Limited Coverage Drugs - Special Authority Criteria
Generic Name / Strength / Form
morphine sulfate sustained-release suppositories
|For pain management in cancer, palliative care and chronic pain
patients who are unable to tolerate or receive an adequate response to the regular dosage forms of morphine.
- Oncologists (medical)
- Oncologists (radiation)
- Details regarding patient's condition and previous medication history are required.
Special Authority Request Form(s)
Online Forms (PDF, 524KB)
Click on the link to complete a special authority request form.