Document:

Filed by Automated Filing Services Inc. (604) 609-0244 - Medicure Inc. - Exhibit 4.8

Medicure Inc.
(a Development State Enterprise)

Item - 18 Reconciliation with United States Generally Accepted
Accounting Principles 
Years Ended May 31, 2005 and 2004
Nine months ended
February 28, 2006 and 2005 (Unaudited)
(expressed in Canadan
dollars)

          Medicure
Inc. (the “Company”) follows generally accepted accounting principles in Canada
(“Canadian GAAP”) in the preparation of its consolidated financial statements,
which principles are different in some respects from those applicable in the
United States (“U.S.GAAP”) and from practices prescribed by the United States
Securities and Exchange Commission. The Company has prepared a reconciliation of
the significant measurement differences between Canadian GAAP and U.S. GAAP in
accordance with Item 17 of Form 20-F, which, for the years ended May 31, 2005
and 2004 is included in the Company’s 2005 consolidated financial statements in
its Annual Report on Form 20-F and for the nine months ended February 28, 2006
and 2005 is included in the Company’s fiscal 2006 third quarter consolidated
financial statements included in its periodic report on Form 6-K. For purposes
of this registration statement on Form F-10, the Company is also required to
reconcile additional significant disclosure differences in accordance with Item
18 of Form 20-F. The additional significant disclosure differences between
Canadian GAAP and U.S. GAAP are set out below. 

The financial information set out below as at February 28, 2006
and for the nine months ended February 28, 2006 and 2005 is unaudited; however,
such information reflects all adjustments, consisting only of normal recurring
adjustments, necessary for a fair presentation of the financial information for
the periods presented. 

	(a) 	
      Accounts Payable and Accrued
  Liabilities:

	           
       As at: 	 	February 28, 	 	 	May 31, 	 	 	May 31, 	 
	  	 	2006 	 	 	2005 	 	 	2004 	 
	  	 	(Unaudited) 	 	 	 
    	 	 	 
    	 
	  	 	  	 	 	  	 	 	  	 
	Trade and other accounts
      payable and accrued liabilities 	$	 583,425 	 	$	 275,624 	 	$	 160,260 	 
	Accounts payable related to research and
      development 	 	1,420,534 	 	 	2,457,130 	 	 	657,316 	 
	  	$	 2,003,959 	 	$	 2,732,754 	 	$	 817,576 	 

	(b) 	
      Accounts Receivable

	             As
      at 	 	February 28, 	 	 	May 31, 	 	 	May 31, 	 
	  	 	2006 	 	 	2005 	 	 	2004 	 
	  	 	(Unaudited) 	 	 	 
    	 	 	 
    	 
	  	 	  	 	 	  	 	 	  	 
	Interest receivable 	$	 35,606 	 	$	 97,917 	 	$	 234,009 	 
	SR&ED refundable tax credit receivable
	 	440,025 	 	 	341,887 	 	 	– 	 
	GST receivable 	 	34,433 	 	 	28,389 	 	 	16,924 	 
	Other 	 	– 	 	 	1,557
    	 	 	27,164 	 
	  	$	 510,064 	 	$	 469,750 	 	$	 278,097 	 

	(c) 	
      Contributed Surplus:

	                   
      Period ended 	 	February 28, 	 	 	May 31, 	 	 	May 31, 	 	 	May 31, 	 
	  	 	2006 	 	 	2005 	 	 	2004 	 	 	2003 	 
		 	(Unaudited)    	 	 	 	 	 	 	 	 	 	 
	  	 	  	 	 	  	 	 	  	 	 	  	 
	Balance, beginning of period 	$	 996,301 	 	$	 491,423 	 	$	 105,375 	 	$	 – 	 
	  	 	  	 	 	  	 	 	  	 	 	  	 
	Stock-based compensation on options granted
      in the 	 	  	 	 	  	 	 	  	 	 	  	 
	   period 	 	505,068 	 	 	504,878 	 	 	368,048 	 	 	105,375 	 
	Agent’s stock-based compensation 	 	42,759 	 	 	– 	 	 	– 	 	 	– 	 
	  	 	  	 	 	  	 	 	  	 	 	  	 
	Balance, end of period 	$	 1,544,128 	 	$	 996,301 	 	$	 491,423 	 	$	 105,375 	 

	(d) 	
      Foreign Exchange Gain
(Loss)

  	                   
      Period ended 	 	February 28, 	 	 	February 28, 	 	 	May 31, 	 	 	May 31, 	 	 	May 31, 	 
	  	 	2006 	 	 	2005 	 	 	2005 	 	 	2004 	 	 	2003 	 
	  	 	(Unaudited) 	 	 	(Unaudited) 	 	 	 
    	 	 	 
    	 	 	 
    	 
	  	 	  	 	 	  	 	 	  	 	 	  	 	 	  	 
	Foreign exchange gain (loss) 	$	 (83,453	) 	$	 11,079 	 	$	 64,413 	 	$	 – 	 	$	 – 	 

	(e) 	Stock-based Compensation:

  	                   
      Period ended 	 	February 28, 	 	 	February 28, 	 	 	May 31, 	 	 	May 31, 	 	 	May 31, 	 
	  	 	2006 	 	 	2005 	 	 	2005 	 	 	2004 	 	 	2003 	 
	  	 	(Unaudited) 	 	 	(Unaudited) 	 	 	 
    	 	 	 
    	 	 	 
    	 
	  	 	  	 	 	  	 	 	  	 	 	  	 	 	  	 
	Stock-based compensation 	 	  	 	 	  	 	 	  	 	 	  	 	 	  	 
	 expense recorded to: 	 	  	 	 	  	 	 	  	 	 	  	 	 	  	 
	         Research
      and development 	$	 111,166 	 	$	 84,540 	 	$	 132,174 	 	$	 156,642 	 	$	 – 	 
	         General and
      administrative 	 	393,902 	 	 	250,744 	 	 	372,704 	 	 	229,406 	 	 	105,375 	 
	  	$	 505,068 	 	$	 335,284 	 	$	 504,878 	 	$	 386,048 	 	$	 105,375 	 

	(f) 	
      Earnings per share

	 	 
		
      The following securities could potentially dilute basic
      earnings per share but have been excluded from its calculation since their
      effect would be anti-dilutive:

  	  	 	February 28, 	 	 	February 28, 	 	 	May 31, 	 	 	May 31, 	 	 	May 31, 	 
	  	 	2006 	 	 	2005 	 	 	2005 	 	 	2004 	 	 	2003 	 
	  	 	(Unaudited) 	 	 	(Unaudited) 	 	 	 
    	 	 	 
    	 	 	 
    	 
	  	 	  	 	 	  	 	 	  	 	 	  	 	 	  	 
	Options: 	 	  	 	 	  	 	 	  	 	 	  	 	 	  	 
	   As at end of period 	 	3,091,333 	 	 	2,347,033 	 	 	 2,372,333 	 	 	2,307,033 	 	 	2,137,033 	 
	  	 	  	 	 	  	 	 	  	 	 	  	 	 	  	 
	Warrants: 	 	  	 	 	  	 	 	  	 	 	  	 	 	  	 
	   As at end of period 	 	2,706,860 	 	 	502,403 	 	 	502,403 	 	 	502,403 	 	 	18,446,537 	 
	  	 	  	 	 	  	 	 	  	 	 	  	 	 	  	 
	Total: 	 	  	 	 	  	 	 	  	 	 	  	 	 	  	 
	   As at end of period 	 	5,798,193 	 	 	2,849,436 	 	 	2,874,736 	 	 	2,809,436 	 	 	20,583,570 	 

	(g) 	
      Shareholders’ equity from inception until May 31,
      2002:

	CAPITAL STOCK 	 	  	 	 	  	 
	  	 	  	 	 	  	 
	   COMMON SHARES 	 	Number of 	 	 	  	 
	  	 	Shares 	 	 	Amount 	 
	  	 	  	 	 	  	 
	         Share
      capital of Medicure since inception on September 15, 1997 	 	9,500,000 	 	$	 100 	 
	         Shares deemed to be
      issued pursuant to reverse takeover 	 	  	 	 	  	 
	           
       accounting principles 	 	6,908,200 	 	 	1,482,384 	 
	         Private placements for
      cash, on January 27, 2000 at $0.72 per share 	 	694,444 	 	 	500,000 	 
	         Private
      placement for cash, on April 7, 2000, at $2.00 per share 	 	1,000,000 	 	 	2,000,000 	 
	         Exercise of options for
      cash 	 	224,000 	 	 	44,800 	 
	         Exercise
      of warrants for cash 	 	345,698 	 	 	175,913 	 
	         Balance at May 31, 2000
    	 	18,672,342 	 	 	4,203,197 	 
	  	 	  	 	 	  	 
	  	 	  	 	 	  	 
	         Private
      placement for cash on May 31, 2001, at $1.00 per share, 	 	  	 	 	  	 
	             net of
      share issue costs of $153,247 	 	2,600,000 	 	 	2,446,753 	 
	         Exercise
      of options for cash 	 	21,667 	 	 	16,250 	 
	         Exercise of warrants for
      cash 	 	423,632 	 	 	402,857 	 
	         Balance
      at May 31, 2001 	 	21,717,641 	 	 	7,069,057 	 
	  	 	  	 	 	  	 
	         Private
      placement for cash on June 14, 2001, at $1.00 per share, 	 	  	 	 	  	 
	             net of
      share issue costs of $153,247 	 	200,000 	 	 	200,000 	 
	         Exercise
      of options for cash 	 	8,333 	 	 	6,250 	 
	         Shares returned to
      treasury 	 	(221,725	) 	 	– 	 
	         Public
      offering for cash on December 31, 2001 and January 31, 	 	  	 	 	  	 
	             2002 at
      $0.65 per share, net of share issue costs of $1,195,998 	 	15,384,615 	 	 	8,804,002 	 
	         Balance
      at May 31, 2002 	 	37,088,864 	 	 	16,079,309 	 
	  	 	  	 	 	  	 
	   CLASS A COMMON SHARES 	 	  	 	 	  	 
	         Public offering for cash
      on February 28, 2000 at $1.25 	 	  	 	 	  	 
	           
       per share, net of share issue costs of $220,373 	 	1,280,000 	 	 	1,379,627 	 
	  	 	  	 	 	  	 
	  	 	  	 	 	  	 
	Total capital stock at May 31, 2002 	 	38,368,864 	 	$	 17,458,936 	 

CONTRIBUTED SURPLUS 

     No transactions to May 31, 2002 

	DEFICIT 	 	  	 
	  	 	  	 
	   Loss for the period from inception on
      September 15, 1997 	 	  	 
	         to August
      31, 1998, being deficit at August 31, 1998 	$	 240,366 	 
	   Loss for the year ended August 31, 1999 	 	252,752 	 
	   Deficit at August 31, 1999 	 	493,118 	 
	   Loss for the period from September 1, 1999 to
      May 31, 2000 	 	871,593 	 
	   Deficit at May 31, 2000 	 	1,364,711 	 
	   Loss for the year ended May 31, 2001 	 	3,232,010 	 
	   Deficit at May 31, 2001 	 	4,596,721 	 
	   Loss for the year ended May 31, 2002 	 	3,875,087 	 
	   Deficit at May 31, 2002 	$	 8,471,808Filed by Automated Filing Services Inc. (604) 609-0244 - Medicure Inc. - Exhibit 4.8 Report

REPORT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM

The Board of Directors
Medicure Inc. 

Under date of June 30, 2005, except as to Note 10, which is as
of August 19, 2005, we reported on the consolidated balance sheets of Medicure
Inc. (a Development Stage Enterprise) as at May 31, 2005 and 2004 and the
consolidated statements of operations and deficit and cash flows for each of the
years in the three-year period ended May 31, 2005 and for the cumulative period
from inception on September 15, 1997 to May 31, 2005 which consolidated
financial statements are incorporated by reference in the prospectus dated May
12, 2006 included in the Registration Statement on Form F-10. In connection with
our audits of the aforementioned consolidated financial statements, we also have
audited the related supplemental note entitled “Item 18 - Reconciliation with
United States Generally Accepted Accounting Principles” as set forth in the
Registration Statement. This supplemental note is the responsibility of the
Company’s management. Our responsibility is to express an opinion on this
supplemental note based on our audits.

In our opinion, such supplemental note, when considered in
relation to the basic consolidated financial statements taken as a whole,
presents fairly, in all material respects, the information set forth therein.

Signed “KPMG LLP”

Chartered Accountants 

Winnipeg, Canada 
June 30, 2005, except as to Note 10,

which is as of August 19, 2005

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