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Anti-Infectives

miconazole buccal tablets (Oravig®)

PA Criteria:

FDA-approved diagnosis of oropharyngeal candidiasis in adults age 18 and older.

  • Recent trials (within the last month) of the following medications at recommended dosing and duration of therapy:
    • Clotrimazole troches, AND
    • Nystatin suspension, AND
    • Fluconazole tablets
  • Contraindication(s) to all available alternative medications.
Last Modified on Jul 26, 2021
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Oklahoma Health Care Authority

4345 N Lincoln Blvd

Oklahoma City, OK 73105

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The Oklahoma Health Care Authority collects the personally identifiable data submitted and received in regard to applications for services, renewals, appeals, provision of health care and processing of claims. This data is treated as confidential and is stored securely in accordance with applicable law and regulations. OHCA may share this personally identifiable data with its authorized business associates, government agencies with jurisdiction over the OHCA, or as otherwise required or permitted by applicable law.