Mictoryl Pediatric · DIN 02460289 · 5mg · tablet
Limited Use — Reason for Use code 530 requiredMarketed · checked 2026-09-20
StatusLimited Use — Reason for Use code 530 required
Write on scriptLU code 530 (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 530
Reason for Use code 530
For the symptomatic treatment of urinary incontinence and/or increased urinary frequency and urgency in pediatric patients with overactive bladder.
Coverage limit:
LU Authorization Period: 1 year
No interchangeable product listed in the Ontario extract
Mictoryl Pediatric · DIN 02460289
Manufacturer: Duchesnay Inc.; listing date 2018-05-31
Health Canada: Marketed since 2017-04-13 · brand MICTORYL PEDIATRIC · ATC G04BD06 PROPIVERINE · form Tablet · route Oral · ingredients PROPIVERINE HYDROCHLORIDE 5 MG · company Duchesnay inc · schedule Prescription
Mictoryl Pediatric: Formulary list price $0.3889/unit (unit not stated in source; not the patient's cost)
Ministry pays: $0.3889 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=94757 · Verify on the e-Formulary ↗ (DIN 02460289)
Source record
DIN 02460289: Mictoryl Pediatric
Raw flags: sec12=Y, sec3=Y
Item: 861204001; group id 879; item number 2120; lccId 00303; manufacturer id DUI
Source form: Tab; strength: 5mg
Recorded listing: Limited Use: paid only with a Reason for Use code and the criteria below
Source prices (unrounded): $0.3889; ministry $0.3889
Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02460289
Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=94757
Shortage status: not checked (no credentials)