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

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MIDAZOLAM

2 Limited Use · 1 not a benefit

Other products in the same Health Canada class (N05C, N05CD) — coverage varies; not interchangeable

  • Flurazepam (Dalmane): general benefit, Not a benefit
  • Nitrazepam (Mogadon): general benefit
  • Temazepam (Restoril): general benefit
  • Triazolam (Halcion): general benefit, Not a benefit
  • Eszopiclone (Lunesta): not a benefit
  • Zolpidem (Sublinox): not a benefit

1 more in the class list below

Midazolam Injection · DIN 02240286 · 5mg/mL · injection solution (with Preservative)

Limited Use — Reason for Use code 495, 496 requiredMarketed · checked 2026-09-02
StatusLimited Use — Reason for Use code 495, 496 required
Write on scriptLU code 495, 496 (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 495, 496
Reason for Use code 495 For intermittent injection used for symptomatic relief in patients receiving palliative care*. Coverage limit: LU Authorization Period: 1 year Coverage limit: *The patient must have a progressive life-limiting illness and require this medication for palliative purposes. Reason for Use code 496 For continuous infusion in patients receiving palliative sedation*. Coverage limit: LU Authorization Period: 1 year Coverage limit: *The patient must have a progressive life-limiting illness and require this medication for palliative purposes.
1 brand, same coverage
Midazolam Injection · DIN 02240286 Manufacturer: Sandoz Canada Inc.; listing date 2017-05-31 Health Canada: Marketed since 2005-10-06 · brand MIDAZOLAM INJECTION · ATC N05CD08 MIDAZOLAM · form Solution · route Intramuscular, Intravenous · ingredients MIDAZOLAM 5 MG/ML · company Sandoz canada incorporated · schedule Targeted substances (cdsa iv)
Check this DIN again · Health Canada product record

Midazolam Injection: Formulary list price $4.1000/unit (unit not stated in source; not the patient's cost)

Ministry pays: $4.1000 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=63824 · Verify on the e-Formulary ↗ (DIN 02240286)

Source record
DIN 02240286: Midazolam Injection Raw flags: sec12=Y, sec3=Y Item: 282400180; group id 525; item number 1421; lccId 00284; manufacturer id SDZ Source form: Inj Sol (with Preservative); strength: 5mg/mL Recorded listing: Limited Use: paid only with a Reason for Use code and the criteria below Source prices (unrounded): $4.1000; ministry $4.1000 Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02240286 Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=63824
Interchangeable products
Midazolam Injection · DIN 02242905 · $4.1000 Versed · DIN 00766011 · not recorded
Shortage status: resolved shortage (ended 2026-05-05); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada) Source: https://healthproductshortages.ca/search?term=02240286
Shortage record checked 2026-09-13T08:10:21.292534+00:00

Midazolam Injection · DIN 02242905 · 5mg/mL · injection solution (with Preservative)

Limited Use — Reason for Use code 495, 496 requiredMarketed · checked 2026-09-02
StatusLimited Use — Reason for Use code 495, 496 required
Write on scriptLU code 495, 496 (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 495, 496
Reason for Use code 495 For intermittent injection used for symptomatic relief in patients receiving palliative care*. Coverage limit: LU Authorization Period: 1 year Coverage limit: *The patient must have a progressive life-limiting illness and require this medication for palliative purposes. Reason for Use code 496 For continuous infusion in patients receiving palliative sedation*. Coverage limit: LU Authorization Period: 1 year Coverage limit: *The patient must have a progressive life-limiting illness and require this medication for palliative purposes.
1 brand, same coverage
Midazolam Injection · DIN 02242905 Manufacturer: Fresenius Kabi Canada Ltd.; listing date 2014-01-03 Health Canada: Marketed since 2025-06-09 · brand MIDAZOLAM INJECTION, USP · ATC N05CD08 MIDAZOLAM · form Solution · route Intravenous, Intramuscular · ingredients MIDAZOLAM 5 MG/ML · company Fresenius kabi canada ltd · schedule Targeted substances (cdsa iv)
Check this DIN again · Health Canada product record

Midazolam Injection: Formulary list price $4.1000/unit (unit not stated in source; not the patient's cost)

Ministry pays: $4.1000 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=66737 · Verify on the e-Formulary ↗ (DIN 02242905)

Source record
DIN 02242905: Midazolam Injection Raw flags: sec12=Y, sec3=Y Item: 282400180; group id 525; item number 1421; lccId 00284; manufacturer id FKC Source form: Inj Sol (with Preservative); strength: 5mg/mL Recorded listing: Limited Use: paid only with a Reason for Use code and the criteria below Source prices (unrounded): $4.1000; ministry $4.1000 Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=02242905 Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=66737
Interchangeable products
Midazolam Injection · DIN 02240286 · $4.1000 Versed · DIN 00766011 · not recorded
Shortage status: resolved shortage (ended 2023-04-01); reports as of 2026-09-13T08:10:21.292534+00:00 (Health Product Shortages Canada) Source: https://healthproductshortages.ca/search?term=02242905
Shortage record checked 2026-09-13T08:10:21.292534+00:00

Versed · DIN 00766011 · 5mg/mL · injection solution (with Preservative)

Listed, not a benefit; Health Canada lists this DIN as Cancelled post market since 2004-06-28 — choose a marketed DIN from the same-category list.Discontinued 2004-06-28 · checked 2026-09-02
StatusListed, not a benefit; Health Canada lists this DIN as Cancelled post market since 2004-06-28 — choose a marketed DIN from the same-category list.
Write on scriptnot a benefit; no Exceptional Access criteria on record; see alternatives; Health Canada lists this DIN as Cancelled post market since 2004-06-28 — choose a marketed DIN from the same-category list.
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 495, 496
Reason for Use code 495 For intermittent injection used for symptomatic relief in patients receiving palliative care*. Coverage limit: LU Authorization Period: 1 year Coverage limit: *The patient must have a progressive life-limiting illness and require this medication for palliative purposes. Reason for Use code 496 For continuous infusion in patients receiving palliative sedation*. Coverage limit: LU Authorization Period: 1 year Coverage limit: *The patient must have a progressive life-limiting illness and require this medication for palliative purposes.
1 brand, same coverage
Versed · DIN 00766011 Manufacturer: Hoffmann-La Roche Limited; listing date 2017-05-31 Health Canada: Cancelled post market since 2004-06-28 · brand VERSED INJ 5MG/ML · ATC N05CD08 MIDAZOLAM · form Liquid · route Intravenous, Intramuscular · ingredients MIDAZOLAM (MIDAZOLAM HYDROCHLORIDE) 5 MG/ML · company Hoffmann-la roche limited · schedule Targeted substances (cdsa iv)
Check this DIN again · Health Canada product record

Versed: Formulary list price not recorded/unit (unit not stated in source; not the patient's cost)

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=8457 · Verify on the e-Formulary ↗ (DIN 00766011)

Source record
DIN 00766011: Versed Raw flags: notABenefit=Y, sec3=Y Item: 282400180; group id 525; item number 1421; lccId 00284; manufacturer id HLR Source form: Inj Sol (with Preservative); strength: 5mg/mL Recorded listing: Listed, not a benefit; ODB pays only for the benefit products in this interchangeable category Source prices (unrounded): not recorded; ministry not recorded Source: ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26 DIN=00766011 Health Canada DPD extract of Sep 2, 2026 (Open Government Licence – Canada) · https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=8457
Interchangeable products
Midazolam Injection · DIN 02240286 · $4.1000 Midazolam Injection · DIN 02242905 · $4.1000
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=00766011
Shortage record checked 2026-09-13T08:10:21.292534+00:00
Health Canada lists this DIN as Cancelled post market since 2004-06-28 — choose a marketed DIN from the same-category list.
Other drugs in the same formulary class (28:24 Sedatives and Hypnotics) and how they are covered

Matched class: 28:24 Sedatives and Hypnotics

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: NITRAZEPAM, PHENOBARBITAL, TEMAZEPAM Some products covered without a code (check the product listing): BUSPIRONE HYDROCHLORIDE, FLURAZEPAM, METHOTRIMEPRAZINE, TRIAZOLAM 28:24 Sedatives and Hypnotics

FLURAZEPAM

· 4 products · Listed, not a benefit (2), General benefit (2) · strengths: 15mg, 30mg · Cap

NITRAZEPAM

· 2 products · General benefit · strengths: 5mg, 10mg · Tab

TEMAZEPAM

· 2 products · General benefit · strengths: 15mg, 30mg · Cap

TRIAZOLAM

· 4 products · Listed, not a benefit (2), General benefit (2) · strengths: 0.125mg, 0.25mg · Tab

ESZOPICLONE

· 6 products · Off-Formulary Interchangeable, not an ODB benefit · strengths: 1mg, 2mg, 3mg · Tab

ZOLPIDEM TARTRATE

· 10 products · Off-Formulary Interchangeable, not an ODB benefit · strengths: 5mg, 10mg · SL Tab

ZOPICLONE

· 40 products · Off-Formulary Interchangeable, not an ODB benefit · strengths: 3.75mg, 5mg, 7.5mg · Tab

BUSPIRONE HYDROCHLORIDE

· 9 products · Listed, not a benefit (1), General benefit (8) · strengths: 10mg · Tab

METHOTRIMEPRAZINE

· 9 products · General benefit (5), Listed, not a benefit (4) · strengths: 25mg/mL, 2mg, 5mg, 25mg, 50mg · Inj Sol-1mL Pk, Tab

PHENOBARBITAL

· 5 products · General benefit · strengths: 5mg/mL, 15mg, 30mg, 60mg, 100mg · Oral Elixir, Tab

LORAZEPAM

· 9 products · Listed, not a benefit (1), Limited Use, codes 481 (2), Off-Formulary Interchangeable, not an ODB benefit (6) · strengths: 4mg/mL, 0.5mg, 1mg, 2mg · Inj Sol (with preservative), SL Tab Source: formulary-ed43-front-matter.txt Part V; ODB odb-formulary-ed43-extract-2026-08-26.xml extract_date=2026-08-26; class 28:24
Full class listing Related classes: 28:08 Analgesics, 28:10 Opiate Antagonists, 28:12 Anticonvulsants, 28:16 Psychotherapeutic Agents, 28:20 C.N.S. Stimulants, 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 MIDAZOLAM INJECTION (midazolam) is indicated as: • an intramuscular premedication prior to surgical or diagnostic procedures. • an intravenous agent for patients requiring sedation/anxiolysis/amnesia prior to and during short endoscopic or short diagnostic procedures and direct-current cardioversion. • an alternative intravenous agent for the induction of anesthesia. • a continuous intravenous infusion in intubated, mechanically ventilated patients requiring sedation in the Intensive Care Unit (ICU). 1.1 Pediatrics Pediatrics (<18 years old): Health Canada has authorized an indication for pediatric use of MIDAZOLAM INJECTION for: • sedation, anxiolysis, and/or amnesia for diagnostic or therapeutic procedures • preanesthesia • a component of anesthesia during surgical procedures, or during treatment in critical care settings. (see 4.1 Dosing Considerations; 4.2 Recommended Dose and Dosage Adjustment; 7.1.3 Pediatrics) 1.2 Geriatrics Geriatrics (>55 years old): Evidence suggests that use in the geriatric population is associated with differences in safety or effectiveness. Intravenous sedation with MIDAZOLAM IN… https://pdf.hres.ca/dpd_pm/00083597.PDF PM date: July 21, 1999 Source product: MIDAZOLAM INJECTION; DIN 02240286; fetched 2026-09-10 Product monograph posted by Health Canada; excerpt for lookup only.

Other review policies

For Versed: no applicable EAP criteria are held and no ODB benefit is established. These policies do not establish coverage.

For rare, immediately life-, limb- or organ-threatening circumstances, the Compassionate Review Policy may consider an unfunded drug or indication, subject to its criteria and without bypassing the drug review process. Compassionate Review Policy

Compassionate Review Policy: source quote
Where there are rare clinical circumstances in immediately life, limb, or organ-threatening conditions, the Executive Officer will also consider requests for drugs or indications in situations where there has not been a decision by the Executive Officer to provide funding of the drug or indication as part of the Ontario Drug Benefit program (and the EAP), and the drug or indication requested would not circumvent the established review process for new drugs or indications as part of the drug submission process for listing within the Ontario Drug Benefit program. Requests must meet the criteria for the Compassionate Review Policy.

Ontario source; updated September 15, 2026

For cancer drugs, Case-by-Case Review considers rare, immediately life-threatening circumstances when no satisfactory funded treatment exists; its criteria and application process apply. Case-by-Case Review (cancer drugs)

Case-by-Case Review (cancer drugs): source quote
Note: Requests for cancer drugs are considered under the Case-by-Case Review Program (CBCRP) which is administered by Ontario Health (Cancer Care Ontario) on behalf of the Ministry of Health. The CBCRP considers funding requests for drugs (both oral therapies and injectable drugs) for the treatment of cancer in patients who have a rare clinical circumstance that is immediately life-threatening (death is likely within a matter of months) and who require treatment with an unfunded drug, because there is no other satisfactory and funded treatment. Please refer to the Ontario Health website for information on the application process, FAQs, eligibility criteria and program policies.

Ontario source; updated September 15, 2026