Limited Coverage Drugs – Chlorambucil

Last updated on October 6, 2023

Special Authority requests can now be submitted online. It's simple and quick!

Generic name	chlorambucil
Strength	2 mg
Form	tablet

Special Authority criteria	Approval period
1. Diagnosis of vasculitis OR 2. Diagnosis of lupus	Indefinite

Special Authority criteria

Approval period

1. Diagnosis of vasculitis

2. Diagnosis of lupus

Indefinite

Practitioner exemptions

Practitioners in the following specialty are not required to submit a Special Authority request for coverage:

rheumatologists

Special notes

For any cancer-related condition, please contact the British Columbia Cancer Agency at (604) 877-6098 ext. 4610.

Special Authority requests

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5328 - General Special Authority Request form (PDF, 656KB)

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Limited Coverage Drugs – Chlorambucil

Practitioner exemptions

Special notes

Special Authority requests