Limited Coverage Drugs - linezolid

Generic Name

linezolid

Strength

600mg
Form tablet

Criteria

Approval Period

1. treatment of vancomycin-resistant enterococcus infections

OR

2. treatment of methicillin-resistant staphylococcus aureus in individuals who are unresponsive to or intolerant of parenteral vancomycin

Maximum 30 days

Practitioner Exemptions

  • Infectious Disease Specialists

Special Notes

  • None

Special Authority Request Form(s)