Drugs - Topical benzoyl peroxide products
December 2010
Therapeutic area - Acne
Covered Benzoyl Peroxide Products
Strength and dose form | 10% Cleanser | 5% Cleanser | 10% Gel | 5% Gel | 2.5% Gel |
Examples of product names |
Desquam-X
|
Benzoyl peroxide
Desquam-X Benzac W Wash Benzac AC |
Acne 10
Benzoyl peroxide Benzac AC Desquam-X |
Benzoyl peroxide
Benzac AC |
Benzoyl peroxide |
Products covered only by Prior Authorization
Generic name | Dose form | Strengths |
benzoyl peroxide/aloe vera | gel | 2.75%, 4%, 5.25%, 7%, 8% |
benzoyl peroxide/sulfur | gel | 6%-3% |
benzoyl peroxide microspheres | cream | 3.5%, 5.5%, 8.5%, 10% |
benzoyl peroxide/aloe vera | topical suspension | 5.25% |
benzoyl peroxide microspheres | cream in packet | 3.5%, 5.5%, 8.5% |
benzoyl peroxide/urea | cream | 4.5%-10%, 6.5%-10%, 8.5%-10% |
benzoyl peroxide | medicated shaving cream | 5%, 10% |
benzoyl peroxide | cleanser | 2.5%, 3%, 4%, 6%, 8% |
benzoyl peroxide | cleanser mL | 5.75% |
benzoyl peroxide/urea | cleanser mL | 4.5%-10%, 6.5%-10% |
benzoyl peroxide/urea | liquid | 5.75%-10% |
benzoyl peroxide | lotion | 4%, 8%, 10% |
benzoyl peroxide&skin cleansr5 | kit | 4%, 8% |
benzoyl peroxide/blemish cnclr | combo pack each | 4.75% |
benzoyl peroxide | combo pack | 4%-5%, 8%-5% |
benzoyl peroxide/hyaluront sod | combo pack | 8%-0.2%, 4%-0.2% |
benzoyl peroxide/hydrocortisone (Bencort) | Cream and kits | 5%-0.5% |
These are typically more expensive dosage forms with no known efficacy advantage.
Single agent benzoyl peroxide agents not typically recommended for continuous use secondary to the development of resistant bacteria.
Patient has tried at least two of the preferred products without noticeable improvement.
MHCP Provider Call Center 651-431-2700 or 800-366-5411