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Ontario coverage, price, criteria word for word, Health Canada status and shortages for one product

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HYOSCINE BUTYLBROMIDE

All injection strengths: Limited Use (codes 481)

Buscopan · DIN 00363839 · 20mg/mL · injection solution

Limited Use — Reason for Use code 481 requiredMarketed · checked 2026-09-20
StatusLimited Use — Reason for Use code 481 required
Write on scriptLU code 481 (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 481
Reason for Use code 481 For the management of patients receiving palliative care*. Coverage limit: LU Authorization Period: 1 year Coverage limit: *The patient must have a progressive life-limiting illness and require this medication for palliative purposes.
No interchangeable product listed in the Ontario extract
Buscopan · DIN 00363839 Manufacturer: Sanofi Consumer Health Inc.; listing date 2017-06-29 Health Canada: Marketed since 2022-08-16 · brand BUSCOPAN · ATC A03BB01 BUTYLSCOPOLAMINE · form Solution · route Intramuscular, Intravenous, Subcutaneous · ingredients HYOSCINE BUTYLBROMIDE 20 MG/ML · company Sanofi consumer health inc · schedule Prescription
Check this DIN again · Health Canada product record

Buscopan: Formulary list price $4.8880/unit (unit not stated in source; not the patient's cost)

Ministry pays: $4.8880 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=2483 · Verify on the e-Formulary ↗ (DIN 00363839)

Source record
DIN 00363839: Buscopan Raw flags: sec12=Y, sec3=Y Item: 120808006; group id 215; item number 0391; lccId 00286; manufacturer id SCO Source form: Inj Sol; strength: 20mg/mL Recorded listing: Limited Use: paid only with a Reason for Use code and the criteria below Source prices (unrounded): $4.8880; ministry $4.8880 Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=00363839 Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=2483
Shortage status: not checked (no credentials)
Other drugs in the same formulary class (12:08:08 Antimuscarinics/Antispasmodics) and how they are covered

Matched class: 12:08:08 Antimuscarinics/Antispasmodics

Drug-class inventory only. Lists recorded Ontario formulary products, not every Canadian medication; does not recommend treatment. Covered without a code on the Ontario formulary: TIOTROPIUM BROMIDE MONOHYDRATE, UMECLIDINIUM 12:08:08 Antimuscarinics/Antispasmodics

TIOTROPIUM BROMIDE MONOHYDRATE

· 4 products · General benefit · strengths: 18mcg, 2.5mcg/Actuation · Inh Cap, Inh Sol-60 Actuation Pk

UMECLIDINIUM

· 1 products · General benefit · strengths: 62.5mcg · Blister Pd Inh-30 Dose Pk

GLYCOPYRROLATE

· 10 products · Limited Use, codes 481 (7), Listed, not a benefit (3) · strengths: 0.2mg/mL, 0.4mg/2mL, 4mg/20mL · Inj Sol, Inj Sol (Preservative Free), Inj Sol (With Preservative)

TIOTROPIUM BROMIDE MONOHYDRATE & OLODATEROL HYDROCHLORIDE

· 1 products · Limited Use, codes 459 · strengths: 2.5mcg & 2.5mcg/Actuation · Inh Sol-60 Actuation Pk Source: formulary-ed43-front-matter.txt Part V; ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26; class 12:08:08
Full class listing Related classes: 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 BUSCOPAN (hyoscine butylbromide) tablets are indicated for:  The relief of smooth muscle spasm/cramping of the gastrointestinal system and its associated pain and discomfort. BUSCOPAN solution is indicated for:  The relief of acute genitourinary or gastrointestinal spasm (e.g., renal or biliary colic), or to produce smooth muscle relaxation prior to radiological procedures such as pyelography or other diagnostic procedures where spasm may be a problem (e.g., gastro- duodenal endoscopy). Geriatrics: No data is available. Buscopan® Prescribing Information Page 3 of 28 Pediatrics: No data is available. https://pdf.hres.ca/dpd_pm/00060599.PDF PM date: March 31, 2021 Source product: BUSCOPAN; DIN 00363812; fetched 2026-09-10 Product monograph posted by Health Canada; excerpt for lookup only.