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INCOBOTULINUMTOXINA

All injection strengths: Limited Use (codes 130, 412, 421)

Other products in the same Health Canada class (M03AX) — coverage varies; not interchangeable

  • Abobotulinum toxin a (Dysport Therapeutic): limited Use 130, 412, 413
  • Botulinum toxin type a (Botox): limited Use 130, 412, 413, 440, 460

Xeomin · DIN 02371081 · 50 LD50 Units · Pd for injection-vial

Limited Use — Reason for Use code 130, 412, 421 requiredMarketed · checked 2026-09-02
StatusLimited Use — Reason for Use code 130, 412, 421 required
Write on scriptLU code 130, 412, 421 (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 130, 412, 421
Reason for Use code 130 To reduce the subjective symptoms and objective signs of cervical dystonia (spasmodic torticollis) in adults. Coverage limit: LU Authorization Period: 1 year Reason for Use code 412 For the management of focal spasticity, due to stroke or spinal cord injury in adults. Coverage limit: LU Authorization Period: 1 year Reason for Use code 421 For the treatment of blepharospasm associated with dystonia, including benign essential blepharospasm or VII nerve disorders in adults. Coverage limit: LU Authorization Period: 1 year Coverage limit: Xeomin should be administered personally by a neurologist or a physician with equivalent post-graduate training and experience with neuromuscular disorders.
No interchangeable product listed in the Ontario extract
Xeomin · DIN 02371081 Manufacturer: Merz Pharmaceutical Gmbh; listing date 2013-10-31 Health Canada: Marketed since 2021-07-16 · brand XEOMIN · ATC M03AX01 BOTULINUM TOXIN · form Powder for solution · route Intraglandular, Intramuscular · ingredients INCOBOTULINUMTOXINA 50 UNIT/VIAL · company Merz pharmaceuticals gmbh · schedule Schedule d, Prescription
Check this DIN again · Health Canada product record

Xeomin: Formulary list price $169.4550/unit (unit not stated in source; not the patient's cost)

Ministry pays: $169.4550 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=85628 · Verify on the e-Formulary ↗ (DIN 02371081)

Source record
DIN 02371081: Xeomin Raw flags: sec12=Y, sec3=Y Item: 920000684; group id 924; item number 2199; lccId 00427; manufacturer id MEZ Source form: Pd for Inj-Vial Pk; strength: 50 LD50 Units Recorded listing: Limited Use: paid only with a Reason for Use code and the criteria below Source prices (unrounded): $169.4550; ministry $169.4550 Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02371081 Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=85628
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=02371081
Shortage record checked 2026-09-13T08:10:21.292534+00:00
Other drugs in the same formulary class (92:00 UNCLASSIFIED THERAPEUTIC AGENTS) and how they are covered

Matched class: 92:00 UNCLASSIFIED THERAPEUTIC AGENTS

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: ALENDRONATE & CHOLECALCIFEROL, AZATHIOPRINE, CYCLOSPORINE, GLUCAGON RDNA ORIGIN, LANREOTIDE ACETATE, LEFLUNOMIDE, LEVODOPA & BENSERAZIDE, MYCOPHENOLATE SODIUM Some products covered without a code (check the product listing): ALENDRONATE, ALLOPURINOL, AMANTADINE HCL, BROMOCRIPTINE, CLOPIDOGREL BISULFATE, LEVODOPA & CARBIDOPA, MYCOPHENOLATE MOFETIL, OCTREOTIDE, RISEDRONATE SODIUM, ROPINIROLE, SELEGILINE HCL, TAMSULOSIN HCL 92:00 UNCLASSIFIED THERAPEUTIC AGENTS

BOTULINUM TOXIN TYPE A

· 5 products · Limited Use, codes 10, 130, 412, 413, 440, 460 · strengths: 100U/Vial, 200U/Vial, 50U/Vial · Pd Inj-100U Vial Pk, Pd Inj-200U Vial Pk, Pd Inj-50U Vial Pk

ALENDRONATE

· 28 products · Off-Formulary Interchangeable, not an ODB benefit (4), Listed, not a benefit (1), General benefit (23) · strengths: 5mg, 10mg, 70mg · Tab

ALENDRONATE & CHOLECALCIFEROL

· 6 products · General benefit · strengths: 70mg & 70mcg, 70mg & 140mcg · Tab

ALLOPURINOL

· 10 products · General benefit (6), Listed, not a benefit (4) · strengths: 100mg, 200mg, 300mg · Tab

AMANTADINE HCL

· 5 products · Listed, not a benefit (2), General benefit (3) · strengths: 100mg, 10mg/mL · Cap, O/L

AZATHIOPRINE

· 3 products · General benefit · strengths: 50mg · Tab

BROMOCRIPTINE

· 4 products · Listed, not a benefit (2), General benefit (2) · strengths: 5mg, 2.5mg · Cap, Tab

CLOPIDOGREL BISULFATE

· 19 products · General benefit (16), Off-Formulary Interchangeable, not an ODB benefit (3) · strengths: 75mg, 300mg · Tab

CYCLOSPORINE

· 8 products · General benefit · strengths: 10mg, 25mg, 50mg, 100mg, 100mg/mL · Cap, O/L

GLUCAGON RDNA ORIGIN

· 2 products · General benefit · strengths: 1mg/Vial · Inj Pd-Syr Pk, Inj Pd-Vial Pk

LANREOTIDE ACETATE

· 6 products · General benefit · strengths: 60mg/Syr, 90mg/Syr, 120mg/Syr · ER Pref Syr Pk

LEFLUNOMIDE

· 16 products · General benefit · strengths: 10mg, 20mg · Tab Source: formulary-ed43-front-matter.txt Part V; ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26; class 92:00 and 75 more
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
1 INDICATIONS Xeomin (incobotulinumtoxinA) is indicated: • for the treatment of hypertonicity disorders of the 7th nerve such as blepharospasm including benign essential blepharospasm and hemifacial spasm in adults • to reduce the subjective symptoms and objective signs of cervical dystonia (spasmodic torticollis) in adults • for the treatment of spasticity of the upper limb in adults • for the treatment of post-stroke lower limb spasticity involving the ankle and foot in adults • for the treatment of chronic sialorrhea associated with neurological disorders in adults • for the treatment of chronic sialorrhea associated with neurological disorders in pediatric patients (age 2-17 years weighing 12 kg or more) Xeomin may only be used by physicians with suitable qualifications and experience in the application of Botulinum neurotoxin type A (BoNT/A) 1.1 Pediatrics Pediatrics (< 18 years of age): The safety and efficacy of Xeomin for the treatment of chronic (lasting at least 3 months) sialorrhea in children with neurological disorders below the age of 2 years or with a weight less than 12 kg, an… https://pdf.hres.ca/dpd_pm/00078891.PDF PM date: MAR 17, 2025 Source product: XEOMIN; DIN 02324032; fetched 2026-09-10 Product monograph posted by Health Canada; excerpt for lookup only.