Limited coverage drugs – ciprofloxacin ophthalmic

Last updated on August 20, 2024
Generic name

ciprofloxacin ophthalmic

Strength 0.3 %
 
Form eye drop
 

Special Authority criteria

Approval period

Failure or intolerance to first-line agents. (e.g., aminoglycosides)

Short term

Practitioner exemptions

  • Practitioners in the following specialty are not required to submit a Special Authority request form for coverage:
    • Ophthalmologists

Special notes

  • None

Special Authority request form(s)