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PRIOR AUTHORIZATION FORM TOPICAL ANTIFUNGAL AGENTS Ciclopirox (, CNL8), efinaconazole (Julia), lulizonazole (Lulu) Requests for prior authorization (PA) must include patient name, Medicaid ID #, drug

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How to fill out topical antifungal agents

01

Start by washing and drying the affected area before applying any topical antifungal agent.

02

Read and follow the instructions provided with the specific topical antifungal agent you are using.

03

Apply a thin layer of the medication onto the affected area and gently rub it in.

04

Make sure to cover the entire affected area with the medication.

05

Wash your hands thoroughly after applying the topical antifungal agent.

06

Use the medication as directed by your healthcare provider or as directed on the product packaging.

07

Continue to use the topical antifungal agent for the recommended duration, even if symptoms improve.

08

If you experience any irritation or adverse reactions, discontinue use and consult your healthcare provider.

09

Store the topical antifungal agent according to the instructions provided, away from heat and moisture.

Who needs topical antifungal agents?

01

Topical antifungal agents are needed by individuals who are suffering from fungal infections on the skin, hair, or nails.

02

People with conditions such as athlete's foot, ringworm, jock itch, or fungal nail infections may benefit from the use of topical antifungal agents.

03

These agents can also be prescribed by healthcare providers for specific cases of fungal infections or as a treatment option for individuals who prefer topical medications.

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What is topical antifungal agents?

Topical antifungal agents are medications that are applied directly to the skin to treat fungal infections.

Who is required to file topical antifungal agents?

Healthcare providers or pharmacists who prescribe or dispense topical antifungal agents are required to report them.

How to fill out topical antifungal agents?

Topical antifungal agents can be filled out by including the name of the medication, dosage, frequency of use, and any known side effects.

What is the purpose of topical antifungal agents?

The purpose of topical antifungal agents is to treat fungal infections on the skin.

What information must be reported on topical antifungal agents?

Information such as the name of the medication, dosage, frequency of use, and any known side effects must be reported.

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