Limited coverage drugs – clioquinol topical

Last updated on August 20, 2024

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

Generic name / Strength / Form
clioquinol/flumethasone / 3 % - 0.02 % / cream
clioquinol/hydrocortisone / 3 % - 1 % / cream

Special Authority criteria	Approval period
1. Diagnosis of diabetes PLUS Diagnosis of a fungal infection of the lower extremities OR 2. Diagnosis of a circulatory condition PLUS Diagnosis of a fungal infection of the lower extremities	3 months

Special Authority criteria

Approval period

1. Diagnosis of diabetes

PLUS

Diagnosis of a fungal infection of the lower extremities

2. Diagnosis of a circulatory condition

PLUS

Diagnosis of a fungal infection of the lower extremities

3 months

Practitioner exemptions

None

Special notes

Details regarding patient's condition are required
Compounded formulations containing this medication will not be eligible for coverage

Special Authority request form(s)

Log in to eForms
5328 - General Special Authority request (PDF, 656KB)

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The B.C. Public Service acknowledges the territories of First Nations around B.C. and is grateful to carry out our work on these lands. We acknowledge the rights, interests, priorities, and concerns of all Indigenous Peoples - First Nations, Métis, and Inuit - respecting and acknowledging their distinct cultures, histories, rights, laws, and governments.

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Limited coverage drugs – clioquinol topical

Practitioner exemptions

Special notes

Special Authority request form(s)