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PENTOXIFYLLINE

All products: Limited Use (codes 529, 76)

Apo-Pentoxifylline SR · DIN 02230090 · 400mg · extended release tablet

Limited Use — Reason for Use code 76, 529 requiredMarketed · checked 2026-09-21
StatusLimited Use — Reason for Use code 76, 529 required
Write on scriptLU code 76, 529 (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 76, 529
Reason for Use code 76 For the treatment of patients with critical limb ischemia (with arterial ulcers, gangrene and/or rest pain) and documented arterial vascular disease. Coverage limit: Limited Use form must specify if arterial ulcers, gangrene and/or rest pain are present. Coverage limit: LU Authorization Period: Indefinite Reason for Use code 529 For the treatment of patients with venous ulcers lasting, or expected to last, more than 8 weeks. Treatment should be discontinued after 3 months if there is no indication of objective benefit. The duration of therapy with pentoxifylline should not exceed 12 months. Coverage limit: Pentoxifylline should be used in combination with compression therapy. Coverage limit: LU Authorization Period: 1 year
1 brand, same coverage
Apo-Pentoxifylline SR · DIN 02230090 Manufacturer: Apotex Inc.; listing date 1997-08-28 Health Canada: Marketed since 2025-06-25 · brand APO-PENTOXIFYLLINE SR · ATC C04AD03 PENTOXIFYLLINE · form Tablet (extended-release) · route Oral · ingredients PENTOXIFYLLINE 400 MG · company Apotex inc · schedule Prescription
Check this DIN again · Health Canada product record

Apo-Pentoxifylline SR: Formulary list price $0.7238/unit (unit not stated in source; not the patient's cost)

Ministry pays: $0.7238 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=48622 · Verify on the e-Formulary ↗ (DIN 02230090)

Source record
DIN 02230090: Apo-Pentoxifylline SR Raw flags: chronicUseMed=Y, sec12=Y, sec3=Y Item: 202400001; group id 271; item number 0561; lccId 00049; manufacturer id APX Source form: SR Tab; strength: 400mg Recorded listing: Limited Use: paid only with a Reason for Use code and the criteria below; chronic-use medication (100-day supply rule, dispensing-fee limit) Source prices (unrounded): $0.7238; ministry $0.7238 Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02230090 Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=48622
Interchangeable products
Jamp Pentoxifylline SR · DIN 02543087 · $0.7238 Trental · DIN 02221977 · not recorded
Shortage status: not checked (no credentials)
Other drugs in the same formulary class (20:24 Hemorrheologic Agents) and how they are covered
No products matched this class search: “20:24”. This is a search result, not a decision about coverage. Try a different class name, abbreviation or class code. Search this as a medication name or DIN
Full class listing Related classes: 20:04 Antianemia Drugs, 20:12 Coagulants and Anti-Coagulants, 20:16 Hematopoietic Agents Same formulary class, not same indication: class membership alone does not establish equivalent uses.
What the Health Canada label says it is for
1 INDICATIONS APO-PENTOXIFYLLINE SR (pentoxifylline) is indicated for: • symptomatic treatment of patients with chronic occlusive peripheral vascular disorders of the extremities. In such patients pentoxifylline may give relief of signs and symptoms of impaired blood flow, such as intermittent claudication or trophic ulcers. 1.1 Pediatrics Pediatrics (<18 years): Based on the data submitted and reviewed by Health Canada, the safety and efficacy of APO-PENTOXIFYLLINE SR in pediatric patients has not been established; therefore, Health Canada has not authorized an indication for pediatric use. 1.2 Geriatrics Geriatrics: Evidence from clinical studies and experience suggests that use in the geriatric population is associated with differences in safety or effectiveness. See 4 DOSAGE AND ADMINISTRATION. In general, dose selection for a geriatric patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy. https://pdf.hres.ca/dpd_pm/00080904.PDF PM date: JAN 14, 1997 Source product: APO-PENTOXIFYLLINE SR; DIN 02230090; fetched 2026-09-10 Product monograph posted by Health Canada; excerpt for lookup only.