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MIDODRINE HCL

All products: Limited Use (codes 01)

Jamp Midodrine · DIN 02517728 · 5mg · tablet

Limited Use — Reason for Use code 01 requiredMarketed · checked 2026-09-02
StatusLimited Use — Reason for Use code 01 required
Write on scriptLU code 01 (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 01
Reason for Use code 01 For the treatment of patients disabled by moderate to severe neurogenic orthostatic hypotension (i.e. drop in systolic BP less than or equal to 20mm Hg from supine to standing position), in whom conventional nonpharmacologic and pharmacologic (i.e. fludrocortisone) therapies have proven ineffective or are poorly tolerated. Coverage limit: LU Authorization Period: Indefinite
1 brand, same coverage
Jamp Midodrine · DIN 02517728 Manufacturer: Jamp Pharma Corporation; listing date 2022-04-29 Health Canada: Marketed since 2025-08-07 · brand JAMP MIDODRINE · ATC C01CA17 MIDODRINE · form Tablet · route Oral · ingredients MIDODRINE HYDROCHLORIDE 5 MG · company Jamp pharma corporation · schedule Prescription
Check this DIN again · Health Canada product record

Jamp Midodrine: Formulary list price $0.1921/unit (unit not stated in source; not the patient's cost)

Ministry pays: $0.1921 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=100708 · Verify on the e-Formulary ↗ (DIN 02517728)

Source record
DIN 02517728: Jamp Midodrine Raw flags: sec12=Y, sec3=Y Item: 402800042; group id 566; item number 1511; lccId 00079; manufacturer id JPC Source form: Tab; strength: 5mg Recorded listing: Limited Use: paid only with a Reason for Use code and the criteria below Source prices (unrounded): $0.1921; ministry $0.1921 Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02517728 Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=100708
Interchangeable products
Amatine · DIN 01934406 · not recorded Apo-Midodrine · DIN 02278685 · $0.1921 Mar-Midodrine · DIN 02473992 · $0.1921 Midodrine · DIN 02533219 · $0.1921
Shortage status: resolved shortage (ended 2025-07-31); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada) Source: https://healthproductshortages.ca/search?term=02517728
Shortage record checked 2026-09-13T08:10:21.292534+00:00
Other drugs in the same formulary class (40:28 Diuretics) and how they are covered

Matched class: 40:28 Diuretics

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: AMILORIDE HCL, METOLAZONE, SPIRONOLACTONE Some products covered without a code (check the product listing): AMILORIDE HCL & HYDROCHLOROTHIAZIDE, CHLORTHALIDONE, FUROSEMIDE, HYDROCHLOROTHIAZIDE, HYDROCHLOROTHIAZIDE & SPIRONOLACTONE, HYDROCHLOROTHIAZIDE & TRIAMTERENE, INDAPAMIDE 40:28 Diuretics

AMILORIDE HCL

· 1 products · General benefit · strengths: 5mg · Tab

AMILORIDE HCL & HYDROCHLOROTHIAZIDE

· 2 products · Listed, not a benefit (1), General benefit (1) · strengths: 5mg & 50mg · Tab

CHLORTHALIDONE

· 3 products · Listed, not a benefit (1), General benefit (2) · strengths: 50mg · Tab

FUROSEMIDE

· 14 products · Limited Use, codes 481, 657 (2), General benefit (9), Listed, not a benefit (2), Limited Use, codes 33 (1) · strengths: 10mg/mL, 20mg, 40mg, 500mg · Inj Sol (Preservative Free), O/L, Tab

HYDROCHLOROTHIAZIDE

· 12 products · Off-Formulary Interchangeable, not an ODB benefit (3), Listed, not a benefit (2), General benefit (7) · strengths: 12.5mg, 25mg, 50mg · Tab

HYDROCHLOROTHIAZIDE & SPIRONOLACTONE

· 4 products · Listed, not a benefit (2), General benefit (2) · strengths: 25mg & 25mg, 50mg & 50mg · Tab

HYDROCHLOROTHIAZIDE & TRIAMTERENE

· 3 products · General benefit (2), Listed, not a benefit (1) · strengths: 25mg & 50mg · Tab

INDAPAMIDE

· 6 products · Listed, not a benefit (2), General benefit (4) · strengths: 1.25mg, 2.5mg · Tab

METOLAZONE

· 1 products · General benefit · strengths: 2.5mg · Tab

SPIRONOLACTONE

· 8 products · General benefit · strengths: 25mg, 100mg · Tab

TOLVAPTAN

· 10 products · Off-Formulary Interchangeable, not an ODB benefit · strengths: 15mg & 15mg, 30mg & 15mg, 45mg & 15mg, 60mg & 30mg, 90mg & 30mg · 14-Tabs Pk Source: formulary-ed43-front-matter.txt Part V; ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26; class 40:28
Full class listing Related classes: 40:12 Replacement Agents, 40:18 Potassium-Removing Resins, 40:40 Uricosuric Drugs Same formulary class, not same indication: class membership alone does not establish equivalent uses.
What the Health Canada label says it is for
INDICATIONS AND CLINICAL USE Because midodrine hydrochloride can cause marked elevation of supine blood pressure, it should only be used in patients whose lives are considerably impaired despite standard clinical care including non-pharmacologic treatment, plasma volume expansion and lifestyle alterations. The use of midodrine hydrochloride in the management of symptomatic orthostatic hypotension is based primarily on a change in a surrogate endpoint of effectiveness, an increase in systolic blood pressure measured one minute after standing, a surrogate endpoint considered likely to correspond to clinical benefits. At present, however, clinical benefits of midodrine hydrochloride, principally improved ability to carry out activities of daily life, have not been verified. APO-MIDODRINE (midodrine hydrochloride) may be used to attenuate symptoms of chronic orthostatic hypotension due to autonomic failure in patients with Bradbury-Eggleston syndrome, Shy-Drager syndrome, diabetes mellitus disease and Parkinson’s disease. The initiation and up-titration of midodrine therapy should be undertaken under close medical supervision in a controlled clinical setting (see DOSAGE AND ADMINIS… https://pdf.hres.ca/dpd_pm/00047855.PDF PM date: not printed or not captured Source product: APO-MIDODRINE; DIN 02278677; fetched 2026-09-10 Product monograph posted by Health Canada; excerpt for lookup only.