Ertaczo (sertaconazole cream) — CareFirst (Caremark)
Candidiasis/Candida
Preferred products
- ciclopirox cream
- ciclopirox gel
- ciclopirox shampoo
- clotrimazole cream
- clotrimazole solution
- econazole cream
- ketoconazole cream
- ketoconazole shampoo
- ketoconazole foam
- luliconazole cream
- naftifine cream
- naftifine gel 1%
- naftifine gel 2%
- oxiconazole cream
- oxiconazole lotion
- sulconazole cream
- sulconazole solution
- butenafine cream
- miconazole-zinc oxide-white petrolatum ointment
- nystatin cream
- nystatin ointment
- nystatin powder
Initial criteria
- Authorization may be granted when ALL of the following criteria are met:
- The requested drug is NOT being used in a footbath.
- For Candidiasis/Candida: requested drug is any of ciclopirox cream or suspension/lotion (Loprox cream, suspension/lotion); clotrimazole cream or solution; econazole cream; ketoconazole cream; miconazole-zinc oxide-white petrolatum ointment (Vusion); or nystatin cream, ointment, powder.
- For Seborrheic Dermatitis: requested drug is any of ciclopirox gel or shampoo (Loprox shampoo); ketoconazole cream, foam, or shampoo.
- For Tinea Corporis: requested drug is any of ciclopirox cream, gel, suspension/lotion (Loprox cream, suspension/lotion); clotrimazole cream or solution; econazole cream; ketoconazole cream; luliconazole cream (Luzu); naftifine cream or 1% gel (Naftin 1% gel); oxiconazole cream or lotion (Oxistat); sulconazole cream or solution (Exelderm).
- For Tinea Cruris: requested drug is any of ciclopirox cream, suspension/lotion (Loprox cream, suspension/lotion); clotrimazole cream or solution; econazole cream; ketoconazole cream; luliconazole cream (Luzu); naftifine cream or 1% gel (Naftin 1% gel); oxiconazole cream or lotion (Oxistat); sulconazole cream or solution (Exelderm).
- For Tinea Pedis: requested drug is any of ciclopirox cream, gel, suspension/lotion (Loprox cream, suspension/lotion); clotrimazole cream or solution; econazole cream or foam (Ecoza); ketoconazole cream; luliconazole cream (Luzu); naftifine cream or gel (Naftin); oxiconazole cream or lotion (Oxistat); sertaconazole cream (Ertaczo); sulconazole cream (Exelderm cream).
- For Tinea (Pityriasis) Versicolor: requested drug is any of butenafine cream (Mentax); ciclopirox cream, suspension/lotion (Loprox cream, suspension/lotion); clotrimazole cream or solution; econazole cream; ketoconazole cream or shampoo; oxiconazole cream (Oxistat cream); sulconazole cream or solution (Exelderm).
Approval duration
3 months