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OPTIMA HEALTH COMMUNITY CARE AND OPTIMA FAMILY CARE (MEDICAID) PHARMACY PRIOR AUTHORIZATION/STEPPED REQUEST* Directions: The prescribing physician must sign and clearly print name (preprinted stamps
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How to fill out drug requested sodium oxybate

01
Step 1: Ensure that you have the correct dosage prescribed by your doctor.
02
Step 2: Take the sodium oxybate solution immediately before going to bed.
03
Step 3: Measure the prescribed amount using the provided dosing cup or oral syringe.
04
Step 4: Take the medicine on an empty stomach, at least 2 hours after eating.
05
Step 5: Swallow the prescribed dose of sodium oxybate all at once.
06
Step 6: Do not eat or drink anything, including water, for at least 2 hours after taking the medication.
07
Step 7: Follow any additional instructions provided by your healthcare provider.
08
Step 8: Store the medication at room temperature, away from moisture and heat.

Who needs drug requested sodium oxybate?

01
Sodium oxybate is a medication primarily used to treat narcolepsy (a sleep disorder). It is prescribed to individuals who experience excessive daytime sleepiness and cataplexy (sudden loss of muscle tone). Only individuals with a valid prescription from a healthcare professional should use sodium oxybate.
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Sodium oxybate is a medication primarily used to treat narcolepsy, specifically for the management of excessive daytime sleepiness and cataplexy.
Healthcare providers, pharmacies, and manufacturers involved in the distribution and prescription of sodium oxybate are required to file requests for this drug.
To fill out the drug request for sodium oxybate, one must complete a specific application form, provide necessary patient information, prescribe correct dosage, and submit it to relevant health authorities.
The purpose of drug requested sodium oxybate is to gain authorization for prescribing, dispensing, and using sodium oxybate for patients with narcolepsy.
The report must include patient identification, dosage requirements, the healthcare provider's details, and rationale for requesting sodium oxybate.
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