Drug shortages

Last updated on April 11, 2024

 Current Drug Shortages List (.xls)

Active advisories

Dextroamphetamine sustained-release (SR) capsules

  • Shortage: Dextroamphetamine sustained-release (SR) capsules
  • Mitigation:
    • Vyvanse (lisdexamfetamine) capsules temporarily made a regular benefit until dextroamphetamine SR capsules (brand name Dexedrine or generic formulations) are back in stock at wholesale. Future coverage of Vyvanse will need a request for Special Authority and meet criteria. Coverage is not available for diagnoses other than ADHD
    • Vyvanse chewable tablets remain a non-benefit
  • Effective date: April 5, 2024
  • Notes:
    • Dextroamphetamine immediate-release (IR) tablets remain in stock
    • BC’s Drug Benefit Council's clinical evidence review determined similar evidence of efficacy and safety between IR and ER formulations in adult and pediatric patients; and no significant differences between the ER stimulant drugs based on the clinical data, however, there may be other differences (such as ability to sprinkle some medications)
    • Dextroamphetamine and lisdexamfetamine are controlled drugs, and switching to Vyvanse (lisdexamfetamine) may not be suitable for all patients
      • Consultation with prescriber needed to assess appropriateness and issue a new prescription
      • As per College of Pharmacists of BC’s PPP-58: Adapting a Prescription, a pharmacist must not change the dose, formulation or regimen, nor make a therapeutic substitution of a prescription for a narcotic, controlled drug or targeted substance
  • Resources:
  • Reason:
    • Generic shortage is due to manufacturing disruptions. Brand name is not short in Canada but experienced an increase in demand and requires time to be shipped from manufacturer warehouse to wholesale
  • Expected resolution:
    • McKesson reports resupplies expected by April 11, 2024, for both strengths of brand name Dexedrine. Generic dextroamphetamine SR is expected by end of April

Cholestyramine, colestipol and colesevelam

  • Mitigation: US-labelled colesevelam tablets from Glenmark Pharmaceuticals have been temporarily added as a PharmaCare regular benefit. Use PIN 09858334
  • Effective date: April 11, 2024
  • Notes: The US-labelled product has the same active ingredient, strength, dosage form, route of administration, product formulation, indications, dosage, and administration instructions as the Canadian-authorized products. The products differ in the non-medicinal ingredients, tablet markings, and storage conditions. The US-labelled product has English only labels. See: FDA Label for Colesevelam Hydrochloride Tablet
  • Resources: 
  • Reason: Product disruptions and increased demand
  • Expected resolution: As early as June 2024

Tamsulosin capsules and tablets

  • Note: Resupplies of tamsulosin continue to be received but all manufacturers are reporting actual or anticipated shortages. Supply during March and April is expected to be particularly impacted
  • Reasons: Discontinuation, production disruptions and increased demand
  • Expected resolution: Summer 2024
  • Resource: Tamsulosin Shortage - CPhA (PDF, 110KB) 

Prazosin tablets

  • Effective date: October 4, 2023
  • Shortage: Prazosin tablets
  • Mitigation: SteriMax’s US-authorized prazosin capsules have been temporarily added as PharmaCare regular benefits
    • PIN 09858281 1 mg US-labelled prazosin capsule
    • PIN 09858282 2 mg US-labelled prazosin capsule
    • PIN 09858283 5 mg US-labelled prazosin capsule
  • Notes: Consult the following SteriMax document for more information:

Sabril® tablets and sachets

Tablets

  • Effective date: December 5, 2023
  • Shortage: Sabril® 500 mg vigabatrin tablets
  • Mitigation: Use US-labelled vigabatrin tablets from Dr. Reddy’s Laboratories using PIN 66128438
  • Notes:
    • Previous mitigation was US-labelled Sabril® tablets from Lundbeck and claimed using PIN 66128410. More information: Lundbeck Canada letter (PDF, 587 KB)
    • Due to the potential contamination risk with trace amounts of tiapride, the distribution of Lundbeck’s vigabatrin tablets will be stopped once Dr. Reddy’s supply is available at the beginning of December
  • Info and ordering: Product available through usual distributors

Sachets

  • Effective date: October 27, 2023
  • Shortage: Sabril® 500 mg vigabatrin sachets
  • Mitigation: Use US-labelled vigabatrin sachets from Dr. Reddy’s Laboratories using PIN 09858315
  • Notes:
  • Ordering: Product available through usual distributors

 Nitroglycerin sprays and tablets

  • Limited supply: Nitroglycerin sprays and tablets (treatment for pain from angina)
  • Mitigation:
    • Strategies to conserve and increase supply, extended expiry dates, and expedited resupplies
    • Option to use Juno Pharmaceuticals UK-labelled nitroglycerin spray using PIN 09858317​
  • Differences for UK labelled product:
    • English only labels
    • “Glyceryl trinitrate” is used in UK product labelling whereas “nitroglycerin” is used in labelling of Canadian-marketed products
    • The UK-labelled product contains 180 metered doses while the Canadian-marketed products contain 200 metered doses
    • The UK-labelled product states “400 mcg per metered dose” whereas the Canadian format for expressing the equivalent strength is “0.4 mg per metered dose”
    • The Canadian-marketed products contain peppermint oil as a flavouring agent. The UK-labelled product does not, and thus does not have a peppermint aroma
    • The UK-labelled product contains propylene glycol as an excipient, which is not present in the Canadian-marketed products. Due to its propylene glycol content, the UK-labelled product can cause skin irritation
  • Pharmacists are requested to:
  • Guidance: Canadian Cardiovascular Society for pharmacy guidance on managing the shortage
  • Reason: Raw material supply issues and increased demand

 Pediatric antibiotic oral suspensions

  • Effective date: January 12, 2023
  • Shortage: Antibiotic oral suspension formats
  • Mitigation: Cyprus-labelled 250 mg/5 mL amoxicillin oral suspension (Moxilen Forte) (PIN 09858237) added as a PharmaCare regular benefit
  • Notes:
    • Capsules of amoxicillin continue to be available in Canada. Children able to safely swallow capsules should be given capsules where dosing permits

Glucagon for injection

  • Effective date: October 6, 2023
  • Shortage: Glucagon for injection
  • Mitigation: Use US-labelled glucagon from Amphastar Pharmaceuticals using PIN 09858279 
  • Notes:
    • US labelled glucagon is limited coverage
      • For Special Authority details see: Limited coverage drugs - glucagon
      • Criteria: for the treatment of severe hypoglycemia in patients who the nasal spray dosage is not appropriate
    • Amphastar's glucagon for injection is NOT considered equivalent to Eli Lilly's Canadian marked glucagon (DIN 02243297). Please follow the US labelling when using Amphastar's glucagon, since there is no equivalent Canadian Labelling available
    • Baqsimi, a nasal formulation of glucagon, is available and is a regular benefit under PharmaCare

Drug shortages lists 

Current Drug Shortages (.xls)

Resolved Drug Shortages (.xls)

The Current Drug Shortages List provides details about drugs covered by PharmaCare that are in short supply at B.C. community pharmacies. It includes coverage options and replacement products PharmaCare is covering during the shortage. The list does not include drugs dispensed in hospitals.

The Resolved Shortages List provides details about drug shortages that have ended and for which PharmaCare is no longer covering a replacement product.

The Drug Shortage Lists user guide (PDF, 516KB) provides tips for navigating these files.

Coverage for replacement drugs

In almost all cases, PharmaCare covers an alternative drug during a shortage. During the shortage, coverage for the alternative drug is the same as it would be for the drug that is in short supply (e.g., the plan it is covered under and whether it needs Special Authority approval for coverage). For PharmaCare coverage of a specific drug, use the Formulary Search.

Note: In many cases, PharmaCare already covers several versions of a drug. If one supplier’s version runs short, see Low Cost Alternative Program listings for other versions that PharmaCare already covers.

Coverage for compounded drugs

If an alternative drug isn't available, PharmaCare may cover a compounded drug on a last-resort basis. The Current Drug Shortages List will indicate if a compound is covered and if Special Authority (SA) is required.

In all cases, the prescriber will need to write a prescription for the compound.

Pharmacies: For more information, view Compounded Prescription — Section 5.13, PharmaCare Policy Manual.

If no alternatives are available

If no alternative drug is available and compounding is not covered, the Current Drug Shortages List indicates that patients and their health care provider may need to discuss a therapeutic alternative.

What is a drug shortage?

A drug shortage happens when a drug manufacturer or distributor cannot supply enough of a drug to fill prescriptions. It can result from various supply and demand causes, including manufacturing issues, distribution issues (including importation) and product discontinuations.

Shortages happen fairly regularly. Most drug shortages are temporary, but permanent shortages may occur when a drug is discontinued.

When a shortage ends, the information is removed from the Current Drug Shortage List and the alternative product(s) returns to its former benefit status.

 

Report a drug shortage

If you know of a drug shortage that is not included in the Current Drug Shortages List and have confirmed the shortage with your wholesaler, please contact the PharmaNet Help Desk.

Lower Mainland:

  • 604-682-7120

Elsewhere in B.C.:

  • 1-800-554-0225
Drug shortages in Canada

BC PharmaCare collaborates with provinces and territories, Health Canada, and the pharmaceutical industry to minimize the impact of drug shortages. 

For more information on drug shortages in Canada, view Health Canada's Drug Shortages Year in Review Report for 2022-23 (PDF, 777KB).