generic sulfacetamide-sulfur 10-5% lotion — Medica

Preferred products

• sodium sulfacetamide/sulfur 10%/5% emollient cream
• generic prescription topical adapalene products
• benzoyl peroxide-containing products
• clindamycin products (excluding generic Clindagel and clindamycin phosphate 1% foam)
• dapsone-containing products
• erythromycin-containing products
• sodium sulfacetamide-containing products

Initial criteria

• Patient has tried one Step 1 Product (sodium sulfacetamide/sulfur 10%/5% emollient cream, generic prescription topical adapalene-, benzoyl peroxide-, clindamycin products other than generic Clindagel and clindamycin phosphate 1% foam, dapsone-, erythromycin-, or sodium sulfacetamide-containing product) within the 130-day look-back period

Approval duration

1 year