Limited coverage drugs – ciclopirox
Last updated on August 20, 2024
| Generic name | ciclopirox |
|---|---|
| Strength | 1% |
| Form | topical cream, topical lotion |
|
Special Authority criteria |
Approval period |
|---|---|
|
1. Diagnosis of diabetes PLUS diagnosis of a fungal infection of the lower extremities OR 2. Diagnosis of a circulatory condition PLUS diagnosis of a fungal infection of the lower extremities |
3 months |
Practitioner exemptions
- None
Special notes
- Details regarding patient's condition is required.
- Compounded formulations containing this medication require further Special Authority consideration.
Special Authority requests