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Exceptional Access criteria on record are for Brand(s): Zomig; DOSAGE FORM/ STRENGTH: 2.5 mg tablet — not this product; no criteria on record for this product in this block. Exceptional Access Program criteria on record (ministry list dated 2025-01-01, not exhaustive): Ministry criteria list dated January 1, 2025; the program's current criteria may differ; SADIE shows the current version. https://www.ontario.ca/page/sadie-special-authorization-digital-information-exchange Zolmitriptan Brand(s): Zomig DOSAGE FORM/ STRENGTH: 2.5 mg tablet Brand(s): Zomig Rapimelt DOSAGE FORM/ STRENGTH: 2.5 mg dispersible tablet For the treatment of migraines with or without aura in patients who have failed an adequate trial of or experienced intolerance to all other oral triptans considered under the Exceptional Access Program. Duration of Approvals: 5 years Renewal requests may be considered for patients who continue to benefit from treatment. The physician must provide the frequency of triptan use. 218  EAP source: eap-frequently-requested-drugs-2025-01-01.txt, page 218, record 128, corpus 2025-01-01; name match only, not an eligibility decision

Lowest DBP recovery rule under medically necessary no-substitution claims: 6.2 Medically Necessary "No Substitution" Claims The Side Effect Reporting Form will not have to be renewed. However, the pharmacy must maintain a copy of the prescription that contains a direction that there be no substitution and the required Health Canada Side Effect Reporting Form (completed and signed by the prescriber). The prescriber must write “No Substitution” or “No Sub” on renewal or subsequent new written prescriptions, and indicate “No Substitution” on subsequent new oral prescriptions. The dispenser will be reimbursed the DBP plus a mark-up and the lesser of the posted usual and customary fee or the ODB dispensing fee minus the applicable ODB co-payment amount. Where a completed Side Effect Reporting Form is not available at the pharmacy during an inspection, the difference between the cost of the higher-cost product and the lowest DBP listed for the interchangeable category will be recovered. (ontario.ca, Revision #17; 2026-08-03 ↗) 6.2 Medically Necessary "No Substitution" Claims The Ministry will provide reimbursement of a higher-cost interchangeable product in medically necessary circumstances where a patient has experienced a significant adverse reaction with two (2) lower-cost interchangeable drug products, where available. When a prescriber identifies a patient for which it is medically necessary that a higher cost interchangeable product be provided, the prescriber must: • Complete, sign and forward to the pharmacist a copy of the Health Canada side effect reporting form for each lower-cost interchangeable drug product trialed (Side Effect Reporting Form[s]); and • Write “No Substitution” or “No Sub” on a written prescription or indicate “No Substitution” to the pharmacist in the case of a verbal prescription. The prescriber should keep a copy of the completed form in the patient’s record for future use and reference. In the case of a written prescription, when the pharmacist or dispensing physician receives a prescription with the written notation “No Substitution” or “No Sub”, reimbursement will be provided for the higher-cost interchangeable product only if the prescription is accompanied by a completed Health Canada Side Effect Reporting Form for each of the lower-cost interchangeable drug products trialed. This form must be completely filled out noting the details of the adverse reaction and signed by the prescriber. In the case of a verbal prescription, the prescriber must satisfy the operator of the pharmacy or dispensing physician that a completed Health Canada Side Effect Reporting Form for each of the lower-cost interchangeable drug products trialed has been completed and signed by the prescriber. A written record of this verbal prescription and the completed Health Canada Side Effect Reporting Form must be received by the pharmacy prior to claim submission. Upon receipt, the pharmacist must: • Fax, submit online or mail the completed and signed form to Health Canada’s Canada Vigilance Program; and • Retain his or her copy of the completed and signed Side Effect Reporting Form. (ontario.ca, Revision #17; 2026-08-03 ↗)

Mint-Zolmitriptan ODT · DIN 02419513 Manufacturer: Mint Pharmaceuticals Inc.; listing date 2014-06-26 Health Canada: Cancelled post market since 2017-06-19 · brand MINT-ZOLMITRIPTAN ODT · ATC N02CC03 ZOLMITRIPTAN · form Tablet (orally-disintegrating) · route Oral · ingredients ZOLMITRIPTAN 2.5 MG · company Mint pharmaceuticals inc · schedule Prescription

The source extract's flag for this DIN is unclear — confirm on the e-Formulary before prescribing (DIN 02419513). DIN 02419513: Mint-Zolmitriptan ODT Raw flags: sec3=Y, sec3b=Y, sec3bEAP=Y Item: 289200015; group id 546; item number 1477; lccId None; manufacturer id MIN Source form: Orally Disintegrating Tab; strength: 2.5mg Recorded listing: Off-Formulary Interchangeable, not an ODB benefit; may be reimbursed through the Exceptional Access Program when approved (likely, unconfirmed) Source prices (unrounded): $6.8625; ministry $6.8625 Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02419513 Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=90414

Interchangeable products

Apo-Zolmitriptan Rapid · DIN 02381575 · $6.8633 Jamp-Zolmitriptan ODT · DIN 02428237 · $6.8633 Sandoz Zolmitriptan ODT · DIN 02362996 · $6.8625 Septa-Zolmitriptan-ODT · DIN 02428474 · $6.8633 Teva-Zolmitriptan OD · DIN 02342545 · $6.8633 Zolmitriptan ODT · DIN 02442671 · $6.8633 Zomig Rapimelt · DIN 02243045 · $6.8633

Shortage status: not checked (no credentials)

Health Canada lists this DIN as Cancelled post market since 2017-06-19 — choose a marketed DIN from the same-category list.