Non-Formulary Use Criteria: 1. Diabetic or circulatory disorders evidenced by absence of pedal pulses and/or extremity hair loss due to poor circulation, or abnormal monofilament exam demonstrating
loss of sensation. 2. Onychomycosis requests meeting criteria will be approved for terbinafine (Lamisil ) 250 mg daily for 6 to 12 weeks for fingernails or toenails respectively. Formulary Restrictions****RESTRICTED TO HISTOPLASMOSIS, BLASTOMYCOSIS, ASPERGILLOSIS, AND SYSTEMIC MYCOSIS** **NOT APPROVED FOR ONYCHOMYCOSIS**Formulary Restrictions: RESTRICTED TO HISTOPLASMOSIS, BLASTOMYCOSIS, ASPERGILLOSIS, AND SYSTEMIC MYCOSIS** **NOT APPROVED FOR ONYCHOMYCOSIS