TELL ME, wHAT IS THE XYREM® REMS PROGRAM?

TELL ME, wHAT IS THE XYREM® REMS PROGRAM?

Patient enrollment in the XYREM REMS Program.

Patients must be enrolled one time in the XYREM REMS Program.1

  • Prescribers should refer to the XYREM REMS Program Prescriber Brochure for details on patient enrollment requirements, available for download at
    XYREMREMS.com.

Follow these steps to enroll your patients in the XYREM REMS Program.

1

Screen

Screen each patient for certain medical conditions and concomitant medications.1

2

Counsel

Counsel each patient on the serious risks, safe use, handling, and storage of XYREM as described in the XYREM REMS Program Patient Quick Start Guide.1

Review

Review the contents of the XYREM REMS Program Patient Quick Start Guide with each patient.1

Encourage

Encourage all patients to read the XYREM Medication Guide and to ask any questions they may have regarding treatment with XYREM.1

3

Complete

Complete the one-time XYREM REMS Program Patient Enrollment Form.1

Both the prescriber and the patient must sign the Patient Enrollment Form, available for download or online submission at XYREMREMS.com. By signing…1
  • The prescriber acknowledges having counseled the patient about the serious risks associated with XYREM and the safe use conditions.
  • The patient acknowledges having been counseled on the serious risks and safe use of XYREM and has asked any questions he or she had about XYREM.
The XYREM REMS Patient Enrollment Form is available for download or online submission at XYREMREMS.com.
  • All required fields must be completed clearly and accurately for timely enrollment. Required fields are indicated by an asterisk (*).1

4

Submit

Submit the completed and signed XYREM REMS Program Patient Enrollment Form to the Certified Pharmacy by either1:

send
Faxing to 1-866-470-1744
(toll-free).
send
Mailing to XYREM REMS Program,
PO Box 66589,
St. Louis, MO 63166-6589.
The Certified Pharmacy will notify you when your patient is enrolled and eligible to receive XYREM.1
need to download

Need to download forms or enroll in the program?

XYREMREMS.com
Find out how to properly dose XYREM

Find out how to properly dose XYREM.

STARTING & TITRATING XYREM

Need help? Have questions? Get answers.

For further information, visit or call

XYREMREMS.com |
1-866-XYREM88®

(1-866-997-3688).

A Nurse Case Manager is available Monday – Friday, 7 AM – 8 PM, Central Time.
A pharmacist is available 24 hours a day, 7 days a week.