generic luliconazole — Point32Health
tinea corporis caused by Trichophyton rubrum and Epidermophyton floccosum
Preferred products
- ketoconazole 2% cream
- ciclopirox 0.77%
- econazole 1% cream
Initial criteria
- The patient has had a trial and failure, inadequate response, or contraindication to two formulary alternatives (e.g., ketoconazole 2% cream, ciclopirox 0.77%, econazole 1% cream)
Reauthorization criteria
- Documentation that patient has shown improvement on the requested medication
Approval duration
12 months