Limited coverage drugs – chloroquine

Last updated on August 20, 2024

Generic name

chloroquine

Strength

250 mg

Form

tablet

Special Authority criteria

Approval period

Treatment of extraintestinal amebiasis

OR

Treatment of rheumatoid arthritis or lupus

3-week supply

 

Indefinite

Practitioner exemptions

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

Special notes

  • Chloroquine for prevention of malaria is not an eligible PharmaCare benefit

Special Authority request form(s)