Efinaconazole (Jublia®)

TOPICAL ADMINISTRATION

Indications for Prior Authorization:

  • Treatment of onychomycosis of the toenails due to Trichophyton rubrum or Trichophyton mentagrophytes

Patient must meet the following criteria for the above indications:

  • Medical record documenation confirms onychomycosis is not cosmetic in nature, AND
  • Treatment failure of oral antifungals (azoles and allylamines) and topical ciclopirox

The following indications do not meet the criteria for use established by the Western Health Advantage Pharmacy and Therapeutics Committee:

  • Not approvable for cosmetic treatment of onychomycosis
  • For any indications not mentioned above

Dosing:

  • Apply to affected toenails once daily for 48 weeks

Approval:

48 weeks


 

Last review date: July 3, 2017