To order additional copies, please call Massachusetts Medical

Dermatologic Agents (Antifungals)
Name AETNA BCBSMA BMCHP FCHP HPHC HNE NHP NTWK MAHLTH THP
BUTENAFINE [Mentax] NC NC X X PA X
CICLOPIROX [0 .77% cream,
suspension]
X* X* X X X X X X X X
CICLOPIROX [Loprox 1% shampoo,
Loprox 0 .77% gel]
FE X PA X X PA PA X
CICLOPIROX nail lacquer PA* DL* PA PA X PA NC PA PA
CICLOPIROX nail lacquer [Penlac] FE PA DL PA PA PA PA NC NC PA PA
CLOTRIMAzOLE (OTC) NC NC X NC NC X X X
CLOTRIMAzOLE (Rx) X* X* X X X X X X X X
CLOTRIMAzOLE solution X* X* X X X1 X X X X X
CLOTRIMAzOLE lotion NC X* X X X X X1 CLOTRIMAzOLE lotion [Lotrimin] (Rx) NC X X X NC PA X
CLOTRIMAzOLE lotion [Lotrimin] OTC NC NC NC NC NC X
CLOTRIMAzOLE TROCHE X* X* X X X X X X X X
CLOTRIMAzOLE/BETAMETHAsONE X* X* X X X X X X X X
ECONAzOLE X* X* X X X X X X X X
HALOPROgIN [Halotin] FE NC X X PA X
KETOCONAzOLE topical X* X* X X X X X X X X
KETOCONAzOLE topical [Extina] FE NC PA PA X NC PA NC
KETOCONAzOLE topical [Nizoral] X X PA X X NC PA X
KETOCONAzOLE topical [Xolegel] FE NC PA PA X PA NC
MICONAzOLE X* 1 NC2 X X X1 X X2 X X1 MICONAzOLE/zINC OXIDE [Vusion] X NC X PA X PA NC
NAFTIFINE [Naftin] FE X X X X X PA PA X
NysTATIN cream, ointment, powder X* X* X X X X X X X X
NysTATIN/TRIAMCINOLONE X* X* X X X X X X X X
OXICONAzOLE [Oxistat] FE X X X PA X
sERTACONAzOLE NITRATE [Ertaczo] FE NC X X PA X
sULCONAzOLE [Exelderm] FE X X X PA PA X
TERBINAFINE (OTC) NC NC X NC NC NC X
TERBINAFINE spray [Lamisil] (OTC) NC NC PA NC NC NC PA PA
TERBINAFINE topical [Lamisil] (Rx) FE sT NC PA NC X NC PA X
TOLNAFTATE (OTC) NC NC X NC NC X X
1 Rx
2 OTC
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