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