Skip to content
The Policy VaultThe Policy Vault

ZyvoxMedica

Continuation of linezolid therapy

Initial criteria

  • For Methicillin-Resistant Staphylococcus species infection, treatment – Approve for 1 month
  • For Vancomycin-Resistant Enterococcus species infection, treatment – Approve for 1 month
  • For continuation of linezolid therapy – Approve for 1 month if patient is transitioning from IV linezolid or IV vancomycin to oral linezolid therapy OR patient was started on oral linezolid in an inpatient facility and is continuing therapy
  • For treatment of an infection that is resistant to other antibiotics but the organism is sensitive to linezolid – Approve for 1 month
  • If there is insufficient information available to make a determination regarding coverage and the prescriber or representative cannot be contacted – Approve for up to 2 weeks of therapy
  • For tuberculosis – Approve for 9 months if patient is age ≥ 18 years AND patient has extensively drug-resistant tuberculosis OR treatment-intolerant tuberculosis OR nonresponsive multidrug-resistant tuberculosis AND linezolid is prescribed in combination with Sirturo (bedaquiline) and Pretomanid

Approval duration

varies by indication (2 weeks, 1 month, or 9 months)