Drug shortages

Last updated on June 28, 2024

 Current Drug Shortages List (.xls)

Active advisories

Abatacept (Orencia®) 125 mg/mL solution for subcutaneous injection

  • Shortage: Abatacept (Orencia®) 125 mg/mL solution for subcutaneous injection (DIN: 02402475)
  • Mitigation: Option to use US supply – temporary coverage of US supply abatacept (Orencia®) 125 mg/mL will be provided as a limited coverage benefit with criteria under the PharmaCare program. Use PIN 09858343
  • Effective date: June 27, 2024
  • Ordering: Innomar Strategies
  • Reason: BMS shortage is due to manufacturing disruptions
  • Expected resolution: December 20, 2024

Carbamazepine CR tablets

  • Shortage: Carbamazepine CR tablets
  • Mitigation: Option to use US-labelled carbamazepine extended-release tables from Septa Pharmaceuticals
    • Use PIN 09858341 for 200 mg tablets
    • Use PIN 09858342 for 400 mg tablets
  • Effective date: June 11, 2024
  • Notes: The US products have the same active ingredient, strengths, dosage form (expressed as "extended release tablets" instead of "controlled release" tablets), and route of administration as the Canadian products. However, US products have a different formulation and its bioequivalence to the Canadian products has not been confirmed. These products have English only labels, with a different physical appearance and non-medicinal ingredients. Carbamazepine has a narrow therapeutic index and interchanging between non-bioequivalent products that have a narrow therapeutic index may result in patients being exposed to minor variations in drug concentrations, which may affect the effectiveness or safety of the drug. Enhanced monitoring for the imported drug for the intended disease condition is recommended. Refer to Importation of USA-authorized carbamazepine extended-release tablets for details
  • Ordering: Some product may be at select distributors in B.C. Direct order available from Septa Pharmaceuticals. For inquiries contact orders@septapharma.com or 1-905-564-5665
  • Reason: Sandoz shortage is due to manufacturing disruptions, and Novartis shortage is due to increased demand as result of Sandoz shortage
  • Expected resolution: Mid-July 2024 for 400 mg CR tablets and mid-August for 200 mg CR tablets
  • Resources:

Cholestyramine and colesevelam

  • Mitigation:
    • US-labelled colesevelam tablets from Glenmark Pharmaceuticals have been temporarily added as a PharmaCare regular benefit - use PIN 09858334
    • US-labelled cholestyramine for oral suspension sachets from Juno Pharmaceuticals has been temporarily added as a PharmaCare regular benefit - use PIN 09858335
      • Juno is importing limited quantities. Please use this product for patients who have no other therapeutic alternatives
  • Effective date: April 11, 2024 for colesevelam tablets and May 17, 2024 for cholestyramine sachets
  • Notes:
    • The US-labelled colesevelam 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. Refer to: FDA Label for Colesevelam Hydrochloride Tablet
    • The US-labelled cholestyramine has the same active ingredient, strength, dosage form, and route of administration as the Canadian-marketed products. The products differ in the non-medicinal ingredients, appearance, inner and outer labels, and packaging. The US product is a pale yellow to yellow powder with orange flavour and may taste or appear different than Canadian-marketed products due to the differences in non-medicinal ingredients. There are also differences in the approved indications; however, the US product can be used for the same indications as the Canadian-marketed products. The US-labelled product has English only labels
  • Resources: 
  • Reason: Product disruptions and increased demand
  • Expected resolution: Late summer/fall for cholestyramine and mid-to-late July for colesevelam

Valacyclovir 500 mg and 1000 mg tablets

  • Shortage: Valacyclovir 500 mg and 1000 mg tablets
  • Mitigation: Valacyclovir 1000 mg generics are being temporarily covered
  • Effective date: May 16, 2024
  • Reason: Manufacturing disruptions and increased demand of other brands
  • Expected resolution: Full resolution not expected until late summer; however, steady resupplies continue to be received

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:

Apomorphine injection and sublingual film

  • Shortage: Apomorphine injection and sublingual film
  • Mitigation: Use UK-labelled APO-go PEN (apomorphine injection) 30mg/3mL using PIN 66128457. Note that APO-go PEN is not an eligible benefit under PharmaCare
  • Notes:
    • UK-labelled apomorphine may be imported until December 31, 2024
    • Patients are encouraged to discuss options with their healthcare providers and transition off product as there is uncertainty with the availability of apomorphine
  • Reason: Kynmobi (sublingual film) and Movapo (injection) have been discontinued in Canada
  • Resolution: There is no anticipated resolution. Canadian products have been discontinued and the UK-labelled product importation is only a temporary measure

Collagenase (Santyl®) ointment shortage

  • Update: United States supply of Collagenase (Santyl®) ointment has been imported into Canada and is available for order through McKesson Canada. Note that US supply of collagenase (Santyl®) is not an eligible benefit under PharmaCare. Please use PIN 066128469 to enter prescriptions into PharmaNet
  • Effective date: April 25, 2024
  • Resources:
  • Resolution: US supply has been imported

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:

 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

 Amoxicillin oral suspensions

  • Effective date: January 12, 2023
  • Shortage: Amoxicillin 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 alternative drugs that PharmaCare is covering during the shortage. The list does not include drugs used in hospitals.

The Resolved Drug Shortages list provides details about drug shortages that have ended.

Coverage for alternative drugs

PharmaCare may cover an alternative drug during a shortage. Coverage for the alternative drug is often the same as 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). To look up PharmaCare coverage of a specific drug, use the Formulary Search.

Sometimes the alternative is a foreign-labelled product. If this is the case, PharmaCare assigns the product a PIN, as it will not have a DIN.

PharmaCare may cover a compounded drug as the alternative drug on a last-resort basis.

When a shortage ends, the information is removed from the Current Drug Shortages list and is added to the Resolved Drug Shortages list, and any alternative product returns to its former benefit status.

PharmaCare often covers several versions of a drug. If one supplier’s version runs short, prescribers and pharmacists can consult the Low Cost Alternative program listings to learn whether another version is covered.

If PharmaCare is not covering an alternative drug

If there is no covered alternative drug, patients and their health care providers may need to discuss different treatment options.

Reasons for drug shortages

A drug shortage happens when a drug manufacturer or distributor cannot supply enough of a drug to meet demand. It can result from various supply and demand issues, including manufacturing delays, 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.

 

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).