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FLUTICASONE FUROATE & VILANTEROL

All products: Limited Use (codes 330)

Other products in the same Health Canada class (R03A, R03AK) — coverage varies; not interchangeable

  • Budesonide + formoterol (Symbicort 100 Turbuhaler): limited Use 330
  • Formoterol + mometasone furoate (Zenhale): limited Use 330
  • Fluticasone + salmeterol (Advair 125): limited Use 330
  • Salbutamol (Teva-Salbutamol Sterinebs P.F.): general benefit, Limited Use 256, 257, 258, 259, Limited Use 265, 266, 267, 268, Not a benefit
  • Terbutaline (Bricanyl Turbuhaler): general benefit
  • Aclidinium + formoterol (Duaklir Genuair): limited Use 459

8 more in the class list below

Breo Ellipta · DIN 02444186 · 200mcg & 25mcg · Blister dry-powder inhaler, 30 doses

Limited Use — Reason for Use code 330 requiredMarketed · checked 2026-09-19
StatusLimited Use — Reason for Use code 330 required
Write on scriptLU code 330 (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 330
Reason for Use code 330 For the treatment of asthma in patients who are using optimum anti-inflammatory treatment and are still experiencing breakthrough symptoms. Coverage limit: LU Authorization Period: Indefinite
No interchangeable product listed in the Ontario extract
Breo Ellipta · DIN 02444186 Manufacturer: GlaxoSmithKline Inc., GlaxoSmithKline Consumer Health Care; listing date 2016-08-30 Health Canada: Marketed since 2015-10-02 · brand BREO ELLIPTA · ATC R03AK10 VILANTEROL AND FLUTICASONE FUROATE · form Powder · route Inhalation · ingredients FLUTICASONE FUROATE 200 MCG/ACT, VILANTEROL (VILANTEROL TRIFENATATE) 25 MCG/ACT · company Glaxosmithkline inc · schedule Prescription
Check this DIN again · Health Canada product record

Breo Ellipta: Formulary list price $175.1600/unit (unit not stated in source; not the patient's cost)

Ministry pays: $175.1600 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=92906 · Verify on the e-Formulary ↗ (DIN 02444186)

Source record
DIN 02444186: Breo Ellipta Raw flags: sec12=Y, sec3=Y Item: 121200111; group id 225; item number 0403; lccId 00268; manufacturer id GSK Source form: Blister Pd Inh-30 Dose Pk; strength: 200mcg & 25mcg Recorded listing: Limited Use: paid only with a Reason for Use code and the criteria below Source prices (unrounded): $175.1600; ministry $175.1600 Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02444186 Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=92906
Shortage status: not checked (no credentials)
Other drugs in the same formulary class (12:12 Sympathomimetic (Adrenergic) Agents) and how they are covered

Matched class: 12:12 Sympathomimetic (Adrenergic) 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: EPINEPHRINE HCL, TERBUTALINE SULFATE Some products covered without a code (check the product listing): ORCIPRENALINE SULFATE, SALBUTAMOL 12:12 Sympathomimetic (Adrenergic) Agents

BUDESONIDE & FORMOTEROL FUMARATE DIHYDRATE

· 2 products · Limited Use, codes 330 · strengths: 100mcg/6mcg, 200mcg/6mcg · Pd Inh-120 Dose Pk

MOMETASONE FUROATE & FORMOTEROL FUMARATE DIHYDRATE

· 2 products · Limited Use, codes 330 · strengths: 100mcg & 5mcg, 200mcg & 5mcg · Metered Dose Inh-120 Dose Pk

SALMETEROL XINAFOATE & FLUTICASONE PROPIONATE

· 11 products · Limited Use, codes 330 · strengths: 25/125mcg/Metered Dose, 25/250mcg/Metered Dose, 50/100mcg, 50/250mcg, 50/500mcg · Inh-120 Dose Pk, Inh-60 Dose Pk

SALBUTAMOL

· 20 products · Limited Use, codes 265, 266, 267, 268 (4), Listed, not a benefit (8), Limited Use, codes 256, 257, 258, 259 (1), General benefit (7) · strengths: 1mg/mL, 2mg/mL, 5mg/mL, 100mcg/Metered Dose, 2mg, 4mg · Inh Sol- 2.5mL Pk, Inh Sol-10mL Pk, Inh-200 dose Pk, Tab

TERBUTALINE SULFATE

· 2 products · General benefit · strengths: 0.5mg/Dose · Inh-100 Dose Pk, Inh-120 Dose Pk

ACLIDINIUM BROMIDE & FORMOTEROL FUMARATE DIHYDRATE

· 1 products · Limited Use, codes 459 · strengths: 400mcg & 12mcg · Metered Dose Pd Inh-60 Dose Pk

BUDESONIDE&GLYCOPYRRONIUM (GLYCOPYRRONIUM BROMIDE)&FORMOTEROL FUMARATE DIHYDRATE

· 1 products · Limited Use, codes 638 · strengths: 160mcg & 7.2mcg & 5mcg/Act · Metered Dose Inh-120 Dose Pk

FLUTICASONE FUROATE & UMECLIDINIUM BROMIDE & VILANTEROL TRIFENATATE

· 1 products · Limited Use, codes 567 · strengths: 100mcg & 62.5mcg & 25mcg · Pd Inh-30 Dose Pk

FORMOTEROL FUMARATE

· 1 products · Limited Use, codes 132 · strengths: 12mcg/Cap · Inh Pd-Device Pk

FORMOTEROL FUMARATE DIHYDRATE

· 2 products · Limited Use, codes 132 · strengths: 6mcg/Metered Dose, 12mcg/Metered Dose · Pd Inh-60 Dose Pk

INDACATEROL

· 1 products · Limited Use, codes 443 · strengths: 75mcg · Inh Pd-Cap

INDACATEROL & GLYCOPYRRONIUM

· 1 products · Limited Use, codes 459 · strengths: 110mcg & 50mcg · Inh Pd-Cap Source: formulary-ed43-front-matter.txt Part V; ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26; class 12:12 and 4 more
Full class listing Related classes: 12:04 Parasympathomimetic (Cholinergic) Agents, 12:08 Parasympatholytic (Cholinergic Blocking) Agents, 12:20 Skeletal Muscle Relaxants Same formulary class, not same indication: class membership alone does not establish equivalent uses.
Other drugs whose Health Canada label lists a similar indication: asthma, copd, obstructive pulmonary disease
From Health Canada product monographs; label wording only, not a treatment recommendation. Matching is lexical and uses one held product label per generic; formulations and qualifying criteria may differ. Covered without a code on the Ontario formulary: ACLIDINIUM BROMIDE, GLYCOPYRRONIUM BROMIDE, TIOTROPIUM BROMIDE MONOHYDRATE ACLIDINIUM BROMIDE · General benefit INDICATIONS AND CLINICAL USE TUDORZA GENUAIR (aclidinium bromide) is indicated as a long-term maintenance bronchodilator treatment in patients with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema. PM: https://pdf.hres.ca/dpd_pm/00067375.PDF; date not captured; DIN 02409720; fetched 2026-09-10 Product monograph ACLIDINIUM BROMIDE & FORMOTEROL FUMARATE DIHYDRATE · Limited Use, codes 459 INDICATIONS AND CLINICAL USE DUAKLIR GENUAIR (aclidinium bromide/formoterol fumarate dihydrate) is a combination of a long-acting muscarinic antagonist (LAMA) and a long-acting beta2-agonist (LABA) indicated as a long-term maintenance bronchodilator treatment for airflow obstruction in patients with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and/or emphysema. PM: https://pdf.hres.ca/dpd_pm/00067361.PDF; date not captured; DIN 02439530; fetched 2026-09-10 Product monograph BUDESONIDE & FORMOTEROL FUMARATE DIHYDRATE · Limited Use, codes 330 INDICATIONS AND CLINICAL USE Asthma SYMBICORT TURBUHALER (budesonide and formoterol fumarate dihydrate) is indicated for the treatment of asthma in patients 12 years and older with reversible obstructive airways disease. PM: https://pdf.hres.ca/dpd_pm/00059997.PDF; date February 8, 2021; DIN 02245385; fetched 2026-09-10 Product monograph GLYCOPYRRONIUM BROMIDE · General benefit 1 INDICATIONS SEEBRI ® BREEZHALER ® (glycopyrronium bromide) is indicated as a long-term once-daily maintenance bronchodilator treatment in patients with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema. PM: https://pdf.hres.ca/dpd_pm/00067963.PDF; date October 16, 2012; DIN 02394936; fetched 2026-09-10 Product monograph INDACATEROL & GLYCOPYRRONIUM · Limited Use, codes 459 1 INDICATIONS ULTIBRO BREEZHALER (indacaterol maleate and glycopyrronium bromide) is a combination of a long- acting beta2-agonist (LABA) and a long-acting muscarinic antagonist (LAMA), indicated for the long-term once-daily maintenance bronchodilator treatment of airflow obstruction in patients with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema, and for the reduction of exacerbations of COPD in patients with a history of exacerbations. PM: https://pdf.hres.ca/dpd_pm/00072513.PDF; date Dec 23, 2013; DIN 02418282; fetched 2026-09-10 Product monograph INDACATEROL ACETATE & MOMETASONE FUROATE · Limited Use, codes 626 1 INDICATIONS ATECTURA BREEZHALER (indacaterol/mometasone furoate) is a combination of a long-acting beta2- adrenergic agonist (LABA) and an inhaled corticosteroid (ICS) indicated as a once-daily maintenance treatment of asthma in adults and adolescents 12 years of age and older with reversible obstructive airways disease. PM: https://pdf.hres.ca/dpd_pm/00063537.PDF; date May 5, 2020; DIN 02498685; fetched 2026-09-10 Product monograph MOMETASONE FUROATE & FORMOTEROL FUMARATE DIHYDRATE · Limited Use, codes 330 1 Indications ZENHALE® (mometasone furoate / formoterol fumarate dihydrate inhalation aerosol), is a combination of an inhaled corticosteroid (ICS) and a long-acting beta2-adrenergic agonist (LABA) indicated for: • the treatment of asthma, in patients 12 years of age and older with reversible obstructive airway disease. PM: https://pdf.hres.ca/dpd_pm/00080784.PDF; date 2025-06-09; DIN 02361752; fetched 2026-09-10 Product monograph SALMETEROL XINAFOATE & FLUTICASONE PROPIONATE · Limited Use, codes 330 Chronic Obstructive Pulmonary Disease (COPD) ADVAIR DISKUS 250 and ADVAIR DISKUS 500 are indicated for:  the maintenance treatment of COPD, including emphysema and chronic bronchitis, in patients where the use of a combination product is considered appropriate. PM: https://pdf.hres.ca/dpd_pm/00056976.PDF; date June 17, 2020; DIN 02240835; fetched 2026-09-10 Product monograph TIOTROPIUM BROMIDE MONOHYDRATE · General benefit 1 INDICATIONS SPIRIVA (tiotropium bromide monohydrate) is indicated for:  long-term once-daily maintenance bronchodilator treatment of airflow obstruction in patients with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and/or emphysema. PM: https://pdf.hres.ca/dpd_pm/00065560.PDF; date NOV 20, 2002; DIN 02246793; fetched 2026-09-10 Product monograph TIOTROPIUM BROMIDE MONOHYDRATE & OLODATEROL HYDROCHLORIDE · Limited Use, codes 459 INDICATIONS AND CLINICAL USE INSPIOLTO RESPIMAT (tiotropium bromide monohydrate and olodaterol hydrochloride) is a combination of a long-acting muscarinic antagonist (LAMA) and a long-acting beta2-adrenergic agonist (LABA) indicated for the long term, once daily maintenance bronchodilator treatment of airflow obstruction in patients with Chronic Obstructive Pulmonary Disease (COPD), including chronic bronchitis and emphysema. PM: https://pdf.hres.ca/dpd_pm/00054220.PDF; date November 14, 2019; DIN 02441888; fetched 2026-09-10 Product monograph and 2 more Coverage source: ON formulary extract 2026-08-26
What the Health Canada label says it is for
INDICATIONS AND CLINICAL USE COPD BREO ELLIPTA (fluticasone furoate/vilanterol) 100/25 mcg is a combination of an inhaled corticosteroid (ICS) and a long-acting beta2-adrenergic agonist (LABA), indicated for the long-term once-daily maintenance treatment of airflow obstruction in patients with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and/or emphysema, and to reduce exacerbations of COPD in patients with a history of exacerbations. BREO ELLIPTA 100/25 mcg once daily is the only strength indicated for the treatment of COPD. BREO ELLIPTA 200/25 mcg is not indicated for patients with COPD. There is no additional benefit of the 200/25 mcg dose compared to the 100/25 mcg dose and there is a potential increased risk of pneumonia and systemic corticosteroid-related adverse reactions. BREO ELLIPTA is not indicated for the relief of acute bronchospasm (see WARNINGS AND PRECAUTIONS, General). Page 3 of 74 Asthma BREO ELLIPTA 100/25 mcg and BREO ELLIPTA 200/25 mcg are indicated for the once-daily maintenance treatment of asthma in patients aged 18 years and older with reve… https://pdf.hres.ca/dpd_pm/00049111.PDF PM date: January 7, 2019 Source product: BREO ELLIPTA; DIN 02408872; fetched 2026-09-10 Product monograph posted by Health Canada; excerpt for lookup only.