Limited coverage criteria – chlorambucil

Last updated on February 28, 2025

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

Generic name	chlorambucil
Strength & form	2 mg tablet

Special Authority criteria	Approval period
Diagnosis of vasculitis OR Diagnosis of lupus	Indefinite

Special Authority criteria

Approval period

Diagnosis of vasculitis

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 request form

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