XYREM” tab.
To become certified, each prescriber must complete a XYWAV and XYREM REMS Prescriber Enrollment Form once and submit it to the XYWAV and XYREM REMS via the options shown on the right.
Before enrolling in the XYWAV and XYREM REMS, ensure you’re familiar by reading the XYWAV and XYREM Prescribing Information Prescriber Roles & Responsibilities and theXYWAV and XYREM Prescriber Brochure.
To become certified, each prescriber must complete a XYWAV and XYREM REMS Prescriber Enrollment Form once and submit it to the XYWAV and XYREM REMS via the options shown on the right.
Before enrolling in the XYWAV and XYREM REMS, ensure you’re familiar by reading the XYWAV and XYREM Prescribing Information Prescriber Roles & Responsibilities and theXYWAV and XYREM Prescriber Brochure.
The enrollment process for prescribers is quick, easy, and secure. Choose one of the two methods described below. Complete your enrollment form and submit it to the Certified Pharmacy for processing. For best results please use Adobe Acrobat to fill out the forms.
Download: Prescriber Enrollment Form | ||
Scan and Email to: ESSDSPrescribers@express-scripts.com | ||
Fax to: XYWAV and XYREM REMS 1-866-470-1744 (toll free) | ||
Mail to: XYWAV and XYREM REMS PO Box 66589 St. Louis, MO 63166-6589 |
Submit using DocuSign
By using DocuSign, the XYWAV and XYREM REMS can ensure that your personal information can stay safe, secure, and protected.
If you begin patient enrollment online, your patient will receive an e-mail to complete his/her portions of the form, including an e-signature. Then, you will submit the form to the Certified Pharmacy. Both you and your patient will be notified when enrollment in the program is successful.
If you begin patient enrollment online, your patient will receive an e-mail to complete his/her portions of the form, including an e-signature. Then, you will submit the form to the Certified Pharmacy. Both you and your patient will be notified when enrollment in the program is successful.
If you choose Option 1, have your patient sign the enrollment form in your office. You will then submit it to the Certified Pharmacy by e-mail, fax, or mail. For best results please use Adobe Acrobat to fill out the forms.
Download: Patient Enrollment Form | ||
Scan and Email to: ESSDSPrescribers@express-scripts.com | ||
Fax to: XYWAV and XYREM REMS 1-866-470-1744 (toll free) | ||
Mail to: XYWAV and XYREM REMS PO Box 66589 St. Louis, MO 63166-6589 |
Submit using DocuSign
By using DocuSign, the XYWAV and XYREM REMS can ensure that your personal information can stay safe, secure, and protected.
Utilize the resources here to understand the benefits and risks of XYWAV and XYREM and to prescribe XYWAV and XYREM. For more information please call the XYWAV and XYREM REMS toll free at 1-866-997-3688.
To prescribe XYWAV and XYREM, both prescriber and patient must be enrolled in the XYWAV and XYREM REMS.
To submit the XYWAV or XYREM Prescription Form online for your patient, select the ePrescribe Now button below | |
Completed electronic prescriptions are submitted directly to the XYWAV and XYREM REMS | |
If you prefer to not use electronic prescriptions, the XYWAV and XYREM Prescription Forms are available to download, but must be printed, signed, and sent by Fax or Mail to the XYWAV and XYREM REMS.
Download the XYWAV Prescription Form | ||
Download the XYREM Prescription Form | ||
Print and Sign the completed XYWAV or XYREM Prescription Form for your Patient | ||
Fax to: XYWAV and XYREM REMS 1-866-470-1744 (toll free) | ||
Mail to: XYWAV and XYREM REMS PO Box 66589 St. Louis, MO 63166-6589 |
***PLEASE BE AWARE***
that the XYWAV and XYREM Prescription Forms are available for prescribers from the XYWAV and XYREM REMS website within the “Prescribe XYWAV and XYREM” tab.
To become certified, each prescriber must complete a XYWAV and XYREM REMS Prescriber Enrollment Form once and submit it to the XYWAV and XYREM REMS via the options shown on the right.
Before enrolling in the XYWAV and XYREM REMS, ensure you’re familiar by reading the XYWAV and XYREM Prescribing Information Prescriber Roles & Responsibilities and theXYWAV and XYREM Prescriber Brochure.
To become certified, each prescriber must complete a XYWAV and XYREM REMS Prescriber Enrollment Form once and submit it to the XYWAV and XYREM REMS via the options shown on the right.
Before enrolling in the XYWAV and XYREM REMS, ensure you’re familiar by reading the XYWAV and XYREM Prescribing Information Prescriber Roles & Responsibilities and theXYWAV and XYREM Prescriber Brochure.
The enrollment process for prescribers is quick, easy, and secure. Choose one of the two methods described below. Complete your enrollment form and submit it to the Certified Pharmacy for processing. For best results please use Adobe Acrobat to fill out the forms.
Download: Prescriber Enrollment Form | ||
Scan and Email to: ESSDSPrescribers@express-scripts.com | ||
Fax to: XYWAV and XYREM REMS 1-866-470-1744 (toll free) | ||
Mail to: XYWAV and XYREM REMS PO Box 66589 St. Louis, MO 63166-6589 |
Submit using DocuSign
By using DocuSign, the XYWAV and XYREM REMS can ensure that your personal information can stay safe, secure, and protected.
If you begin patient enrollment online, your patient will receive an e-mail to complete his/her portions of the form, including an e-signature. Then, you will submit the form to the Certified Pharmacy. Both you and your patient will be notified when enrollment in the program is successful.
If you begin patient enrollment online, your patient will receive an e-mail to complete his/her portions of the form, including an e-signature. Then, you will submit the form to the Certified Pharmacy. Both you and your patient will be notified when enrollment in the program is successful.
If you choose Option 1, have your patient sign the enrollment form in your office. You will then submit it to the Certified Pharmacy by e-mail, fax, or mail. For best results please use Adobe Acrobat to fill out the forms.
Download: Patient Enrollment Form | ||
Scan and Email to: ESSDSPrescribers@express-scripts.com | ||
Fax to: XYWAV and XYREM REMS 1-866-470-1744 (toll free) | ||
Mail to: XYWAV and XYREM REMS PO Box 66589 St. Louis, MO 63166-6589 |
Submit using DocuSign
By using DocuSign, the XYWAV and XYREM REMS can ensure that your personal information can stay safe, secure, and protected.
Utilize the resources here to understand the benefits and risks of XYWAV and XYREM and to prescribe XYWAV and XYREM. For more information please call the XYWAV and XYREM REMS toll free at 1-866-997-3688.
To prescribe XYWAV and XYREM, both prescriber and patient must be enrolled in the XYWAV and XYREM REMS.
To submit the XYWAV or XYREM Prescription Form online for your patient, select the ePrescribe Now button below | |
Completed electronic prescriptions are submitted directly to the XYWAV and XYREM REMS | |
If you prefer to not use electronic prescriptions, the XYWAV and XYREM Prescription Forms are available to download, but must be printed, signed, and sent by Fax or Mail to the XYWAV and XYREM REMS.
Download the XYWAV Prescription Form | ||
Download the XYREM Prescription Form | ||
Print and Sign the completed XYWAV or XYREM Prescription Form for your Patient | ||
Fax to: XYWAV and XYREM REMS 1-866-470-1744 (toll free) | ||
Mail to: XYWAV and XYREM REMS PO Box 66589 St. Louis, MO 63166-6589 |