Brilinta · DIN 02368544 · 90mg · tablet
Limited Use — Reason for Use code 441 requiredMarketed · checked 2026-09-02
StatusLimited Use — Reason for Use code 441 required
Write on scriptLU code 441 (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 441
Reason for Use code 441
In combination with low-dose ASA for patients with:
- Non-ST elevation acute coronary syndrome (ACS)* (unstable angina or myocardial infarction [MI]); OR
- ST-segment elevation myocardial infarction (STEMI); OR
- Stent thrombosis while taking clopidogrel plus low-dose ASA.
Treatment must be initiated in hospital.
Notes:
A) *ACS without ST elevation is defined as 2 of 3 of the following criteria:
1. ST-segment changes on electrocardiogram (ECG) indicating ischemia
2. Positive biomarker indicating myocardial necrosis
3. One of the following:
- Greater than or equal to 60 years of age
- Previous MI or coronary artery bypass graft (CABG)
- Coronary artery disease (CAD) with greater than or equal to 50% stenosis in greater than or equal to 2 vessels
- Previous ischemic stroke, transient ischemic attack (TIA; hospital-based diagnosis), carotid stenosis (greater than or equal to 50%), or cerebral revascularization
- Diabetes mellitus
- Peripheral artery disease
- Chronic renal dysfunction
B) Co-administration of ticagrelor with high maintenance dose ASA (greater than 150mg daily) is not recommended.
C) Definite stent thrombosis, according to the Academic Research Consortium, is a total occlusion originating in or within 5 mm of the stent, or is a visible thrombus within the stent, or is within 5 mm of the stent in the presence of an acute ischemic clinical syndrome within 48 hours. Definite stent thrombosis must be confirmed by angiography or by pathologic confirmation of acute thrombosis.
D) Ticagrelor is contraindicated in patients with active pathological bleeding, in those with a history of intracranial hemorrhage and moderate to severe hepatic impairment.
Coverage limit:
LU Authorization Period: 1 year
Savings card: innoviCares lists Brilinta (Ontario list dated 2026-09-10) — pays part of the brand-versus-generic difference after other coverage; free sign-up. (innovicares.ca ↗)
Savings card: RxHelp ONE lists BRILINTA (read 2026-09-10) — brand-name savings card, free; cannot be combined with another card on the same claim. (rxhelp.ca ↗)
Limit of one Prescription Drug Card Program / Patient Financial Assistance Card from any adjudicator per DIN and claim submitted. The RxHelpONE card CANNOT be combined with any other card or offer. (Terms of Use) (rxhelp.ca, Sep 10, 2026 ↗)
1 brand, same coverage
Brilinta · DIN 02368544
Manufacturer: AstraZeneca; listing date 2013-04-30
Health Canada: Marketed since 2011-06-01 · brand BRILINTA · ATC B01AC24 TICAGRELOR · form Tablet · route Oral · ingredients TICAGRELOR 90 MG · company Astrazeneca canada inc · schedule Prescription
Ministry pays: $0.3960 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=85352 · Verify on the e-Formulary ↗ (DIN 02368544)
Source record
DIN 02368544: Brilinta
Raw flags: sec12=Y, sec3=Y
Item: 201200088; group id 261; item number 0511; lccId 00230; manufacturer id AZC
Source form: Tab; strength: 90mg
Recorded listing: Limited Use: paid only with a Reason for Use code and the criteria below
Source prices (unrounded): $1.8187; ministry $0.3960
Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02368544
Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=85352
Interchangeable products
Apo-Ticagrelor · DIN 02482630 · $0.3960
Jamp Ticagrelor · DIN 02531801 · $0.3960
M-Ticagrelor · DIN 02529769 · $0.3960
Taro-Ticagrelor · DIN 02492598 · $0.3960
Shortage status: no shortage or discontinuation reported (checked 2026-09-13T08:10:21.292534+00:00); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada)
Source: https://healthproductshortages.ca/search?term=02368544
Shortage record checked 2026-09-13T08:10:21.292534+00:00