Limited coverage drugs – ciclopirox

Last updated on February 28, 2025

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Generic name	ciclopirox
Strength & form	1% topical cream, topical lotion

Special Authority criteria	Approval period
Diagnosis of diabetes PLUS diagnosis of a fungal infection of the lower extremities OR Diagnosis of a circulatory condition PLUS diagnosis of a fungal infection of the lower extremities	3 months

Special Authority criteria

Approval period

Diagnosis of diabetes PLUS diagnosis of a fungal infection of the lower extremities

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 request form

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