Limited Coverage Drugs - Special Authority Criteria

Generic Name / Strength / Form

hydromorphone controlled release AND prolonged release

Criteria

Approval Period

Pain management in a specified chronic pain (including cancer pain) diagnosis*

PLUS

For patients who are unable to tolerate or receive an adequate response to either the regular release dosage forms of hydromorphone alone OR the sustained release preparations of morphine.

One Year

Practitioner Exemptions

  • Oncologist (medical)
  • Oncologist (radiation)
  • Haematologist

Special Notes

  • Details regarding patient's condition and previous medication history are required.
  • Renewal requests should provide update on patient’s current dose and condition.
  • Hydromorphone controlled release and prolonged release are full benefits for patients registered with the BC Palliative Care Benefits Program.

Special Authority Request Form(s)

Online Forms (PDF, 523KB)
Click on the link to complete a special authority request form.