albendazole — CareFirst (Caremark)
Hydatid disease of the liver, lung, or peritoneum caused by Echinococcus granulosus
Initial criteria
- Infection confirmed by diagnostic or laboratory test
- Request is for a second course of therapy (first course administered within the past year)
- Dose up to 4 tablets per day for three 28‑day cycles with 14‑day free intervals
Approval duration
4 months