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Prescribing Clinician or Authorized Representative Signature Created 10/11/2016 Reviewed/Revised 01/24/2017 Date 3/23/2017 9 31 AM. Topical Antifungal Agents Luzu luliconazole butenafine Medication Request Form MRF FAX TO 888 807-6643 c/o MedImpact Healthcare Systems Inc. Attn Prior Authorization Department 10181 Scripps Gateway Court San Diego CA 92131 - Phone 1-800-788-2949 Instructions This form is to be used by participating providers to obtain coverage for the drug listed above which...
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How to fill out topical antifungal agents

How to fill out topical antifungal agents
01
Clean and dry the affected area before applying the topical antifungal agent.
02
Follow the instructions provided with the medication.
03
Apply a thin layer of the antifungal agent to the affected area, gently spreading it to cover the entire area.
04
If directed, cover the area with a bandage or dressing to enhance absorption.
05
Wash your hands after applying the medication, unless your hands are the affected area.
06
Continue using the antifungal agent as prescribed, even if the symptoms improve.
07
Avoid contact with eyes, nose, mouth, or other mucous membranes.
08
Store the medication in a cool, dry place, away from direct sunlight and heat.
09
If any side effects or allergic reactions occur, discontinue use and consult a healthcare professional.
Who needs topical antifungal agents?
01
Individuals with fungal skin infections such as athlete's foot, ringworm, or jock itch.
02
People who have a weakened immune system that makes them more susceptible to fungal infections.
03
Those who have a history of recurrent fungal infections.
04
Individuals who frequently visit public facilities that increase the risk of exposure to fungi, such as gyms or swimming pools.
05
People who live in hot and humid climates, as these conditions promote fungal growth on the skin.
06
Anyone experiencing symptoms like itching, redness, rash, or scaling in a specific area of the skin.
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What is topical antifungal agents?
Topical antifungal agents are medications used to treat fungal infections of the skin, nails, and mucous membranes.
Who is required to file topical antifungal agents?
Manufacturers and distributors of topical antifungal agents are required to file this information.
How to fill out topical antifungal agents?
Topical antifungal agents can be filled out by providing detailed information about the product, including its ingredients, indications, dosage forms, and contraindications.
What is the purpose of topical antifungal agents?
The purpose of topical antifungal agents is to eliminate or prevent the growth of fungi that cause infections.
What information must be reported on topical antifungal agents?
Information such as the active ingredients, strength, dosage forms, indications, contraindications, and adverse effects must be reported on topical antifungal agents.
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