Limited Coverage Drugs – Chlorambucil

Generic Name chlorambucil
Strength 2 MG
Form tablet

Special Authority Criteria

Approval Period

1. Diagnosis of vasculitis.


2. Diagnosis of lupus.


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 Request Form(s)