Specific Drug Shortages & Discontinuations

A-B

Drug	Availability / Alternatives
Acenocoumarol	Sintrom® 1mg and 4mg tablets have been discontinued. Acenocoumarol is approximately twice as potent as warfarin.  See CPS (subscription). Available through SHIRP
Acetaminophen Pediatric	Pediatric doses of acetaminophen have been on shortage with intermittent availability in various dosage forms (e.g., liquid, chewable and suppositories). Health Canada has approved importation of a limited quantity of Genexa US-labelled Kids’ Pain & Fever, Acetaminophen Suspension for children. See the letter to Wholesalers, Distributors, and Retailers. Note: French tear-away pads must be printed and kept beside the product on the shelves.                 Options to Address the Shortage Discourage panic-buying by reassuring the public that other products are available to meet their needs and consider limiting quantities sold. Recommend alternative brands (e.g., Tempra) or dosage forms (e.g., chewables, tablets). Counsel on the appropriate dose as the product may not provide an appropriate dose on the label. Repackage larger stock bottles of acetaminophen. All sales of repackaged acetaminophen must be patient-specific to be exempt from DEL requirements. In addition to the labelling requirements for patient-specific medication (e.g. prescriptions, see section 13 of Part J, the repackaged acetaminophen must also include: patient-specific directions for use (i.e., weight-adjusted dose) lot# drug expiry date must not: repackage acetaminophen in bulk, and/or make them available for patient self-selection Use compounded acetaminophen if no commercial product is available, which can be prescribed by pharmacists during this shortage. See medSask's Acetaminophen Shortagepage for background, prescribing (including PAR), and dispensing information as well as information for the general public. Medisca supplies formulae using tablets and powder. See our tips for administration of adult tablets (whole or crushed) to children. Last updated: Jan 23/23
Adefovir	Adefovir 10mg tablets are shorting with estimated availability of Mar/24 For therapeutic alternatives see RxFiles Hepatitis B Drug Therapy. RxFiles is available through SHIRP  Last updated: Mar 1/23
Alfacalcidol	One-Alpha® oral drops are shorting with indeterminate availability. Alternatives: The injectable formulation is available and can be used orally The oral capsules remain available Contact medSask for information on use via feeding tubes see CPS Vitamin D: CPhA Monograph for alternate Vit D analogues. CPS is available through SHIRP Last updated: Apr 5/23
Amoxicillin oral suspension	Sporadic availability of all brands/strengths of amoxicillin suspension and chewable amoxicillin tablets.  Alternatives: Viral infections are common and antibiotic therapy is inappropriate to treat these infections. Before selecting an alternative for amoxicillin, ensure antibiotic therapy is necessary. Infections for which antibiotics are inappropriate include bronchitis, viral pharyngitis, COVID-19, and others. RxFiles has prescriptions for viral infections for children and adults, which validate their symptoms, explain why antibiotics are inappropriate, and provide management strategies.  For therapeutic alternatives see medSask/CPhA shortage document (updated Nov 2022) Medisca supplies a compounding formula using capsules See our tips on how to administer adult formulations or opened capsule contents to children Last updated: Apr 17/23
Amoxicillin/clavulanic acid oral suspension	Amoxi-clav suspension is on short although some strengths sporadically available.  Medisca supplies a compounding formula See our tips for administration of adult tablets (whole or crushed) to children For alternative antibiotic options see indication in Bugs & Drugs Last updated: Dec 14/22
Antibiotics - pediatric formulations	Pediatric formulations of many commonly used antibiotics are undergoing shortages - including amoxicillin, amoxi/clav, azithromycin, cefuroxime, cefprozil, cephalexin, and clarithromycin.  For specifics, see listing under individual medication. Pharmacists may help minimize the shortages: ensure that liquid preparations or chewable tablets are needed.  Could the child swallow a tablet/capsule or could the adult product be split/crushed/opened? We have compiled some helpful tips on how to administer adult formulations (whole/opened/split/crushed) to children ensure duration of therapy is appropriate. See CPhA's  Optimizing Duration of Therapy: Is Shorter Smarter? promote proper use of antibiotics and discourage use for viral infections. Some useful resources for patient education: Choosing Wisely Canada Canadian Pediatric Society's  How to make sure antibiotics are the right choice Last updated Dec 7/22
Auralgan Otic Drops (antipyrine 5.4% & benzocaine 1.4%)	Auralgan Otic drops have been discontinued by the manufacturer. Possible alternative: Polysporin® Plus Pain Relief Ear Drops. These contain lidocaine 50 mg/mL & polymyxin B sulfate 10 000 IU/mL. Last updated: Jul 27/22
Betamethasone valerate topical lotion	Ectosone 0.05 & 0.1% regular lotions are shorting. Estimated availability: mid Jul/23 for the 0.1% lotion and Nov/23 for the 0.05% lotion Alternatives : no other brands are marketed for topical corticosteroids of similar potency see RxFiles Topical Corticosteroids. RxFiles is available through SHIRP  Last updated: May 28/23
Budesonide nasal spray	The 100 mcg nasal spray is shorting with indeterminate availability. Alternatives: Rhinocort ®  Aqua 64 mcg nasal spray is in stock For alternative corticosteroid nasal sprays see CPS (subscription) - Allergic Rhinitis. CPS is available through SHIRP Last updated: May 1/23
Budesonide nebules	All brands and strengths of budesonide for nebulization are shorting. Teva is estimating availability of Jul 4/23.  Alternatives: Pulmicort Turbuhalers available in all strengths contact compounding pharmacies re compounding  see RxFiles (subscription)  Asthma Overview & Drug Comparison Chart. RxFiles is available through SHIRP  Last updated May 26/23
Buprenorphine Implant	Probuphine®  80mg implant is to be discontinued when current inventory has been depleted -  anticipated to be May 2023. Information from manufacturer: The reason for discontinuation is due to the inability to successfully acquire continued supply and is unrelated to any safety concerns. Last updated: Oct 7/22

C

Drug	Availability
Calcitonin, Salmon, synthetic	Calcimar® 200U/ml (2ml) INJECTION available.              Calcitonin (salmon synthetic) injectable remains on the market but is indicated only for Paget’s Disease and hypercalcemia. Due to the increased cancer risk the duration of treatment should be limited to the shortest period of time possible and the minimum effective dose.              All nasal spray calcitonin products have been withdrawn and discontinued from the market due to a small increased rate of cancer (up to 2.4 %). DINs became inactive October 1st, 2013.
Cefadroxil oral capsule	All brands are shorting. Apo is predicting availability of mid June/23 For alternative antibiotic options see indication in Bugs & Drugs Last updated: May 22/23
Cefuroxime oral suspension	Ceftin® suspension is shorting. Estimated availability: Aug/23 Alternatives: 250mg & 500mg tablets are still available crushing not recommended due to extremely bitter taste, however, crushed tablets have been found to be compatible with apple, grape & orange juice as well as chocolate milk see our tips for administration of adult tablets (whole & crushed) to children for alternative antibiotic options see indication in Bugs & Drugs Last updated: May 28/23
Clindamycin 1% topical solution	Shorting with estimated availability: early Jun/23 Bulk clindamycin powder is in stock at McKesson. Compounding is an option. See RxFiles: Acne Treatment for alternative acne treatment options. RxFiles is available through SHIRP  Last updated: May 5/23
Clobetasol scalp lotion	All brands shorting. Earliest estimated availability is for Dermovate®: mid Jun/23 Alternatives: All other topical clobetasol formulations remain in stock. The topical solution is indicated for use in scalp conditions for alternative corticosteroid scalp lotions see RxFiles Topical Corticosteroids.  RxFiles is available through SHIRP  Last updated: May 28/23
Clomiphene	Clomid® and Serophene® - discontinued                   Alternatives:                   Compounded by compounding pharmacy or pharmacological alternatives - see  PDF
Colestipol	Colestid® granules and tablets are shorted. No date given for availability.  Alternatives:  The bile acid sequestrant cholestyramine is available in both powder and tablet form.  See RxFiles Lipid Lowering Therapy: Drug Comparison Chart (subscription) for dosing details.  RxFiles is available through SHIRP Last updated: May 22/23
Contraceptives (Oral)	For discontinued or shorted products refer, to SK Formulary for similar ingredients or RxFiles Oral Hormonal Contraception: Supplementary Tables, for similar hormonal activity.
Co-trimoxazole (sulfamethoxazole /trimethoprim) oral	Suspension - no date for availability.  The regular, DS and pediatric tablets are available. See PDF for management options. Last updated: May 5/23

D

Drug	Availability
Diclofenac 1.5% topical solution	All brands of diclofenac 1.5% topical solution are shorting. Earliest estimated availability is for Pennsaid® : mid Jul/23. See RxFiles: NSAIDs and Other Analgesics for alternative topical NSAID products. RxFiles is available through SHIRP. Last updated: May 28/23
Diphenoxylate tablet	Lomotil® 2.5mg tablets shorting with estimated availability: early Jun/23 For therapeutic alternatives see CPS (subscription) - Diarrhea. CPS is available through SHIRP. Last updated: Mar 28/23

E-G

Drug	Availability
Erythromycin base oral tab/cap	AA-Erythro 250mg and Eryc® 333mg have been discontinued. No other oral erythromycin products are marketed. Alternatives: bulk powder is available for compounding see Bugs & Drugs for therapeutic alternatives Last updated: Apr 28/23
Estrogens (conjugated) /bazedoxifene acetate	Duavive® - Currently on backorder. Indeterminate availability. Indication: Treatment of vasomotor symptoms associated with menopause. Alternatives: Estrogen + progestin Last updated Aug 29/22
Estradiol transdermal patch	Oesclim® 25 & 50mcg patches are shorting. No restock date given. Climara®  50mcg patches are shorting. Estimated availability: mid Jul/23 Alternatives: other brands of estradiol transdermal patches are available. However, they are NOT considered interchangeable with Oesclim®  or Climara® Climara® 25 & 100 mcg patches remain in stock cutting transdermal patches is not recommended.  However, if NO OTHER OPTIONS,  limited data indicates cutting matrix patches in 1/2 is safe Last updated: May 22/23
Exenatide Injection	Byetta® 1.2 & 2.4 ml prefilled pens and Bydureon® injection have been discontinued by the manufacturer. No other forms or brands of exenatide are available. For GLP-1 receptor agonist alternatives see CPS (subscription): Diabetes Mellitus. CPS is available through SHIRP.
Fluocinonide 0.05% topical	Lyderm 0.05% topical cream, gel and ointment- all are now available from McKesson Tiamol® 0.05% cream (fluocinonide 0.05% in an emollient cream base) -  estimated availability : end of Jun/23  For topical corticosteroids of similar potency, see RxFiles Topical Corticosteroids. RxFiles is available through SHIRP Last updated: May 22/23
Fluphenazine decanoate injection	Both brand name (Modecate®) and generic products have been discontinued.        See PDF for alternative antipsychotic depot injectables. Oral dosage forms are available.
Formula, Infant	A temporary closure of Abbott Nutrition’s U.S. based facility in 2022 resulted in limited supply of infant formula. Specialty formulas were first affected, though the supply of these has largely stabilized. However, strain shifted to supply of regular infant formula in the autumn of 2022 and is expected to continue into the summer of 2023. Supply of liquid formulations has been stable, but the more popular powder formulations are often unavailable. Health Canada continues to import formulas through the interim policy. See CPhA’s Infant Formula Shortage: Information for Pharmacy Professionals, which has comprehensive information, including Health Canada websites and documents.  LAST UPDATED 09 May 2023
Framycetin, gramicidin, phenylephrine nasal spray	See Soframycin Nasal spray
Glaucoma Agents, Topical	Intermittent shortages of various topical products for primary open-angle glaucoma have been occurring in Canada. RxFiles (Topical Ophthalmics for Primary Open Angle Glaucoma),CPS (Glaucoma), and other resources are available through SHIRP to help determine best therapeutic alternatives if the patient’s current agent is not available. While several different products are available, options are limited for patients who are sensitive to the preservative benzalkonium chloride (BAK). For those who are sensitive to BAK: If BAK can be tolerated at all: consider use of a product with a lower concentration. when > 1 agent is required, use a combination product when available to reduce overall exposure to BAK When possible, choose a preservative-free product (few exist) or a product with an alternate preservative. This table lists the agents available in Canada and indicates the preservative contained in each.
Glucagon injectable	Shorting with indeterminate availability - McKesson now has the Lilly brand in stock Baqsimi™ (glucagon nasal spray) remains in stock. Please note that Baqsimi™ is not indicated for use in children < 4 years of age. Last updated: May 22/23
Gramicidin 0.025mg/mL /polymyxin B sulfate 10,000 units/mL (Optimyxin)	Optimyxin eye and ear drops shorted. Estimated availability: Dec/24 Alternatives: Polysporin® drops Last updated: Apr 10/23

H-K

Drug	Availability
Haloperidol LA injection	Haloperidol LA Inj 100mg/ml is on allocation. Contact Sandoz at 1-800-361-3062 for more information. See PDF for alternative antipsychotic depot injectables. Last updated: Sep 21/22
Hydrocortisone tablets (Cortef)	The supply of both strengths of Cortef tablets, 10 mg and 20 mg, is currently vulnerable. Pfizer Canada has placed both strengths on allocation and is monitoring closely to mitigate a potential shortage. See English or French documents for conservation strategies.
Hydrocortisone 1%/ Pramoxine 1% rectal foam (Proctofoam-HC®)	Proctofoam-HC® is being shorted - no availability date given. Alternatives: Proctodan HC rectal ointment and suppositories contain 0.5% hydrocortisone and 1% pramoxine (as well as zinc sulfate) see CPS Hemorrhoids and Pharmacologic Therapy for Prevention and Management of Side Effects of Cancer Therapies and Radiation Therapy for therapeutic alternatives. CPS is available through SHIRP Last updated: Aug 5/22
Hydroxyzine capsules	All strengths of capsules shorting. Estimated availability: mid-July/23 The 10mg/5ml liquid remains in stock. Last updated: Apr 17/23
Ibuprofen, pediatric	Pediatric formulations of ibuprofen have been on shortage with intermittent availability. See medSask's Acetaminophen and Ibuprofen Shortage page for background, prescribing (including PAR) and dispensing information - as well as information for the general public. For compounding formulae see Medisca's Potential Shortage Support page. See our tips for administration of adult tablets (whole or crushed) to children.        Last updated: Nov 30/22
Indacaterol Breezhaler®	Onbrez® Breezhaler® has been discontinued by the manufacturer. There are no other products containing indacaterol alone. Alternatives: There are inhalation products containing indacaterol in combination: Atectura® Breezhaler® - indacaterol & mometasone Ultibro® Breezhaler® - indacaterol & glycopyrronium Enerzair® Breezhaler® - indacaterol, mometasone & glycopyrronium for LABA alternatives, see RxFiles COPD Drug Comparison chart. RxFiles is available through SHIRP
Infant Formula	See "Formula, Infant"
Insulin - premixed	Novolin® GE 40/60 and 50/50 penfills have been discontinued by the manufacturer.  See RxFiles Insulin Comparison Chart for alternate insulin choices. RxFiles is available through SHIRP. Last updated: April 6/23
Iron dextran injection	Dexiron has been discontinued For alternatives see PDF

L-O

Drug	Availability
Metadol®-D liquid	There have been intermittent periods in which Metadol®-D is not available. The only other methadone products that can be used for opioid agonist therapy (OAT) are Methadose™ Sugar Free and Methadose™ Cherry Flavoured.  Methadose™ Sugar Free is preferred because there have been reports of destabilization following switches to the Cherry Flavoured product.  A new prescription is required when switching to a different methadone product as they are not interchangeable.  See Commercially Available Methadone for Opioid Agonist Therapy: Pharmacist Information (especially Product Availability, page 2, and Tips for Communication, page 13). Notes:  Metadol® cannot be used for opioid agonist therapy because it holds Exceptional Drug Status (SK Drug Plan) and Limited Use Benefit (NIHB) status for pain only.  Methadone solutions cannot be compounded while commercial product is available as per Health Canada policy. Last updated: May 18/23
Methotrimeprazine Injection	Nozinan 25mg/ml Injection is on allocation: CONTACT SANOFI CUSTOMER SERVICE LAVALCS@SANOFI.COM Alternatives: tablets are available in all strengths injectable alternatives: See PDF Last updated: Dec 28/22
Methylphenidate, Long Acting	Biphentin®, Foquest®, generic methylphenidate ER-intermittent shortages of some strengths. Alternatives: Some strengths of the formulations may be available. Concerta® is available but is NOT interchangeable with the generic methylphenidate ER. Note that Biphentin®, Foquest® and Concerta® are not interchangeable. Ritalin® SR and Sandoz-methylphenidate SR tablets have been discontinued.  Apo-methylphenidate SR 20mg is still marketed.  Last updated: Oct 14/22
Metronidazole/nystatin-  vaginal	Flagystatin®  (metronidazole & nystatin) vaginal ovules are on back order - indeterminate availability. For vaginal candidiasis and trichomoniasis treatment recommendations,  see Bug & Drugs Last updated: May 1/23
Minoxidil tablets	Loniten® 2.5mg & 10 mg tablets are shorted with indeterminate availability. No other brands manufactured. Alternative: minoxidil powder is stocked by McKesson therefore potential for compounding Last updated: Oct 7/22
Nifedipine IR capsule	Nifedipine 5mg capsules are shorting: Estimated availability: mid-late Jun/23 Alternatives: the 10mg capsules remain in stock all long-acting formulations still available See CPS (subscription) Calcium Channel Blockers (CCBs) for therapeutic alternatives. CPS is available through SHIRP. Last updated: May 22/23
Nitroglycerin sublingual	All brands of the sublingual spray are shorting. Availability is indeterminate.  The shortage of the spray is leading to increased demand for and sporatic availability of the sublingual tablets.  Health Canada has been in contact with the manufacturers of the sublingual spray regarding extensions of expiry dates. Certain extensions have already been granted and Health Canada is asking consumers to: only obtain what they need from their pharmacy keep expired product and check this chart to confirm which products can be used beyond the original expiry date Other Management Strategies: A guidance tool has been developed (in partnership with CCS, CCPN, and supported by CPhA). Q&A for Pharmacy Professionals by CPhA. Optimize angina prophylaxis (nitroglycerin patches remain available). For details see RxFiles - Angina Treatment. RxFiles is available through SHIRP. Isosorbide dinitrate 5-10 mg sublingually prn is an option for pre-emptive treatment (prior to activity expected to cause angina). For details see RxFiles - Angina Treatment. RxFiles is available through SHIRP. Last updated: May 28/23
Nystatin vaginal cream	Estimated availability: Jun 5/23 Therapeutic alternatives for the treatment of vaginal candidiasis can be found at Bugs & Drugs Last updated: May 24/23
Ofloxacin ophthalmic drops	Ocuflox® ophthalmic drops are shorting - estimated availability: early Aug/23 Alternatives: See CPS (subscription) Conjunctivitis for ophthalmic antibiotics. CPS is available through SHIRP. Last updated: May 5/23
Olanzapine IM 10mg injection	Zyprexa® IM 10mg injection shorting. No restock date available. For therapeutic alternatives see RxFiles (subscription) - Antipsychotics: Oral & Short-Acting Injections. RxFiles is available through SHIRP. Last updated: Mar 16/23
Olsalazine 250 mg capsule	Dipentum®  250 mg capsules shorting with indeterminate availability. No other strengths or brands are marketed. Alternatives: Sulfasalazine See RxFiles (subscription) IBD: Ulcerative Colitis vs. Crohn's Disease. RxFiles is available through SHIRP. Last updated: Apr 18/23
Oxybutynin: long-acting formulations and topical gel	Ditropan XL® tablets, Oxytrol® transdermal patches and Gelnique®  topical gel have been discontinued by the manufacturers. Alternatives: generic oxybutynin 2.5mg & 5mg immediate release tablets and 1mg/ml syrup are available for therapeutic alternatives, see RxFiles: Urinary Incontinence. RxFiles is available through SHIRP. Last updated: May 5/22

P

Drug	Availability
Periciazine oral	All strengths/formulations are shorting with indeterminate availability. For therapeutic alternatives see CPS (subscription): Phenothiazines: CPhA monograph. CPS is available through SHIRP Last updated: Mar 22/23
Potassium chloride (Slow-K®)	Slow-K® (NPN 80040226) 600 mg KCl (8 mEq K+) slow release matrix tablets have been discontinued.                       Alternative long acting tablets providing 8 mEq K+: Jamp K-8 (NPN 80013005) 600 mg long acting tablet Sandoz K-8 (NPN 02247834) 600 mg long acting tablet M-K8 (NPN 80035346) 600 mg long acting tablet  Note: These products contain the same strength of KCl in a similar dosage form to Slow-K® and are the closest alternatives. However, the products are not interchangeable. If patient is near the high or low ends of the potassium reference range or if patient has a history of frequent fluctuations, closer monitoring after transition is prudent.                          Note: Inventory of the above products seems to fluctuate frequently. Alternative solid dosage forms providing 8 mEq K+: Jamp Potassium Cl ER 600mg capsules (NPN 80062704) Micro-K® Extencaps (NPN 02042304) Note: These capsules contain the same strength of KCl in a different, yet still modified release, dosage form. If patient is near the high or low ends of the potassium reference range or if patient has a history of frequent fluctuations, closer monitoring after transition is prudent. Alternative liquid providing 1.33mEq/ml KCl+: Odan-Potassium Chloride (NPN 80046782) Jamp KCl liquid (NPN 80024835) PMS KCl liquid (DIN 02238604) Note: Because the absorption pattern will be quite different between Slow-K® and the liquid, closer monitoring of all patients after transition is prudent. Alternative long-acting tablets providing 20 mEq K+: Sandoz K-20 (NPN 02242261) Odan K-20 (NPN 80004415) JAMP K-20 (NPN 80013007) Last updated: Jan 26/23
Prazosin tablets	All strengths/brands of prazosin tablets are shorting.    Teva 1mg tablets - estimated availability: late Jul/23. All other strengths/brands -  indeterminate availability Although DPEB had delisted the Apotex brand of prazosin, it has temporarily added it to the formulary. Apo-prazosin can be considered interchangeable with the Teva brand during this shortage. Therapeutic alternatives for most indications can be found in the CPS: Alpha1 Adrenergic Receptor Antagonists. CPS is available through SHIRP. For PTSD, there is evidence for use of doxazosin and terazosin.  Also some preliminary evidence with use of nabilone. Call medSask for details. Last updated: May 26/23
Prednicarbate 0.1% ointment	Dermatop® 0.1% ointment has been discontinued. Alternatives: the 0.1% cream is still available Last updated: Feb 14/23
Prochlorperazine injectable	Injectable formulation discontinued by manufacturer.                          Alternate forms: 5mg and 10 mg oral tablets available                          Therapeutic alternatives: See PDF. Last updated: Sep 21/22
Prochlorperazine 10mg rectal suppository	Sandoz has discontinued this product.  Odan may take over production in the future, but no suppositories are available at this time. For therapeutic alternatives see RxFiles (subscription) Migraine: Acute Therapy; Nausea & Vomiting Comparison. RxFiles is available through SHIRP. Last updated: Apr 6/23
Proctofoam-HC®	see Hydrocortisone 1%/ Pramoxine 1% rectal foam
Promethazine injectable	Injectable formulation has been discontinued by manufacturer. For information call 1-866-926-7653                          Alternate forms: 50 mg oral tablets   Therapeutic alternatives: See PDF. Last updated: May 5/23
Propranolol immediate-release tablet	Sporadic availability of all strengths. Alternatives: for treatment of HF, HTN, angina, post MI, arrhythmias, and headache, see RxFiles Beta-Blocker comparison chart. RxFiles is a subscription resource available through SHIRP for treatment of essential tremor, see RxFiles  Essential Tremor (ET)-Treatment Options.  for treatment of anxiety, see CPS - Anxiety Disorders. CPS is also available through SHIRP see the medSask/CPhA Inderal®-LA shortage document  Last updated: Apr18/23
Propranolol long-acting capsule	All strengths of Inderal®-LA have been discontinued by the manufacturer.  No alternative brands available in Canada. Consider switching to immediate release propranolol, another beta blocker, or another therapeutic option. See RxFiles or CPS for appropriate alternatives. Both subscription only but available through SHIRP. See the medSask/CPhA Inderal®-LA shortage document for guidance on how to switch to immediate-release propranolol, other beta-blockers, or therapeutic alternatives. Last updated: Jul 22/22

Q-Z

Drug	Availability
Quinagolide	Quinagolide (Norprolac®) has been discontinued. For alternatives see PDF
Quinapril	All strengths/brands of quinapril and quinapril/HCTZ are shorting. Availability is indeterminate. For alternatives see RxFiles - ACEI Comparison Chart and CPS - ACE Inhibitors. Both are subscription only but available through SHIRP. Last updated: May 15/23
Ranitidine injectable	Currently not available through McKesson. Under allocation. Contact Sandoz at 1-800-361-3062.                          Change to alternative if required:         Alternative H2 antagonists:         -IV: famotidine (APX, Omega) – in short supply         -Oral: famotidine 40 mg ~ nizatidine 300 mg ~ ranitidine 150 mg BID or 300 mg HS         Alternative PPIs:         IV: Pantoprazole         Oral: Pantoprazole 40 mg ~ Lansoprazole 30 mg ~ Omeprazole 20 mg ~ Esomeprazole 40 mg ~ Rabeprazole 20 mg         Nasogastric administration: lansoprazole, esomeprazole.
Ranitidine oral solution	Indeterminate availability.         If dose corresponds to tablet strength (75, 150, 300 mg), tablet can be crushed and mixed with soft food such as applesauce immediately before administering.         Extemporaneous compounding: See PDF for details.         Alternatives: See PDF for details
Rivastigmine oral solution	Exelon ®  oral solution is shorting with indeterminate availability. Rivastigmine oral capsules and transdermal patches remain available. There is a case report of the use of capsule contents dispersed in water and administered via nasogastric tube. Contact medSask for more details. Last updated: Apr 18/23
Ropinirole tablets	All strengths/brands of ropinirole currently shorting. Estimated resupply date: mid Jul/23 See PDF (last updated Jan 2020) for therapeutic alternatives. Last updated: May 28/23
Scopolamine transdermal patch	Transderm V transdermal patches have been discontinued by the manufacturer.  See therapeutic alternatives for select indications.
Silodosin tablets	All strengths/brands shorting. Estimated availability: late Jun/23 For therapeutic alternatives see CPS - Alpha1-Adrenergic Receptor Antagonists. CPS is available through SHIRP Last updated: May 8/23
Sodium citrate/​ sodium lauryl sulfoacetate/ ​sorbitol/glycerin/​sorbic acid enema	Microlax® enemas (12 pack) are discontinued. The manufacturer has a 4 pack available for hospital orders. There is no micro enema alternative.  Fleet® (regular, kids and mineral oil) and Lax-a-Nema® enemas are available.
Soframycin® Nasal Spray	Shorting with indeterminate availability. Indications: local treatment of infections and/or congestion caused by susceptible organisms in acute rhino-sinusitis crusting rhinitis nasal conditions accompanying the common cold post-operative care of patients who have undergone intranasal or sinus surgery prophylactic use, for reduction of nasal carriage of staphylococci See CPS or RxFiles for therapeutic alternatives as per indication. CPS and RxFiles are available through SHIRP Last updated: Mar 22/23
Sucralfate tablets	All brands of sucralfate 1g tablets are shorting. Earliest estimated availability: June 10/23 Sulcrate® Suspension Plus 200mg/ml remains in stock. Last updated: May 13/23
Sulfacetamide/ prednisolone ophthalmic	Blephamide® ophthalmic drops and ointment have been discontinued.  No other brands are available. For therapeutic alternatives see CPS (subscription): Eyelid conditions: Stye, Chalazion and Blepharitis.  CPS is available through SHIRP.
Sulfamethoxazole /trimethoprim	See Co-trimoxazole
Testosterone - injectable	Delatestryl® (Testosterone Enanthate) - McKesson has stock Taro Testosterone Cypionate 100mg/ml -  McKesson has stock Depo Testosterone 100mg/ml - indeterminate availability Transdermal gel and nasal gel dosage forms currently available. For alternatives: see PDF Last updated: May 15/23
Testosterone - oral	McKesson has some Taro brand in stock Testosterone 40mg capsules are shorting - estimated availability: early Jun/23 For alternatives: see PDF Last updated: May 24/23
Trifluoperazine	AA-trifluoperazine 1mg & 2mg tablets are shorting. Indeterminate availability date. AA-trifluoperazine 5, 10 & 20mg tablets are available Updated: Nov 15/22
Trifluridine	Viroptic® ophthalmic solution 1% has been discontinued.         No other topical ophthalmic antivirals are currently available in Canada.         Viral conjunctivitis does not usually require treatment, however, cold compresses and ocular lubricants may be used.         If absolutely necessary - oral antiviral treatment.         Reference: CPS (subscription) - Red Eye. CPS is available through SHIRP.
Ulipristal	Ulipristal 5mg(Fibristal) has been voluntarily withdrawn from the market in Canada due to risk of drug-induced liver injury. See: https://healthycanadians.gc.ca/recall-alert-rappel-avis/hc-sc/2020/74063a-eng.php
Valproic Acid EC Capsules	Valproic Acid EC 500mg capsules shorting with availability: Sept/23 Alternatives: Valproic acid 250mg capsules and 50mg/ml syrup are available. Doses > 250mg/day should be divided BID-TID Divalproex sodium tablets – not interchangeable with valproic acid, but dosing is approximately the same. Switch to the same daily dosing schedule; once stabilized, it may be possible to reduce the frequency of doses (while maintaining the same total daily dose). Monitor for continued control of seizures / mood. Last updated: May 15/23
Verapamil SR tablet	Verapamil SR 180 and 240mg tablets are shorting with indeterminate availability. the SR 120mg tablets are still available.  These should NOT be split. if necessary, switch from the SR product to the immediate release (IR) tablets at the same total daily dose (or closest possible). Monitor and adjust dose as required. Last updated: May 22/23
Vigabatrin tablets	Sabril® tablets are shorting. Estimated availability: mid-July/23 Sabril® 500mg sachets remain available. For therapeutic alternatives see RxFiles Seizures: Antiepileptics. RxFiles is available through SHIRP Last updated: May 13/23

Documents of Resolved Drug Shortages

Fludrocortisone (Florinef®) English, French

Hydrocortisone sodium succinate (Solu-Cortef^®) English, French

Ranitidine shortage