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DIPHENOXYLATE HYDROCHLORIDE & ATROPINE SULFATE

All products: Limited Use (codes 110, 111, 112, 113, 114, 115, 224)

Other products in the same Health Canada class (A07DA) — coverage varies; not interchangeable

  • Loperamide (Imodium): limited Use 110, 111, 112, 113, 114, 115, 224, Not a benefit

Lomotil · DIN 00036323 · 2.5mg & 0.025mg · tablet

Limited Use — Reason for Use code 110, 111, 112, 113, 114, 115, 224 requiredMarketed · checked 2026-09-20
StatusLimited Use — Reason for Use code 110, 111, 112, 113, 114, 115, 224 required
Write on scriptLU code 110, 111, 112, 113, 114, 115, 224 (patient must meet the criteria below)
Patient paysPatient pays: program not supplied; amount cannot be determined.
Private plan unknown: ask. If yes, check its coverage and payer coordination; if no, see the public routes below.
Ontario Limited Use criteria — code 110, 111, 112, 113, 114, 115, 224
Coverage limit: For the treatment of diarrhea associated with: Reason for Use code 110 An ileostomy or a colostomy;. Coverage limit: LU Authorization Period: 1 year Reason for Use code 111 Bowel resection, including short bowel syndrome; Coverage limit: LU Authorization Period: 1 year Reason for Use code 112 Inflammatory Bowel Diseases, i.e. Crohn's Disease and Ulcerative Colitis; Coverage limit: LU Authorization Period: 1 year Reason for Use code 113 Cancer, including chemotherapy or radiation therapy; Coverage limit: LU Authorization Period: 1 year Reason for Use code 114 HIV/AIDS; Coverage limit: LU Authorization Period: 1 year Reason for Use code 115 Acute diarrhea in patients in congregated housing, i.e. Long Term Care Facilities (LTCF), or for patients receiving Home Care; Coverage limit: LU Authorization Period: 1 year Reason for Use code 224 Fecal incontinence. Coverage limit: LU Authorization Period: 1 year
No interchangeable product listed in the Ontario extract
Lomotil · DIN 00036323 Manufacturer: Pfizer Canada Inc.; listing date 1996-10-01 Health Canada: Marketed since 2006-01-23 · brand LOMOTIL · ATC A07DA01 DIPHENOXYLATE · form Tablet · route Oral · ingredients DIPHENOXYLATE HYDROCHLORIDE 2.5 MG, ATROPINE SULFATE .025 MG · company Pfizer canada ulc · schedule Narcotics (cdsa i)
Check this DIN again · Health Canada product record

Lomotil: Formulary list price $0.5837/unit (unit not stated in source; not the patient's cost)

Ministry pays: $0.5837 per source unit.

Source explanation: The formulary price is what ODB pays; the cash price at the counter is set by the pharmacy.

Formulary data: Ontario extract of Aug 26, 2026 · Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=937 · Verify on the e-Formulary ↗ (DIN 00036323)

Source record
DIN 00036323: Lomotil Raw flags: sec12=Y, sec3=Y Item: 560800016; group id 646; item number 1625; lccId 00095; manufacturer id PFI Source form: Tab; strength: 2.5mg & 0.025mg Recorded listing: Limited Use: paid only with a Reason for Use code and the criteria below Source prices (unrounded): $0.5837; ministry $0.5837 Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=00036323 Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=937
Shortage status: not checked (no credentials)
Other drugs in the same formulary class (56:08 Antidiarrhea Agents) and how they are covered

Matched class: 56:08 Antidiarrhea Agents

Drug-class inventory only. Lists recorded Ontario formulary products, not every Canadian medication; does not recommend treatment. No displayed product is listed as a general benefit in this extract. Check its listing requirements below. 56:08 Antidiarrhea Agents

LOPERAMIDE HCL

· 4 products · Listed, not a benefit (1), Limited Use, codes 110, 111, 112, 113, 114, 115, 224 (3) · strengths: 2mg · Caplet Source: formulary-ed43-front-matter.txt Part V; ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26; class 56:08
Full class listing Related classes: 56:04 Antacids and Adsorbents, 56:12 Cathartics, 56:16 Digestants, 56:22 Antiemetics and Antinauseants, 56:40 Miscellaneous G.I. Drugs Same formulary class, not same indication: class membership alone does not establish equivalent uses.
What the Health Canada label says it is for
INDICATIONS AND CLINICAL USE LOMOTIL (diphenoxylate hydrochloride with atropine sulfate) is indicated as an adjunct in the management of diarrhea. Bacterially-induced diarrhea should be treated with appropriate antimicrobial therapy. https://pdf.hres.ca/dpd_pm/00051332.PDF PM date: not printed or not captured Source product: LOMOTIL; DIN 00036323; fetched 2026-09-10 Product monograph posted by Health Canada; excerpt for lookup only.