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

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Showing products 1–24 of 49. More products

Listed in the December 27, 2023 extract; not in the current extract (Aug 26, 2026): Nat-Levetiracetam (02440202), Levetiracetam (02454653), Nat-Levetiracetam (02440210), Levetiracetam (02454661), Nat-Levetiracetam (02440229), Levetiracetam (02454688). Source: odb-formulary-ed43-extract-2023-12-27.xml; compared with odb-formulary-ed43-extract-2026-08-26.xml.

LEVETIRACETAM

Form:

24 of 24 products shown

All products: Limited Use (codes 473, 640, 705)

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

  • Lamotrigine (Lamictal): general benefit
  • 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
  • Perampanel (Fycompa): limited Use 430, 564

14 more in the class list below

Mint-Levetiracetam Solution · DIN 02558416 · 100mg/mL · Oral Sol

Limited Use — Reason for Use code 640, 705 requiredMarketed · checked 2026-09-02
StatusLimited Use — Reason for Use code 640, 705 required
Write on scriptLU code 640, 705 (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 640, 705
Reason for Use code 640 For patients unable to swallow or tolerate oral solid dosage forms and who are using this as adjunctive therapy in the treatment of seizure disorders where control by other listed anticonvulsants has been unsatisfactory. Coverage limit: LU Authorization Period: 1 year Reason for Use code 705 As adjunctive therapy in the treatment of seizure disorders in pediatric patients (less than 18 years of age) where control by other listed anticonvulsants has been unsatisfactory and where the appropriate dose cannot be achieved using listed solid oral levetiracetam dosage formats. Coverage limit: LU Authorization Period: 1 year
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
Mint-Levetiracetam Solution · DIN 02558416 Manufacturer: Mint Pharmaceuticals Inc.; listing date 2025-10-31 Health Canada: Marketed since 2025-08-14 · brand MINT-LEVETIRACETAM SOLUTION · ATC N03AX14 LEVETIRACETAM · form Solution · route Oral · ingredients LEVETIRACETAM 100 MG/ML · company Mint pharmaceuticals inc · schedule Prescription
Check this DIN again · Health Canada product record

Mint-Levetiracetam Solution: Formulary list price $0.4071/unit (unit not stated in source; not the patient's cost)

Ministry pays: $0.4071 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=106166 · Verify on the e-Formulary ↗ (DIN 02558416)

Source record
DIN 02558416: Mint-Levetiracetam Solution Raw flags: sec12=Y, sec3=Y Item: 281200183; group id 433; item number 1082; lccId 00365; manufacturer id MIN Source form: Oral Sol; strength: 100mg/mL Recorded listing: Limited Use: paid only with a Reason for Use code and the criteria below Source prices (unrounded): $0.4071; ministry $0.4071 Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02558416 Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=106166
Interchangeable products
PDP-Levetiracetam · DIN 02490447 · $0.4071 Pharma-Levetiracetam · DIN 02515318 · $0.4071
Shortage status: no shortage or discontinuation reported (checked 2026-09-13T08:10:21.292534+00:00); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada) Source: https://healthproductshortages.ca/search?term=02558416
Shortage record checked 2026-09-13T08:10:21.292534+00:00

PDP-Levetiracetam · DIN 02490447 · 100mg/mL · Oral Sol

Limited Use — Reason for Use code 640, 705 requiredMarketed · checked 2026-09-02
StatusLimited Use — Reason for Use code 640, 705 required
Write on scriptLU code 640, 705 (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 640, 705
Reason for Use code 640 For patients unable to swallow or tolerate oral solid dosage forms and who are using this as adjunctive therapy in the treatment of seizure disorders where control by other listed anticonvulsants has been unsatisfactory. Coverage limit: LU Authorization Period: 1 year Reason for Use code 705 As adjunctive therapy in the treatment of seizure disorders in pediatric patients (less than 18 years of age) where control by other listed anticonvulsants has been unsatisfactory and where the appropriate dose cannot be achieved using listed solid oral levetiracetam dosage formats. Coverage limit: LU Authorization Period: 1 year
1 brand, same coverage
PDP-Levetiracetam · DIN 02490447 Manufacturer: Pendopharm, Division of Pharmascience Inc.; listing date 2022-12-21 Health Canada: Marketed since 2020-05-01 · brand PDP-LEVETIRACETAM · ATC N03AX14 LEVETIRACETAM · form Solution · route Oral · ingredients LEVETIRACETAM 100 MG/ML · company Pendopharm division of pharmascience inc · schedule Prescription
Check this DIN again · Health Canada product record

Ministry pays: $0.4071 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=98049 · Verify on the e-Formulary ↗ (DIN 02490447)

Source record
DIN 02490447: PDP-Levetiracetam Raw flags: sec12=Y, sec3=Y Item: 281200183; group id 433; item number 1082; lccId 00365; manufacturer id PEN Source form: Oral Sol; strength: 100mg/mL Recorded listing: Limited Use: paid only with a Reason for Use code and the criteria below Source prices (unrounded): $0.8142; ministry $0.4071 Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02490447 Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=98049
Interchangeable products
Mint-Levetiracetam Solution · DIN 02558416 · $0.4071 Pharma-Levetiracetam · DIN 02515318 · $0.4071
Shortage status: resolved shortage (ended 2021-04-21); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada) Source: https://healthproductshortages.ca/search?term=02490447
Shortage record checked 2026-09-13T08:10:21.292534+00:00

Pharma-Levetiracetam · DIN 02515318 · 100mg/mL · Oral Sol

Limited Use — Reason for Use code 640, 705 requiredMarketed · checked 2026-09-02
StatusLimited Use — Reason for Use code 640, 705 required
Write on scriptLU code 640, 705 (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 640, 705
Reason for Use code 640 For patients unable to swallow or tolerate oral solid dosage forms and who are using this as adjunctive therapy in the treatment of seizure disorders where control by other listed anticonvulsants has been unsatisfactory. Coverage limit: LU Authorization Period: 1 year Reason for Use code 705 As adjunctive therapy in the treatment of seizure disorders in pediatric patients (less than 18 years of age) where control by other listed anticonvulsants has been unsatisfactory and where the appropriate dose cannot be achieved using listed solid oral levetiracetam dosage formats. Coverage limit: LU Authorization Period: 1 year
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
Pharma-Levetiracetam · DIN 02515318 Manufacturer: Pharmascience Inc.; listing date 2025-12-30 Health Canada: Marketed since 2025-12-22 · brand PHARMA-LEVETIRACETAM · ATC N03AX14 LEVETIRACETAM · form Solution · route Oral · ingredients LEVETIRACETAM 100 MG/ML · company Pharmascience inc · schedule Prescription
Check this DIN again · Health Canada product record

Pharma-Levetiracetam: Formulary list price $0.4071/unit (unit not stated in source; not the patient's cost)

Ministry pays: $0.4071 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=100470 · Verify on the e-Formulary ↗ (DIN 02515318)

Source record
DIN 02515318: Pharma-Levetiracetam Raw flags: sec12=Y, sec3=Y Item: 281200183; group id 433; item number 1082; lccId 00365; manufacturer id PMS Source form: Oral Sol; strength: 100mg/mL Recorded listing: Limited Use: paid only with a Reason for Use code and the criteria below Source prices (unrounded): $0.4071; ministry $0.4071 Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02515318 Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=100470
Interchangeable products
Mint-Levetiracetam Solution · DIN 02558416 · $0.4071 PDP-Levetiracetam · DIN 02490447 · $0.4071
Shortage status: no shortage or discontinuation reported (checked 2026-09-13T08:10:21.292534+00:00); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada) Source: https://healthproductshortages.ca/search?term=02515318
Shortage record checked 2026-09-13T08:10:21.292534+00:00

Ach-Levetiracetam · DIN 02399776 · 250mg · tablet

Limited Use — Reason for Use code 473 requiredMarketed · checked 2026-09-02
StatusLimited Use — Reason for Use code 473 required
Write on scriptLU code 473 (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 473
Reason for Use code 473 As adjunctive therapy in the treatment of seizure disorders where control by other listed anticonvulsants has been unsatisfactory. Coverage limit: LU Authorization Period: Indefinite
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
Ach-Levetiracetam · DIN 02399776 Manufacturer: Accord Healthcare Inc.; listing date 2013-06-27 Health Canada: Marketed since 2023-04-14 · brand ACH-LEVETIRACETAM · ATC N03AX14 LEVETIRACETAM · form Tablet · route Oral · ingredients LEVETIRACETAM 250 MG · company Accord healthcare inc · schedule Prescription
Check this DIN again · Health Canada product record

Ach-Levetiracetam: Formulary list price $0.3210/unit (unit not stated in source; not the patient's cost)

Ministry pays: $0.3210 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=88462 · Verify on the e-Formulary ↗ (DIN 02399776)

Source record
DIN 02399776: Ach-Levetiracetam Raw flags: sec12=Y, sec3=Y Item: 281200091; group id 434; item number 1083; lccId 00266; manufacturer id ACH Source form: Tab; strength: 250mg Recorded listing: Limited Use: paid only with a Reason for Use code and the criteria below Source prices (unrounded): $0.3210; ministry $0.3210 Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02399776 Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=88462
Interchangeable products
Act Levetiracetam · DIN 02274183 · $0.3210 Apo-Levetiracetam · DIN 02285924 · $0.3210 Auro-Levetiracetam · DIN 02375249 · $0.3210 Jamp Levetiracetam Tablets · DIN 02504553 · $0.3210 Jamp-Levetiracetam · DIN 02403005 · $0.3210 Keppra · DIN 02247027 · $0.3210 Levetiracetam · DIN 02353342 · $0.3210 Levetiracetam · DIN 02442531 · $0.3210 M-Levetiracetam · DIN 02524562 · $0.3210 Mint-Levetiracetam · DIN 02442388 · $0.3210 NRA-Levetiracetam · DIN 02499193 · $0.3210 PMS-Levetiracetam · DIN 02296101 · $0.3210 Riva-Levetiracetam · DIN 02482274 · $0.3210 Sandoz Levetiracetam · DIN 02461986 · $0.3210
Shortage status: active shortage (reported 2025-03-21, last updated 2025-03-22); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada) Source: https://healthproductshortages.ca/search?term=02399776
Shortage record checked 2026-09-13T08:10:21.292534+00:00

Act Levetiracetam · DIN 02274183 · 250mg · tablet

Limited Use — Reason for Use code 473 requiredMarketed · checked 2026-09-02
StatusLimited Use — Reason for Use code 473 required
Write on scriptLU code 473 (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 473
Reason for Use code 473 As adjunctive therapy in the treatment of seizure disorders where control by other listed anticonvulsants has been unsatisfactory. Coverage limit: LU Authorization Period: Indefinite
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
Act Levetiracetam · DIN 02274183 Manufacturer: Actavis Pharma Company; listing date 2007-12-19 Health Canada: Marketed since 2020-12-17 · brand TEVA-LEVETIRACETAM · ATC N03AX14 LEVETIRACETAM · form Tablet · route Oral · ingredients LEVETIRACETAM 250 MG · company Teva canada limited · schedule Prescription
Check this DIN again · Health Canada product record

Act Levetiracetam: Formulary list price $0.3210/unit (unit not stated in source; not the patient's cost)

Ministry pays: $0.3210 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=75964 · Verify on the e-Formulary ↗ (DIN 02274183)

Source record
DIN 02274183: Act Levetiracetam Raw flags: sec12=Y, sec3=Y Item: 281200091; group id 434; item number 1083; lccId 00266; manufacturer id ACV Source form: Tab; strength: 250mg Recorded listing: Limited Use: paid only with a Reason for Use code and the criteria below Source prices (unrounded): $0.3210; ministry $0.3210 Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02274183 Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=75964
Interchangeable products
Ach-Levetiracetam · DIN 02399776 · $0.3210 Apo-Levetiracetam · DIN 02285924 · $0.3210 Auro-Levetiracetam · DIN 02375249 · $0.3210 Jamp Levetiracetam Tablets · DIN 02504553 · $0.3210 Jamp-Levetiracetam · DIN 02403005 · $0.3210 Keppra · DIN 02247027 · $0.3210 Levetiracetam · DIN 02353342 · $0.3210 Levetiracetam · DIN 02442531 · $0.3210 M-Levetiracetam · DIN 02524562 · $0.3210 Mint-Levetiracetam · DIN 02442388 · $0.3210 NRA-Levetiracetam · DIN 02499193 · $0.3210 PMS-Levetiracetam · DIN 02296101 · $0.3210 Riva-Levetiracetam · DIN 02482274 · $0.3210 Sandoz Levetiracetam · DIN 02461986 · $0.3210
Shortage status: resolved shortage (ended 2026-01-28); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada) Source: https://healthproductshortages.ca/search?term=02274183
Shortage record checked 2026-09-13T08:10:21.292534+00:00

Apo-Levetiracetam · DIN 02285924 · 250mg · tablet

Limited Use — Reason for Use code 473 requiredMarketed · checked 2026-09-02
StatusLimited Use — Reason for Use code 473 required
Write on scriptLU code 473 (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 473
Reason for Use code 473 As adjunctive therapy in the treatment of seizure disorders where control by other listed anticonvulsants has been unsatisfactory. Coverage limit: LU Authorization Period: Indefinite
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
Apo-Levetiracetam · DIN 02285924 Manufacturer: Apotex Inc.; listing date 2007-11-10 Health Canada: Marketed since 2006-10-20 · brand APO-LEVETIRACETAM · ATC N03AX14 LEVETIRACETAM · form Tablet · route Oral · ingredients LEVETIRACETAM 250 MG · company Apotex inc · schedule Prescription
Check this DIN again · Health Canada product record

Apo-Levetiracetam: Formulary list price $0.3210/unit (unit not stated in source; not the patient's cost)

Ministry pays: $0.3210 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=77141 · Verify on the e-Formulary ↗ (DIN 02285924)

Source record
DIN 02285924: Apo-Levetiracetam Raw flags: sec12=Y, sec3=Y Item: 281200091; group id 434; item number 1083; lccId 00266; manufacturer id APX Source form: Tab; strength: 250mg Recorded listing: Limited Use: paid only with a Reason for Use code and the criteria below Source prices (unrounded): $0.3210; ministry $0.3210 Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02285924 Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=77141
Interchangeable products
Ach-Levetiracetam · DIN 02399776 · $0.3210 Act Levetiracetam · DIN 02274183 · $0.3210 Auro-Levetiracetam · DIN 02375249 · $0.3210 Jamp Levetiracetam Tablets · DIN 02504553 · $0.3210 Jamp-Levetiracetam · DIN 02403005 · $0.3210 Keppra · DIN 02247027 · $0.3210 Levetiracetam · DIN 02353342 · $0.3210 Levetiracetam · DIN 02442531 · $0.3210 M-Levetiracetam · DIN 02524562 · $0.3210 Mint-Levetiracetam · DIN 02442388 · $0.3210 NRA-Levetiracetam · DIN 02499193 · $0.3210 PMS-Levetiracetam · DIN 02296101 · $0.3210 Riva-Levetiracetam · DIN 02482274 · $0.3210 Sandoz Levetiracetam · DIN 02461986 · $0.3210
Shortage status: resolved shortage (ended 2026-09-03); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada) Source: https://healthproductshortages.ca/search?term=02285924
Shortage record checked 2026-09-13T08:10:21.292534+00:00

Auro-Levetiracetam · DIN 02375249 · 250mg · tablet

Limited Use — Reason for Use code 473 requiredMarketed · checked 2026-09-02
StatusLimited Use — Reason for Use code 473 required
Write on scriptLU code 473 (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 473
Reason for Use code 473 As adjunctive therapy in the treatment of seizure disorders where control by other listed anticonvulsants has been unsatisfactory. Coverage limit: LU Authorization Period: Indefinite
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
Auro-Levetiracetam · DIN 02375249 Manufacturer: Auro Pharma Inc.; listing date 2012-04-24 Health Canada: Marketed since 2012-02-14 · brand AURO-LEVETIRACETAM · ATC N03AX14 LEVETIRACETAM · form Tablet · route Oral · ingredients LEVETIRACETAM 250 MG · company Auro pharma inc · schedule Prescription
Check this DIN again · Health Canada product record

Auro-Levetiracetam: Formulary list price $0.3210/unit (unit not stated in source; not the patient's cost)

Ministry pays: $0.3210 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=86064 · Verify on the e-Formulary ↗ (DIN 02375249)

Source record
DIN 02375249: Auro-Levetiracetam Raw flags: sec12=Y, sec3=Y Item: 281200091; group id 434; item number 1083; lccId 00266; manufacturer id AUR Source form: Tab; strength: 250mg Recorded listing: Limited Use: paid only with a Reason for Use code and the criteria below Source prices (unrounded): $0.3210; ministry $0.3210 Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02375249 Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=86064
Interchangeable products
Ach-Levetiracetam · DIN 02399776 · $0.3210 Act Levetiracetam · DIN 02274183 · $0.3210 Apo-Levetiracetam · DIN 02285924 · $0.3210 Jamp Levetiracetam Tablets · DIN 02504553 · $0.3210 Jamp-Levetiracetam · DIN 02403005 · $0.3210 Keppra · DIN 02247027 · $0.3210 Levetiracetam · DIN 02353342 · $0.3210 Levetiracetam · DIN 02442531 · $0.3210 M-Levetiracetam · DIN 02524562 · $0.3210 Mint-Levetiracetam · DIN 02442388 · $0.3210 NRA-Levetiracetam · DIN 02499193 · $0.3210 PMS-Levetiracetam · DIN 02296101 · $0.3210 Riva-Levetiracetam · DIN 02482274 · $0.3210 Sandoz Levetiracetam · DIN 02461986 · $0.3210
Shortage status: resolved shortage (ended 2024-03-15); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada) Source: https://healthproductshortages.ca/search?term=02375249
Shortage record checked 2026-09-13T08:10:21.292534+00:00

Jamp Levetiracetam Tablets · DIN 02504553 · 250mg · tablet

Limited Use — Reason for Use code 473 requiredMarketed · checked 2026-09-02
StatusLimited Use — Reason for Use code 473 required
Write on scriptLU code 473 (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 473
Reason for Use code 473 As adjunctive therapy in the treatment of seizure disorders where control by other listed anticonvulsants has been unsatisfactory. Coverage limit: LU Authorization Period: Indefinite
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
Jamp Levetiracetam Tablets · DIN 02504553 Manufacturer: Jamp Pharma Corporation; listing date 2022-08-31 Health Canada: Marketed since 2022-06-10 · brand JAMP LEVETIRACETAM TABLETS · ATC N03AX14 LEVETIRACETAM · form Tablet · route Oral · ingredients LEVETIRACETAM 250 MG · company Jamp pharma corporation · schedule Prescription
Check this DIN again · Health Canada product record

Jamp Levetiracetam Tablets: Formulary list price $0.3210/unit (unit not stated in source; not the patient's cost)

Ministry pays: $0.3210 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=99397 · Verify on the e-Formulary ↗ (DIN 02504553)

Source record
DIN 02504553: Jamp Levetiracetam Tablets Raw flags: sec12=Y, sec3=Y Item: 281200091; group id 434; item number 1083; lccId 00266; manufacturer id JPC Source form: Tab; strength: 250mg Recorded listing: Limited Use: paid only with a Reason for Use code and the criteria below Source prices (unrounded): $0.3210; ministry $0.3210 Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02504553 Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=99397
Interchangeable products
Ach-Levetiracetam · DIN 02399776 · $0.3210 Act Levetiracetam · DIN 02274183 · $0.3210 Apo-Levetiracetam · DIN 02285924 · $0.3210 Auro-Levetiracetam · DIN 02375249 · $0.3210 Jamp-Levetiracetam · DIN 02403005 · $0.3210 Keppra · DIN 02247027 · $0.3210 Levetiracetam · DIN 02353342 · $0.3210 Levetiracetam · DIN 02442531 · $0.3210 M-Levetiracetam · DIN 02524562 · $0.3210 Mint-Levetiracetam · DIN 02442388 · $0.3210 NRA-Levetiracetam · DIN 02499193 · $0.3210 PMS-Levetiracetam · DIN 02296101 · $0.3210 Riva-Levetiracetam · DIN 02482274 · $0.3210 Sandoz Levetiracetam · DIN 02461986 · $0.3210
Shortage status: resolved shortage (ended 2024-12-20); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada) Source: https://healthproductshortages.ca/search?term=02504553
Shortage record checked 2026-09-13T08:10:21.292534+00:00

Keppra · DIN 02247027 · 250mg · tablet

Limited Use — Reason for Use code 473 requiredMarketed · checked 2026-09-02
StatusLimited Use — Reason for Use code 473 required
Write on scriptLU code 473 (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 473
Reason for Use code 473 As adjunctive therapy in the treatment of seizure disorders where control by other listed anticonvulsants has been unsatisfactory. Coverage limit: LU Authorization Period: Indefinite
1 brand, same coverage
Keppra · DIN 02247027 Manufacturer: UCB Canada Inc.; listing date 2007-11-10 Health Canada: Marketed since 2010-09-10 · brand KEPPRA · ATC N03AX14 LEVETIRACETAM · form Tablet · route Oral · ingredients LEVETIRACETAM 250 MG · company Ucb canada inc · schedule Prescription
Check this DIN again · Health Canada product record

Ministry pays: $0.3210 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=71262 · Verify on the e-Formulary ↗ (DIN 02247027)

Source record
DIN 02247027: Keppra Raw flags: sec12=Y, sec3=Y Item: 281200091; group id 434; item number 1083; lccId 00266; manufacturer id UCB Source form: Tab; strength: 250mg Recorded listing: Limited Use: paid only with a Reason for Use code and the criteria below Source prices (unrounded): $1.7836; ministry $0.3210 Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02247027 Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=71262
Interchangeable products
Ach-Levetiracetam · DIN 02399776 · $0.3210 Act Levetiracetam · DIN 02274183 · $0.3210 Apo-Levetiracetam · DIN 02285924 · $0.3210 Auro-Levetiracetam · DIN 02375249 · $0.3210 Jamp Levetiracetam Tablets · DIN 02504553 · $0.3210 Jamp-Levetiracetam · DIN 02403005 · $0.3210 Levetiracetam · DIN 02353342 · $0.3210 Levetiracetam · DIN 02442531 · $0.3210 M-Levetiracetam · DIN 02524562 · $0.3210 Mint-Levetiracetam · DIN 02442388 · $0.3210 NRA-Levetiracetam · DIN 02499193 · $0.3210 PMS-Levetiracetam · DIN 02296101 · $0.3210 Riva-Levetiracetam · DIN 02482274 · $0.3210 Sandoz Levetiracetam · DIN 02461986 · $0.3210
Shortage status: no shortage or discontinuation reported (checked 2026-09-13T08:10:21.292534+00:00); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada) Source: https://healthproductshortages.ca/search?term=02247027
Shortage record checked 2026-09-13T08:10:21.292534+00:00

Levetiracetam · DIN 02353342 · 250mg · tablet

Limited Use — Reason for Use code 473 requiredMarketed · checked 2026-09-02
StatusLimited Use — Reason for Use code 473 required
Write on scriptLU code 473 (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 473
Reason for Use code 473 As adjunctive therapy in the treatment of seizure disorders where control by other listed anticonvulsants has been unsatisfactory. Coverage limit: LU Authorization Period: Indefinite
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
Levetiracetam · DIN 02353342 Manufacturer: Sanis Health Inc.; listing date 2011-08-04 Health Canada: Marketed since 2023-07-04 · brand LEVETIRACETAM · ATC N03AX14 LEVETIRACETAM · form Tablet · route Oral · ingredients LEVETIRACETAM 250 MG · company Sanis health inc · schedule Prescription
Check this DIN again · Health Canada product record

Levetiracetam: Formulary list price $0.3210/unit (unit not stated in source; not the patient's cost)

Ministry pays: $0.3210 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=83854 · Verify on the e-Formulary ↗ (DIN 02353342)

Source record
DIN 02353342: Levetiracetam Raw flags: sec12=Y, sec3=Y Item: 281200091; group id 434; item number 1083; lccId 00266; manufacturer id SAI Source form: Tab; strength: 250mg Recorded listing: Limited Use: paid only with a Reason for Use code and the criteria below Source prices (unrounded): $0.3210; ministry $0.3210 Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02353342 Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=83854
Interchangeable products
Ach-Levetiracetam · DIN 02399776 · $0.3210 Act Levetiracetam · DIN 02274183 · $0.3210 Apo-Levetiracetam · DIN 02285924 · $0.3210 Auro-Levetiracetam · DIN 02375249 · $0.3210 Jamp Levetiracetam Tablets · DIN 02504553 · $0.3210 Jamp-Levetiracetam · DIN 02403005 · $0.3210 Keppra · DIN 02247027 · $0.3210 Levetiracetam · DIN 02442531 · $0.3210 M-Levetiracetam · DIN 02524562 · $0.3210 Mint-Levetiracetam · DIN 02442388 · $0.3210 NRA-Levetiracetam · DIN 02499193 · $0.3210 PMS-Levetiracetam · DIN 02296101 · $0.3210 Riva-Levetiracetam · DIN 02482274 · $0.3210 Sandoz Levetiracetam · DIN 02461986 · $0.3210
Shortage status: resolved shortage (ended 2024-03-01); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada) Source: https://healthproductshortages.ca/search?term=02353342
Shortage record checked 2026-09-13T08:10:21.292534+00:00

Levetiracetam · DIN 02442531 · 250mg · tablet

Limited Use — Reason for Use code 473 requiredMarketed · checked 2026-09-02
StatusLimited Use — Reason for Use code 473 required
Write on scriptLU code 473 (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 473
Reason for Use code 473 As adjunctive therapy in the treatment of seizure disorders where control by other listed anticonvulsants has been unsatisfactory. Coverage limit: LU Authorization Period: Indefinite
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
Levetiracetam · DIN 02442531 Manufacturer: Sivem Pharmaceuticals ULC; listing date 2020-08-28 Health Canada: Marketed since 2018-04-13 · brand LEVETIRACETAM · ATC N03AX14 LEVETIRACETAM · form Tablet · route Oral · ingredients LEVETIRACETAM 250 MG · company Sivem pharmaceuticals ulc · schedule Prescription
Check this DIN again · Health Canada product record

Levetiracetam: Formulary list price $0.3210/unit (unit not stated in source; not the patient's cost)

Ministry pays: $0.3210 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=92688 · Verify on the e-Formulary ↗ (DIN 02442531)

Source record
DIN 02442531: Levetiracetam Raw flags: sec12=Y, sec3=Y Item: 281200091; group id 434; item number 1083; lccId 00266; manufacturer id SIV Source form: Tab; strength: 250mg Recorded listing: Limited Use: paid only with a Reason for Use code and the criteria below Source prices (unrounded): $0.3210; ministry $0.3210 Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02442531 Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=92688
Interchangeable products
Ach-Levetiracetam · DIN 02399776 · $0.3210 Act Levetiracetam · DIN 02274183 · $0.3210 Apo-Levetiracetam · DIN 02285924 · $0.3210 Auro-Levetiracetam · DIN 02375249 · $0.3210 Jamp Levetiracetam Tablets · DIN 02504553 · $0.3210 Jamp-Levetiracetam · DIN 02403005 · $0.3210 Keppra · DIN 02247027 · $0.3210 Levetiracetam · DIN 02353342 · $0.3210 M-Levetiracetam · DIN 02524562 · $0.3210 Mint-Levetiracetam · DIN 02442388 · $0.3210 NRA-Levetiracetam · DIN 02499193 · $0.3210 PMS-Levetiracetam · DIN 02296101 · $0.3210 Riva-Levetiracetam · DIN 02482274 · $0.3210 Sandoz Levetiracetam · DIN 02461986 · $0.3210
Shortage status: resolved shortage (ended 2018-04-27); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada) Source: https://healthproductshortages.ca/search?term=02442531
Shortage record checked 2026-09-13T08:10:21.292534+00:00

Mint-Levetiracetam · DIN 02442388 · 250mg · tablet

Limited Use — Reason for Use code 473 requiredMarketed · checked 2026-09-02
StatusLimited Use — Reason for Use code 473 required
Write on scriptLU code 473 (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 473
Reason for Use code 473 As adjunctive therapy in the treatment of seizure disorders where control by other listed anticonvulsants has been unsatisfactory. Coverage limit: LU Authorization Period: Indefinite
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
Mint-Levetiracetam · DIN 02442388 Manufacturer: Mint Pharmaceuticals Inc.; listing date 2021-11-30 Health Canada: Marketed since 2021-06-28 · brand MINT-LEVETIRACETAM · ATC N03AX14 LEVETIRACETAM · form Tablet · route Oral · ingredients LEVETIRACETAM 250 MG · company Mint pharmaceuticals inc · schedule Prescription
Check this DIN again · Health Canada product record

Mint-Levetiracetam: Formulary list price $0.3210/unit (unit not stated in source; not the patient's cost)

Ministry pays: $0.3210 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=92674 · Verify on the e-Formulary ↗ (DIN 02442388)

Source record
DIN 02442388: Mint-Levetiracetam Raw flags: sec12=Y, sec3=Y Item: 281200091; group id 434; item number 1083; lccId 00266; manufacturer id MIN Source form: Tab; strength: 250mg Recorded listing: Limited Use: paid only with a Reason for Use code and the criteria below Source prices (unrounded): $0.3210; ministry $0.3210 Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02442388 Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=92674
Interchangeable products
Ach-Levetiracetam · DIN 02399776 · $0.3210 Act Levetiracetam · DIN 02274183 · $0.3210 Apo-Levetiracetam · DIN 02285924 · $0.3210 Auro-Levetiracetam · DIN 02375249 · $0.3210 Jamp Levetiracetam Tablets · DIN 02504553 · $0.3210 Jamp-Levetiracetam · DIN 02403005 · $0.3210 Keppra · DIN 02247027 · $0.3210 Levetiracetam · DIN 02353342 · $0.3210 Levetiracetam · DIN 02442531 · $0.3210 M-Levetiracetam · DIN 02524562 · $0.3210 NRA-Levetiracetam · DIN 02499193 · $0.3210 PMS-Levetiracetam · DIN 02296101 · $0.3210 Riva-Levetiracetam · DIN 02482274 · $0.3210 Sandoz Levetiracetam · DIN 02461986 · $0.3210
Shortage status: no shortage or discontinuation reported (checked 2026-09-13T08:10:21.292534+00:00); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada) Source: https://healthproductshortages.ca/search?term=02442388
Shortage record checked 2026-09-13T08:10:21.292534+00:00

NRA-Levetiracetam · DIN 02499193 · 250mg · tablet

Limited Use — Reason for Use code 473 requiredMarketed · checked 2026-09-02
StatusLimited Use — Reason for Use code 473 required
Write on scriptLU code 473 (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 473
Reason for Use code 473 As adjunctive therapy in the treatment of seizure disorders where control by other listed anticonvulsants has been unsatisfactory. Coverage limit: LU Authorization Period: Indefinite
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
NRA-Levetiracetam · DIN 02499193 Manufacturer: Nora Pharma; listing date 2021-05-31 Health Canada: Marketed since 2021-02-17 · brand NRA-LEVETIRACETAM · ATC N03AX14 LEVETIRACETAM · form Tablet · route Oral · ingredients LEVETIRACETAM 250 MG · company Nora pharma inc · schedule Prescription
Check this DIN again · Health Canada product record

NRA-Levetiracetam: Formulary list price $0.3210/unit (unit not stated in source; not the patient's cost)

Ministry pays: $0.3210 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=98894 · Verify on the e-Formulary ↗ (DIN 02499193)

Source record
DIN 02499193: NRA-Levetiracetam Raw flags: sec12=Y, sec3=Y Item: 281200091; group id 434; item number 1083; lccId 00266; manufacturer id NRA Source form: Tab; strength: 250mg Recorded listing: Limited Use: paid only with a Reason for Use code and the criteria below Source prices (unrounded): $0.3210; ministry $0.3210 Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02499193 Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=98894
Interchangeable products
Ach-Levetiracetam · DIN 02399776 · $0.3210 Act Levetiracetam · DIN 02274183 · $0.3210 Apo-Levetiracetam · DIN 02285924 · $0.3210 Auro-Levetiracetam · DIN 02375249 · $0.3210 Jamp Levetiracetam Tablets · DIN 02504553 · $0.3210 Jamp-Levetiracetam · DIN 02403005 · $0.3210 Keppra · DIN 02247027 · $0.3210 Levetiracetam · DIN 02353342 · $0.3210 Levetiracetam · DIN 02442531 · $0.3210 M-Levetiracetam · DIN 02524562 · $0.3210 Mint-Levetiracetam · DIN 02442388 · $0.3210 PMS-Levetiracetam · DIN 02296101 · $0.3210 Riva-Levetiracetam · DIN 02482274 · $0.3210 Sandoz Levetiracetam · DIN 02461986 · $0.3210
Shortage status: no shortage or discontinuation reported (checked 2026-09-13T08:10:21.292534+00:00); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada) Source: https://healthproductshortages.ca/search?term=02499193
Shortage record checked 2026-09-13T08:10:21.292534+00:00

PMS-Levetiracetam · DIN 02296101 · 250mg · tablet

Limited Use — Reason for Use code 473 requiredMarketed · checked 2026-09-02
StatusLimited Use — Reason for Use code 473 required
Write on scriptLU code 473 (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 473
Reason for Use code 473 As adjunctive therapy in the treatment of seizure disorders where control by other listed anticonvulsants has been unsatisfactory. Coverage limit: LU Authorization Period: Indefinite
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
PMS-Levetiracetam · DIN 02296101 Manufacturer: Pharmascience Inc.; listing date 2007-11-10 Health Canada: Marketed since 2021-09-30 · brand PMS-LEVETIRACETAM · ATC N03AX14 LEVETIRACETAM · form Tablet · route Oral · ingredients LEVETIRACETAM 250 MG · company Pharmascience inc · schedule Prescription
Check this DIN again · Health Canada product record

PMS-Levetiracetam: Formulary list price $0.3210/unit (unit not stated in source; not the patient's cost)

Ministry pays: $0.3210 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=78145 · Verify on the e-Formulary ↗ (DIN 02296101)

Source record
DIN 02296101: PMS-Levetiracetam Raw flags: sec12=Y, sec3=Y Item: 281200091; group id 434; item number 1083; lccId 00266; manufacturer id PMS Source form: Tab; strength: 250mg Recorded listing: Limited Use: paid only with a Reason for Use code and the criteria below Source prices (unrounded): $0.3210; ministry $0.3210 Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02296101 Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=78145
Interchangeable products
Ach-Levetiracetam · DIN 02399776 · $0.3210 Act Levetiracetam · DIN 02274183 · $0.3210 Apo-Levetiracetam · DIN 02285924 · $0.3210 Auro-Levetiracetam · DIN 02375249 · $0.3210 Jamp Levetiracetam Tablets · DIN 02504553 · $0.3210 Jamp-Levetiracetam · DIN 02403005 · $0.3210 Keppra · DIN 02247027 · $0.3210 Levetiracetam · DIN 02353342 · $0.3210 Levetiracetam · DIN 02442531 · $0.3210 M-Levetiracetam · DIN 02524562 · $0.3210 Mint-Levetiracetam · DIN 02442388 · $0.3210 NRA-Levetiracetam · DIN 02499193 · $0.3210 Riva-Levetiracetam · DIN 02482274 · $0.3210 Sandoz Levetiracetam · DIN 02461986 · $0.3210
Shortage status: resolved shortage (ended 2023-05-31); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada) Source: https://healthproductshortages.ca/search?term=02296101
Shortage record checked 2026-09-13T08:10:21.292534+00:00

Sandoz Levetiracetam · DIN 02461986 · 250mg · tablet

Limited Use — Reason for Use code 473 requiredMarketed · checked 2026-09-02
StatusLimited Use — Reason for Use code 473 required
Write on scriptLU code 473 (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 473
Reason for Use code 473 As adjunctive therapy in the treatment of seizure disorders where control by other listed anticonvulsants has been unsatisfactory. Coverage limit: LU Authorization Period: Indefinite
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
Sandoz Levetiracetam · DIN 02461986 Manufacturer: Sandoz Canada Inc.; listing date 2017-09-28 Health Canada: Marketed since 2017-08-04 · brand SANDOZ LEVETIRACETAM · ATC N03AX14 LEVETIRACETAM · form Tablet · route Oral · ingredients LEVETIRACETAM 250 MG · company Sandoz canada incorporated · schedule Prescription
Check this DIN again · Health Canada product record

Sandoz Levetiracetam: Formulary list price $0.3210/unit (unit not stated in source; not the patient's cost)

Ministry pays: $0.3210 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=94973 · Verify on the e-Formulary ↗ (DIN 02461986)

Source record
DIN 02461986: Sandoz Levetiracetam Raw flags: sec12=Y, sec3=Y Item: 281200091; group id 434; item number 1083; lccId 00266; manufacturer id SDZ Source form: Tab; strength: 250mg Recorded listing: Limited Use: paid only with a Reason for Use code and the criteria below Source prices (unrounded): $0.3210; ministry $0.3210 Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02461986 Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=94973
Interchangeable products
Ach-Levetiracetam · DIN 02399776 · $0.3210 Act Levetiracetam · DIN 02274183 · $0.3210 Apo-Levetiracetam · DIN 02285924 · $0.3210 Auro-Levetiracetam · DIN 02375249 · $0.3210 Jamp Levetiracetam Tablets · DIN 02504553 · $0.3210 Jamp-Levetiracetam · DIN 02403005 · $0.3210 Keppra · DIN 02247027 · $0.3210 Levetiracetam · DIN 02353342 · $0.3210 Levetiracetam · DIN 02442531 · $0.3210 M-Levetiracetam · DIN 02524562 · $0.3210 Mint-Levetiracetam · DIN 02442388 · $0.3210 NRA-Levetiracetam · DIN 02499193 · $0.3210 PMS-Levetiracetam · DIN 02296101 · $0.3210 Riva-Levetiracetam · DIN 02482274 · $0.3210
Shortage status: resolved shortage (ended 2026-03-20); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada) Source: https://healthproductshortages.ca/search?term=02461986
Shortage record checked 2026-09-13T08:10:21.292534+00:00

Ach-Levetiracetam · DIN 02399784 · 500mg · tablet

Limited Use — Reason for Use code 473 requiredMarketed · checked 2026-09-02
StatusLimited Use — Reason for Use code 473 required
Write on scriptLU code 473 (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 473
Reason for Use code 473 As adjunctive therapy in the treatment of seizure disorders where control by other listed anticonvulsants has been unsatisfactory. Coverage limit: LU Authorization Period: Indefinite
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
Ach-Levetiracetam · DIN 02399784 Manufacturer: Accord Healthcare Inc.; listing date 2013-06-27 Health Canada: Marketed since 2023-03-29 · brand ACH-LEVETIRACETAM · ATC N03AX14 LEVETIRACETAM · form Tablet · route Oral · ingredients LEVETIRACETAM 500 MG · company Accord healthcare inc · schedule Prescription
Check this DIN again · Health Canada product record

Ach-Levetiracetam: Formulary list price $0.3911/unit (unit not stated in source; not the patient's cost)

Ministry pays: $0.3911 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=88463 · Verify on the e-Formulary ↗ (DIN 02399784)

Source record
DIN 02399784: Ach-Levetiracetam Raw flags: sec12=Y, sec3=Y Item: 281200092; group id 434; item number 1084; lccId 00266; manufacturer id ACH Source form: Tab; strength: 500mg Recorded listing: Limited Use: paid only with a Reason for Use code and the criteria below Source prices (unrounded): $0.3911; ministry $0.3911 Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02399784 Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=88463
Interchangeable products
Act Levetiracetam · DIN 02274191 · $0.3911 Apo-Levetiracetam · DIN 02285932 · $0.3911 Auro-Levetiracetam · DIN 02375257 · $0.3911 Jamp Levetiracetam Tablets · DIN 02504561 · $0.3911 Jamp-Levetiracetam · DIN 02403021 · $0.3911 Keppra · DIN 02247028 · $0.3911 Levetiracetam · DIN 02353350 · $0.3911 Levetiracetam · DIN 02442558 · $0.3911 M-Levetiracetam · DIN 02524570 · $0.3911 Mint-Levetiracetam · DIN 02442396 · $0.3911 NRA-Levetiracetam · DIN 02499207 · $0.3911 PMS-Levetiracetam · DIN 02296128 · $0.3911 Riva-Levetiracetam · DIN 02482282 · $0.3911 Sandoz Levetiracetam · DIN 02461994 · $0.3911
Shortage status: active shortage (reported 2024-06-28, last updated 2024-07-16) — report may be stale, confirm; reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada) Source: https://healthproductshortages.ca/search?term=02399784
Shortage record checked 2026-09-13T08:10:21.292534+00:00

Act Levetiracetam · DIN 02274191 · 500mg · tablet

Limited Use — Reason for Use code 473 requiredMarketed · checked 2026-09-02
StatusLimited Use — Reason for Use code 473 required
Write on scriptLU code 473 (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 473
Reason for Use code 473 As adjunctive therapy in the treatment of seizure disorders where control by other listed anticonvulsants has been unsatisfactory. Coverage limit: LU Authorization Period: Indefinite
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
Act Levetiracetam · DIN 02274191 Manufacturer: Actavis Pharma Company; listing date 2007-12-19 Health Canada: Marketed since 2020-12-17 · brand TEVA-LEVETIRACETAM · ATC N03AX14 LEVETIRACETAM · form Tablet · route Oral · ingredients LEVETIRACETAM 500 MG · company Teva canada limited · schedule Prescription
Check this DIN again · Health Canada product record

Act Levetiracetam: Formulary list price $0.3911/unit (unit not stated in source; not the patient's cost)

Ministry pays: $0.3911 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=75965 · Verify on the e-Formulary ↗ (DIN 02274191)

Source record
DIN 02274191: Act Levetiracetam Raw flags: sec12=Y, sec3=Y Item: 281200092; group id 434; item number 1084; lccId 00266; manufacturer id ACV Source form: Tab; strength: 500mg Recorded listing: Limited Use: paid only with a Reason for Use code and the criteria below Source prices (unrounded): $0.3911; ministry $0.3911 Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02274191 Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=75965
Interchangeable products
Ach-Levetiracetam · DIN 02399784 · $0.3911 Apo-Levetiracetam · DIN 02285932 · $0.3911 Auro-Levetiracetam · DIN 02375257 · $0.3911 Jamp Levetiracetam Tablets · DIN 02504561 · $0.3911 Jamp-Levetiracetam · DIN 02403021 · $0.3911 Keppra · DIN 02247028 · $0.3911 Levetiracetam · DIN 02353350 · $0.3911 Levetiracetam · DIN 02442558 · $0.3911 M-Levetiracetam · DIN 02524570 · $0.3911 Mint-Levetiracetam · DIN 02442396 · $0.3911 NRA-Levetiracetam · DIN 02499207 · $0.3911 PMS-Levetiracetam · DIN 02296128 · $0.3911 Riva-Levetiracetam · DIN 02482282 · $0.3911 Sandoz Levetiracetam · DIN 02461994 · $0.3911
Shortage status: resolved shortage (ended 2025-12-17); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada) Source: https://healthproductshortages.ca/search?term=02274191
Shortage record checked 2026-09-13T08:10:21.292534+00:00

Apo-Levetiracetam · DIN 02285932 · 500mg · tablet

Limited Use — Reason for Use code 473 requiredMarketed · checked 2026-09-02
StatusLimited Use — Reason for Use code 473 required
Write on scriptLU code 473 (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 473
Reason for Use code 473 As adjunctive therapy in the treatment of seizure disorders where control by other listed anticonvulsants has been unsatisfactory. Coverage limit: LU Authorization Period: Indefinite
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
Apo-Levetiracetam · DIN 02285932 Manufacturer: Apotex Inc.; listing date 2007-11-10 Health Canada: Marketed since 2006-10-20 · brand APO-LEVETIRACETAM · ATC N03AX14 LEVETIRACETAM · form Tablet · route Oral · ingredients LEVETIRACETAM 500 MG · company Apotex inc · schedule Prescription
Check this DIN again · Health Canada product record

Apo-Levetiracetam: Formulary list price $0.3911/unit (unit not stated in source; not the patient's cost)

Ministry pays: $0.3911 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=77142 · Verify on the e-Formulary ↗ (DIN 02285932)

Source record
DIN 02285932: Apo-Levetiracetam Raw flags: sec12=Y, sec3=Y Item: 281200092; group id 434; item number 1084; lccId 00266; manufacturer id APX Source form: Tab; strength: 500mg Recorded listing: Limited Use: paid only with a Reason for Use code and the criteria below Source prices (unrounded): $0.3911; ministry $0.3911 Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02285932 Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=77142
Interchangeable products
Ach-Levetiracetam · DIN 02399784 · $0.3911 Act Levetiracetam · DIN 02274191 · $0.3911 Auro-Levetiracetam · DIN 02375257 · $0.3911 Jamp Levetiracetam Tablets · DIN 02504561 · $0.3911 Jamp-Levetiracetam · DIN 02403021 · $0.3911 Keppra · DIN 02247028 · $0.3911 Levetiracetam · DIN 02353350 · $0.3911 Levetiracetam · DIN 02442558 · $0.3911 M-Levetiracetam · DIN 02524570 · $0.3911 Mint-Levetiracetam · DIN 02442396 · $0.3911 NRA-Levetiracetam · DIN 02499207 · $0.3911 PMS-Levetiracetam · DIN 02296128 · $0.3911 Riva-Levetiracetam · DIN 02482282 · $0.3911 Sandoz Levetiracetam · DIN 02461994 · $0.3911
Shortage status: resolved shortage (ended 2026-09-03); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada) Source: https://healthproductshortages.ca/search?term=02285932
Shortage record checked 2026-09-13T08:10:21.292534+00:00

Auro-Levetiracetam · DIN 02375257 · 500mg · tablet

Limited Use — Reason for Use code 473 requiredMarketed · checked 2026-09-02
StatusLimited Use — Reason for Use code 473 required
Write on scriptLU code 473 (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 473
Reason for Use code 473 As adjunctive therapy in the treatment of seizure disorders where control by other listed anticonvulsants has been unsatisfactory. Coverage limit: LU Authorization Period: Indefinite
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
Auro-Levetiracetam · DIN 02375257 Manufacturer: Auro Pharma Inc.; listing date 2012-04-24 Health Canada: Marketed since 2012-03-15 · brand AURO-LEVETIRACETAM · ATC N03AX14 LEVETIRACETAM · form Tablet · route Oral · ingredients LEVETIRACETAM 500 MG · company Auro pharma inc · schedule Prescription
Check this DIN again · Health Canada product record

Auro-Levetiracetam: Formulary list price $0.3911/unit (unit not stated in source; not the patient's cost)

Ministry pays: $0.3911 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=86065 · Verify on the e-Formulary ↗ (DIN 02375257)

Source record
DIN 02375257: Auro-Levetiracetam Raw flags: sec12=Y, sec3=Y Item: 281200092; group id 434; item number 1084; lccId 00266; manufacturer id AUR Source form: Tab; strength: 500mg Recorded listing: Limited Use: paid only with a Reason for Use code and the criteria below Source prices (unrounded): $0.3911; ministry $0.3911 Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02375257 Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=86065
Interchangeable products
Ach-Levetiracetam · DIN 02399784 · $0.3911 Act Levetiracetam · DIN 02274191 · $0.3911 Apo-Levetiracetam · DIN 02285932 · $0.3911 Jamp Levetiracetam Tablets · DIN 02504561 · $0.3911 Jamp-Levetiracetam · DIN 02403021 · $0.3911 Keppra · DIN 02247028 · $0.3911 Levetiracetam · DIN 02353350 · $0.3911 Levetiracetam · DIN 02442558 · $0.3911 M-Levetiracetam · DIN 02524570 · $0.3911 Mint-Levetiracetam · DIN 02442396 · $0.3911 NRA-Levetiracetam · DIN 02499207 · $0.3911 PMS-Levetiracetam · DIN 02296128 · $0.3911 Riva-Levetiracetam · DIN 02482282 · $0.3911 Sandoz Levetiracetam · DIN 02461994 · $0.3911
Shortage status: resolved shortage (ended 2024-01-09); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada) Source: https://healthproductshortages.ca/search?term=02375257
Shortage record checked 2026-09-13T08:10:21.292534+00:00

Jamp Levetiracetam Tablets · DIN 02504561 · 500mg · tablet

Limited Use — Reason for Use code 473 requiredMarketed · checked 2026-09-02
StatusLimited Use — Reason for Use code 473 required
Write on scriptLU code 473 (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 473
Reason for Use code 473 As adjunctive therapy in the treatment of seizure disorders where control by other listed anticonvulsants has been unsatisfactory. Coverage limit: LU Authorization Period: Indefinite
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
Jamp Levetiracetam Tablets · DIN 02504561 Manufacturer: Jamp Pharma Corporation; listing date 2022-08-31 Health Canada: Marketed since 2022-06-10 · brand JAMP LEVETIRACETAM TABLETS · ATC N03AX14 LEVETIRACETAM · form Tablet · route Oral · ingredients LEVETIRACETAM 500 MG · company Jamp pharma corporation · schedule Prescription
Check this DIN again · Health Canada product record

Jamp Levetiracetam Tablets: Formulary list price $0.3911/unit (unit not stated in source; not the patient's cost)

Ministry pays: $0.3911 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=99398 · Verify on the e-Formulary ↗ (DIN 02504561)

Source record
DIN 02504561: Jamp Levetiracetam Tablets Raw flags: sec12=Y, sec3=Y Item: 281200092; group id 434; item number 1084; lccId 00266; manufacturer id JPC Source form: Tab; strength: 500mg Recorded listing: Limited Use: paid only with a Reason for Use code and the criteria below Source prices (unrounded): $0.3911; ministry $0.3911 Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02504561 Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=99398
Interchangeable products
Ach-Levetiracetam · DIN 02399784 · $0.3911 Act Levetiracetam · DIN 02274191 · $0.3911 Apo-Levetiracetam · DIN 02285932 · $0.3911 Auro-Levetiracetam · DIN 02375257 · $0.3911 Jamp-Levetiracetam · DIN 02403021 · $0.3911 Keppra · DIN 02247028 · $0.3911 Levetiracetam · DIN 02353350 · $0.3911 Levetiracetam · DIN 02442558 · $0.3911 M-Levetiracetam · DIN 02524570 · $0.3911 Mint-Levetiracetam · DIN 02442396 · $0.3911 NRA-Levetiracetam · DIN 02499207 · $0.3911 PMS-Levetiracetam · DIN 02296128 · $0.3911 Riva-Levetiracetam · DIN 02482282 · $0.3911 Sandoz Levetiracetam · DIN 02461994 · $0.3911
Shortage status: resolved shortage (ended 2024-12-20); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada) Source: https://healthproductshortages.ca/search?term=02504561
Shortage record checked 2026-09-13T08:10:21.292534+00:00

Keppra · DIN 02247028 · 500mg · tablet

Limited Use — Reason for Use code 473 requiredMarketed · checked 2026-09-02
StatusLimited Use — Reason for Use code 473 required
Write on scriptLU code 473 (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 473
Reason for Use code 473 As adjunctive therapy in the treatment of seizure disorders where control by other listed anticonvulsants has been unsatisfactory. Coverage limit: LU Authorization Period: Indefinite
1 brand, same coverage
Keppra · DIN 02247028 Manufacturer: UCB Canada Inc.; listing date 2007-11-10 Health Canada: Marketed since 2010-09-13 · brand KEPPRA · ATC N03AX14 LEVETIRACETAM · form Tablet · route Oral · ingredients LEVETIRACETAM 500 MG · company Ucb canada inc · schedule Prescription
Check this DIN again · Health Canada product record

Ministry pays: $0.3911 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=71263 · Verify on the e-Formulary ↗ (DIN 02247028)

Source record
DIN 02247028: Keppra Raw flags: sec12=Y, sec3=Y Item: 281200092; group id 434; item number 1084; lccId 00266; manufacturer id UCB Source form: Tab; strength: 500mg Recorded listing: Limited Use: paid only with a Reason for Use code and the criteria below Source prices (unrounded): $2.1725; ministry $0.3911 Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02247028 Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=71263
Interchangeable products
Ach-Levetiracetam · DIN 02399784 · $0.3911 Act Levetiracetam · DIN 02274191 · $0.3911 Apo-Levetiracetam · DIN 02285932 · $0.3911 Auro-Levetiracetam · DIN 02375257 · $0.3911 Jamp Levetiracetam Tablets · DIN 02504561 · $0.3911 Jamp-Levetiracetam · DIN 02403021 · $0.3911 Levetiracetam · DIN 02353350 · $0.3911 Levetiracetam · DIN 02442558 · $0.3911 M-Levetiracetam · DIN 02524570 · $0.3911 Mint-Levetiracetam · DIN 02442396 · $0.3911 NRA-Levetiracetam · DIN 02499207 · $0.3911 PMS-Levetiracetam · DIN 02296128 · $0.3911 Riva-Levetiracetam · DIN 02482282 · $0.3911 Sandoz Levetiracetam · DIN 02461994 · $0.3911
Shortage status: no shortage or discontinuation reported (checked 2026-09-13T08:10:21.292534+00:00); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada) Source: https://healthproductshortages.ca/search?term=02247028
Shortage record checked 2026-09-13T08:10:21.292534+00:00

Levetiracetam · DIN 02353350 · 500mg · tablet

Limited Use — Reason for Use code 473 requiredMarketed · checked 2026-09-02
StatusLimited Use — Reason for Use code 473 required
Write on scriptLU code 473 (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 473
Reason for Use code 473 As adjunctive therapy in the treatment of seizure disorders where control by other listed anticonvulsants has been unsatisfactory. Coverage limit: LU Authorization Period: Indefinite
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
Levetiracetam · DIN 02353350 Manufacturer: Sanis Health Inc.; listing date 2011-08-04 Health Canada: Marketed since 2023-07-04 · brand LEVETIRACETAM · ATC N03AX14 LEVETIRACETAM · form Tablet · route Oral · ingredients LEVETIRACETAM 500 MG · company Sanis health inc · schedule Prescription
Check this DIN again · Health Canada product record

Levetiracetam: Formulary list price $0.3911/unit (unit not stated in source; not the patient's cost)

Ministry pays: $0.3911 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=83855 · Verify on the e-Formulary ↗ (DIN 02353350)

Source record
DIN 02353350: Levetiracetam Raw flags: sec12=Y, sec3=Y Item: 281200092; group id 434; item number 1084; lccId 00266; manufacturer id SAI Source form: Tab; strength: 500mg Recorded listing: Limited Use: paid only with a Reason for Use code and the criteria below Source prices (unrounded): $0.3911; ministry $0.3911 Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02353350 Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=83855
Interchangeable products
Ach-Levetiracetam · DIN 02399784 · $0.3911 Act Levetiracetam · DIN 02274191 · $0.3911 Apo-Levetiracetam · DIN 02285932 · $0.3911 Auro-Levetiracetam · DIN 02375257 · $0.3911 Jamp Levetiracetam Tablets · DIN 02504561 · $0.3911 Jamp-Levetiracetam · DIN 02403021 · $0.3911 Keppra · DIN 02247028 · $0.3911 Levetiracetam · DIN 02442558 · $0.3911 M-Levetiracetam · DIN 02524570 · $0.3911 Mint-Levetiracetam · DIN 02442396 · $0.3911 NRA-Levetiracetam · DIN 02499207 · $0.3911 PMS-Levetiracetam · DIN 02296128 · $0.3911 Riva-Levetiracetam · DIN 02482282 · $0.3911 Sandoz Levetiracetam · DIN 02461994 · $0.3911
Shortage status: resolved shortage (ended 2024-04-10); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada) Source: https://healthproductshortages.ca/search?term=02353350
Shortage record checked 2026-09-13T08:10:21.292534+00:00

Levetiracetam · DIN 02442558 · 500mg · tablet

Limited Use — Reason for Use code 473 requiredMarketed · checked 2026-09-02
StatusLimited Use — Reason for Use code 473 required
Write on scriptLU code 473 (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 473
Reason for Use code 473 As adjunctive therapy in the treatment of seizure disorders where control by other listed anticonvulsants has been unsatisfactory. Coverage limit: LU Authorization Period: Indefinite
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
Levetiracetam · DIN 02442558 Manufacturer: Sivem Pharmaceuticals ULC; listing date 2020-08-28 Health Canada: Marketed since 2018-04-13 · brand LEVETIRACETAM · ATC N03AX14 LEVETIRACETAM · form Tablet · route Oral · ingredients LEVETIRACETAM 500 MG · company Sivem pharmaceuticals ulc · schedule Prescription
Check this DIN again · Health Canada product record

Levetiracetam: Formulary list price $0.3911/unit (unit not stated in source; not the patient's cost)

Ministry pays: $0.3911 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=92689 · Verify on the e-Formulary ↗ (DIN 02442558)

Source record
DIN 02442558: Levetiracetam Raw flags: sec12=Y, sec3=Y Item: 281200092; group id 434; item number 1084; lccId 00266; manufacturer id SIV Source form: Tab; strength: 500mg Recorded listing: Limited Use: paid only with a Reason for Use code and the criteria below Source prices (unrounded): $0.3911; ministry $0.3911 Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02442558 Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=92689
Interchangeable products
Ach-Levetiracetam · DIN 02399784 · $0.3911 Act Levetiracetam · DIN 02274191 · $0.3911 Apo-Levetiracetam · DIN 02285932 · $0.3911 Auro-Levetiracetam · DIN 02375257 · $0.3911 Jamp Levetiracetam Tablets · DIN 02504561 · $0.3911 Jamp-Levetiracetam · DIN 02403021 · $0.3911 Keppra · DIN 02247028 · $0.3911 Levetiracetam · DIN 02353350 · $0.3911 M-Levetiracetam · DIN 02524570 · $0.3911 Mint-Levetiracetam · DIN 02442396 · $0.3911 NRA-Levetiracetam · DIN 02499207 · $0.3911 PMS-Levetiracetam · DIN 02296128 · $0.3911 Riva-Levetiracetam · DIN 02482282 · $0.3911 Sandoz Levetiracetam · DIN 02461994 · $0.3911
Shortage status: resolved shortage (ended 2018-04-27); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada) Source: https://healthproductshortages.ca/search?term=02442558
Shortage record checked 2026-09-13T08:10:21.292534+00:00

Mint-Levetiracetam · DIN 02442396 · 500mg · tablet

Limited Use — Reason for Use code 473 requiredMarketed · checked 2026-09-02
StatusLimited Use — Reason for Use code 473 required
Write on scriptLU code 473 (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 473
Reason for Use code 473 As adjunctive therapy in the treatment of seizure disorders where control by other listed anticonvulsants has been unsatisfactory. Coverage limit: LU Authorization Period: Indefinite
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
Mint-Levetiracetam · DIN 02442396 Manufacturer: Mint Pharmaceuticals Inc.; listing date 2021-11-30 Health Canada: Marketed since 2021-06-28 · brand MINT-LEVETIRACETAM · ATC N03AX14 LEVETIRACETAM · form Tablet · route Oral · ingredients LEVETIRACETAM 500 MG · company Mint pharmaceuticals inc · schedule Prescription
Check this DIN again · Health Canada product record

Mint-Levetiracetam: Formulary list price $0.3911/unit (unit not stated in source; not the patient's cost)

Ministry pays: $0.3911 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=92675 · Verify on the e-Formulary ↗ (DIN 02442396)

Source record
DIN 02442396: Mint-Levetiracetam Raw flags: sec12=Y, sec3=Y Item: 281200092; group id 434; item number 1084; lccId 00266; manufacturer id MIN Source form: Tab; strength: 500mg Recorded listing: Limited Use: paid only with a Reason for Use code and the criteria below Source prices (unrounded): $0.3911; ministry $0.3911 Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02442396 Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=92675
Interchangeable products
Ach-Levetiracetam · DIN 02399784 · $0.3911 Act Levetiracetam · DIN 02274191 · $0.3911 Apo-Levetiracetam · DIN 02285932 · $0.3911 Auro-Levetiracetam · DIN 02375257 · $0.3911 Jamp Levetiracetam Tablets · DIN 02504561 · $0.3911 Jamp-Levetiracetam · DIN 02403021 · $0.3911 Keppra · DIN 02247028 · $0.3911 Levetiracetam · DIN 02353350 · $0.3911 Levetiracetam · DIN 02442558 · $0.3911 M-Levetiracetam · DIN 02524570 · $0.3911 NRA-Levetiracetam · DIN 02499207 · $0.3911 PMS-Levetiracetam · DIN 02296128 · $0.3911 Riva-Levetiracetam · DIN 02482282 · $0.3911 Sandoz Levetiracetam · DIN 02461994 · $0.3911
Shortage status: no shortage or discontinuation reported (checked 2026-09-13T08:10:21.292534+00:00); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada) Source: https://healthproductshortages.ca/search?term=02442396
Shortage record checked 2026-09-13T08:10:21.292534+00:00
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, LAMOTRIGINE, 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

LAMOTRIGINE

· 28 products · General benefit · strengths: 25mg, 100mg, 150mg · Tab

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

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 KEPPRA (levetiracetam) is indicated as adjunctive therapy in the management of adult (> 18 years of age) patients with epilepsy who are not satisfactorily controlled by conventional therapy. 1.1 Pediatrics Pediatrics (< 18 years of age): Based on the data submitted and reviewed by Health Canada, the safety and efficacy of KEPPRA in pediatric patients has not been established; therefore, Health Canada has not authorized an indication for pediatric use (see 7.1.3 Pediatrics and 10.3 Pharmacokinetics, Special Populations and Conditions, Pediatrics). 1.2 Geriatrics Geriatrics (≥ 65 years of age): Evidence from clinical studies and experience suggests that use in the geriatric population is associated with differences in safety or efficacy (see 7.1.4 Geriatrics, 4.2 Recommended Dose and Dosage Adjustment, Geriatrics and 10.3 Pharmacokinetics, Special Populations and Conditions, Geriatrics). https://pdf.hres.ca/dpd_pm/00069867.PDF PM date: January 21, 2003 Source product: KEPPRA; DIN 02247027; fetched 2026-09-10 Product monograph posted by Health Canada; excerpt for lookup only.

Availability

Ach-Levetiracetam · DIN 02399776 Shortage status: active shortage (reported 2025-03-21, last updated 2025-03-22); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada) Source: https://healthproductshortages.ca/search?term=02399776

Check this DIN again

Ach-Levetiracetam · DIN 02399784 Shortage status: active shortage (reported 2024-06-28, last updated 2024-07-16) — report may be stale, confirm; reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada) Source: https://healthproductshortages.ca/search?term=02399784

Check this DIN again