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

Patient plan: look up a medication list

LAMOTRIGINE

All products: general benefit

Other products in the same Health Canada class (N03AX) — coverage varies; not interchangeable

  • Topiramate (Topamax Sprinkle): general benefit, Limited Use 321, Not a benefit
  • Brivaracetam (Brivlera): limited Use 548
  • Cenobamate (Xcopri): limited Use 719
  • Lacosamide (Vimpat): limited Use 430
  • Levetiracetam (PDP-Levetiracetam): limited Use 473, Limited Use 640, 705
  • Perampanel (Fycompa): limited Use 430, 564

14 more in the class list below

Lamotrigine · DIN 02428202 · 25mg · tablet

General benefitMarketed · checked 2026-09-20
StatusGeneral benefit
Write on scriptno code needed
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.
Brand vs generic price
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 ↗)
1 brand, same coverage
Lamotrigine · DIN 02428202 Manufacturer: Sivem Pharmaceuticals ULC; listing date 2020-08-28 Health Canada: Marketed since 2014-10-08 · brand LAMOTRIGINE · ATC N03AX09 LAMOTRIGINE · form Tablet · route Oral · ingredients LAMOTRIGINE 25 MG · company Sivem pharmaceuticals ulc · schedule Prescription
Check this DIN again · Health Canada product record

Lamotrigine: Formulary list price $0.0698/unit (unit not stated in source; not the patient's cost)

Ministry pays: $0.0698 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=91268 · Verify on the e-Formulary ↗ (DIN 02428202)

Source record
DIN 02428202: Lamotrigine Raw flags: sec3=Y Item: 281200055; group id 432; item number 1079; lccId None; manufacturer id SIV Source form: Tab; strength: 25mg Recorded listing: General benefit Source prices (unrounded): $0.0698; ministry $0.0698 Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02428202 Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=91268
Interchangeable products
Apo-Lamotrigine · DIN 02245208 · $0.0698 Auro-Lamotrigine · DIN 02381354 · $0.0698 Jamp Lamotrigine · DIN 02542730 · $0.0698 Lamictal · DIN 02142082 · $0.0698 Lamotrigine · DIN 02343010 · $0.0698 Mylan-Lamotrigine · DIN 02265494 · $0.0698 PMS-Lamotrigine · DIN 02246897 · $0.0698 Ratio-Lamotrigine · DIN 02243352 · $0.0698 Teva-Lamotrigine · DIN 02248232 · $0.0698
Shortage status: not checked (no credentials)
Other drugs in the same formulary class (28:12 Anticonvulsants) and how they are covered

Matched class: 28:12 Anticonvulsants

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: CLONAZEPAM, DIVALPROEX SODIUM, ETHOSUXIMIDE, VALPROATE SODIUM Some products covered without a code (check the product listing): CARBAMAZEPINE, GABAPENTIN, PHENYTOIN (DIPHENYLHYDANTOIN), PHENYTOIN (DIPHENYLHYDANTOIN) SODIUM, PREGABALIN, PRIMIDONE, TOPIRAMATE, VALPROIC ACID 28:12 Anticonvulsants

TOPIRAMATE

· 54 products · Limited Use, codes 321 (2), Off-Formulary Interchangeable, not an ODB benefit (3), General benefit (49) · strengths: 15mg, 25mg, 50mg, 100mg, 200mg · Sprinkle Cap, Tab

BRIVARACETAM

· 12 products · Limited Use, codes 548 · strengths: 10mg, 25mg, 50mg, 75mg, 100mg · Tab

CENOBAMATE

· 9 products · Limited Use, codes 719 · strengths: 12.5mg, 25mg, 50mg, 100mg, 150mg, 200mg, 12.5mg & 25mg, 50mg & 100mg, 150mg & 200mg · Tab, Tab - (Starter Kit)

LACOSAMIDE

· 44 products · Limited Use, codes 430 · strengths: 50mg, 100mg, 150mg, 200mg · Tab

LEVETIRACETAM

· 49 products · Limited Use, codes 640, 705 (3), Limited Use, codes 473 (46) · strengths: 100mg/mL, 250mg, 500mg, 750mg, 1000mg · Oral Sol, Tab

PERAMPANEL

· 12 products · Limited Use, codes 430, 564 · strengths: 2mg, 4mg, 6mg, 8mg, 10mg, 12mg · Tab

CARBAMAZEPINE

· 15 products · Listed, not a benefit (3), General benefit (6), Temporary benefit (2), Limited Use, codes 67 (4) · strengths: 100mg, 200mg, 400mg, 100mg/5mL · Chew Tab, ER Tab, LA Tab, Oral Susp, Tab

CLONAZEPAM

· 9 products · General benefit · strengths: 0.5mg, 2mg · Tab

DIVALPROEX SODIUM

· 9 products · General benefit · strengths: 125mg, 250mg, 500mg · Ent Tab

ETHOSUXIMIDE

· 4 products · General benefit · strengths: 250mg, 50mg/mL · Cap, O/L

PHENYTOIN (DIPHENYLHYDANTOIN)

· 4 products · General benefit; DIN status E (meaning unconfirmed); confirm discontinuation/availability with Health Canada (2), General benefit (2) · strengths: 6mg/mL, 25mg/mL, 50mg · O/L, Tab

PHENYTOIN (DIPHENYLHYDANTOIN) SODIUM

· 4 products · General benefit (3), Limited Use, codes 481, 657 (1) · strengths: 30mg, 100mg, 50mg/mL · Cap, Inj Sol (Preservative Free) Source: formulary-ed43-front-matter.txt Part V; ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26; class 28:12 and 11 more
Full class listing Related classes: 28:08 Analgesics, 28:10 Opiate Antagonists, 28:16 Psychotherapeutic Agents, 28:20 C.N.S. Stimulants, 28:24 Sedatives and Hypnotics, 28:36 Antiparkinsonian Agents, 28:92 Miscellaneous Central Nervous System Drugs 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 Adults ( 18 years of age) LAMICTAL (lamotrigine) is indicated: • as adjunctive therapy for the management of epilepsy not satisfactorily controlled by conventional therapy; • for use as monotherapy following withdrawal of concomitant antiepileptic drugs; • as adjunctive therapy for the management of the seizures associated with Lennox-Gastaut syndrome. 1.1 Pediatrics Pediatrics (<18 years of age) LAMICTAL (lamotrigine) is indicated as adjunctive therapy for the management of the seizures associated with Lennox-Gastaut syndrome. LAMICTAL is not recommended in children weighing less than 9 kg (see 4 DOSAGE AND ADMINISTRATION). Safety and efficacy in patients below the age of 16 years, other than those with Lennox-Gastaut Syndrome, have not been established. 1.2 Geriatrics Geriatrics (> 65 years of age): No dosage adjustment is required in patients over 65 years of age. https://pdf.hres.ca/dpd_pm/00080062.PDF PM date: November 21, 1994 Source product: LAMICTAL; DIN 02142082; fetched 2026-09-10 Product monograph posted by Health Canada; excerpt for lookup only.

Prepare an Exceptional Access request

SADIE has its own form for many drugs; this checklist prepares the answers; the ministry decides. Open SADIE

Use this text in SADIE’s free-text fields or read from it on a Telephone Request Service call. Review marks do not indicate eligibility. Evidence stays in this page until you copy it; nothing entered here is sent or saved. Do not enter patient identifiers.

EAP Telephone Request Service: The TRS can be accessed by calling toll-free at 1-866-811-9893 or 416-327-8109 (Toronto area) between 8:30 a.m. and 5:00 p.m. Monday through Friday (except holidays) and selecting the TRS option. Source; updated September 15, 2026

EAP fax: In Ontario: 1-866-811-9908 or 416-327-7526 (Toronto area). Outside Ontario: 1-833-905-4260. Source; updated September 15, 2026

Posted turnaround and Telephone Request Service scope
Turnaround times The Exceptional Access Program receives between 250 and 500 requests a day. Requests are categorized in order of priority based on how quickly a drug is needed, the type of drug, and the condition for which the drug is being used. Turnaround times begin on the business day on which the EAP receives a complete request from a physician or nurse practitioner. You may have to wait longer if the request is missing information or supporting documents required by the EAP criteria, if a request requires external review, or if documents are sent by fax or mail instead of submitted via SADIE. EAP Weekly Progress Report Date: September 15, 2026 Processing categories and examples | Target | Current | Priority 1 — for drugs such as antibiotics, cancer medications, and initial requests for pain medications | 3 business days | 2 business day | Priority 2 — for antiviral drugs to treat HIV, drugs for multiple sclerosis, and pulmonary hypertension | 5 business days | 3 business days | Biologics — for biologic drugs to treat rheumatoid arthritis, psoriatic arthritis, ulcerative colitis and Crohn’s disease | 10 business days | 4 business days | Chronic — for drugs used for chronic conditions such as migraines, chronic pain, Ménière's disease and symptoms of Parkinson’s disease. | 4 to 6 weeks | 11 business days |
For selected drugs, the Telephone Request Service is available to authorized prescribers or their delegates. In most cases, the funding decision is provided by the end of the call and processed within one business day.
Source; updated September 15, 2026

Lamotrigine (chewable) (Lamictal)

Ministry criteria list dated January 1, 2025; the program's current criteria may differ; SADIE shows the current version. Current criteria in SADIE

Prepare answers: See the ministry wording below; no separate indication heading is held.

Ministry criteria corpus 2025-01-01; page 31

Lamotrigine (chewable) Brand(s): Lamictal DOSAGE FORM/ STRENGTH: 5 mg chewable tablet
For the adjunctive therapy for children over 2 years of age who are suffering from refractory seizures associated with Lennox-Gastaut syndrome, and who have previously tried other antiepileptic drugs.
Duration of Approval: 1 year

Prepared from the ministry's published criteria; eligibility is decided by the Exceptional Access Program.