Drug Shortages and Discontinuations


Background Information

Drug shortages can occur for a variety of reasons and may include, but are not limited to, shortages of raw materials, quality control issues which lead to voluntary withdrawal and longer production times for some products, and competition among drug manufacturers. For more details see the  Multi-Stakeholder Toolkit (last revised 2017).

Healthcare providers are responsible for ensuring patients continue to receive appropriate drug therapy. A general protocol to follow in handling drug shortages is offered below:

  1. Confirm that the drug is shorted. For certain drugs, manufacturers are required by law to report anticipated and actual drug shortages and discontinuations. These reports are available and searchable at www.drugshortages.ca.
  2. Ensure there is a valid indication for the drug. Review the patient’s drug and medical history. For a checklist of criteria to consider, check the  CPhA Drug Shortages Guide pg 4 - 6.
  3. Substitution of a different brand of the same drug (molecule):
    • Check the Saskatchewan Prescription Drug Plan (SPDP) Formulary for interchangeable brands of the same drug; then check for availability of these brands. (Call wholesalers, manufacturers)
    • If none are available, is there a non-interchangeable brand of the same drug in the same dosage form? Obtain authorization for substitution from prescriber, start at same dose or a reduced dose and titrate to desired effect (especially important if drug has a narrow therapeutic index) and monitor for beneficial and adverse effects. Follow-up with the patient in 24 – 48 hours, as indicated by kinetic and pharmacologic characteristics of the drug.
    • If no Formulary drug in the same dosage form is available, check the Health Canada Drug Product Database for other brands that may be available and proceed as above.
    • If none available, is there a different dosage form of the same drug? Obtain authorization for substitution from prescriber, start at appropriate dose, titrate to desired effect (especially if narrow therapeutic index), and monitor for therapeutic and adverse effects. Follow-up with the patient in 24 – 48 hours as indicated by kinetic and pharmacologic characteristics of the drug.
    • If no Formulary drug is available, check the Health Canada Drug Product Database for other dosage forms that may be available and proceed as above.
    • As necessary, consult SPDP regarding coverage for substituted product.
  4. If no other forms of the same molecule are available, substitution of another drug in the same therapeutic class can be considered. Check the references below for dose equivalence data. This information is not always available. Even when a therapeutically equivalent dose is administered, patients may react differently. Pharmacists should follow-up with the patient frequently until the patient is stabilized on the new medication.
    • RxFiles Charts (available at SHIRP)
    • CPS (available at SHIRP)
  5. If there is not a therapeutic equivalent, check treatment guidelines and recommend a drug from another pharmacologic class. Monitor and titrate to desired effect.
  6. Compound products when no commercial agents are available.

medSask is not responsible for the content of this database, and does not assume any liability that may arise from any use of or reliance on the information contained therein.  The information in the database has been provided by drug manufacturers, and is presented here for reference purposes only.  There is no warranty, representation or guarantee with respect to the accuracy, timeliness, or completeness of this information.  medSask accepts no responsibility for any errors or omissions, and expressly disclaims any such responsibility.                      

The following tables provide suggestions for handling shortages of specific drugs. This information is intended for use by healthcare providers for general informational purposes only.  It remains the responsibility of the healthcare provider to use professional judgment in evaluating this information in light of any relevant clinical or situational data.  This information is provided without warranty of any kind and medSask and the University of Saskatchewan assume no responsibility and/or legal liability whatsoever for any errors, omissions or inaccuracies contained therein.

Specific Drug Shortages & Discontinuations



Availability / Alternatives


Sintrom® 1mg and 4mg tablets have been discontinued.

Acenocoumarol is approximately twice as potent as warfarin.  See CPS (subscription). Available through SHIRP

Acyclovir oral suspension

Zovirax® oral suspension is shorting. Estimated availability: mid-Dec/23 


  • acyclovir tablets can be dispersed in 20-50 ml of water

  • an oral suspension can be compounded. Medisca supplies a formula

Last updated: Aug 30/23


Adefovir 10mg tablets. Estimated availability: July/24

For therapeutic alternatives see RxFiles Hepatitis B Drug TherapyRxFiles is available through SHIRP 

Last updated: Sep 1/23

Antibiotics - pediatric formulations

Pediatric formulations of many commonly used antibiotics are undergoing shortages -  For specifics, see listing under individual medication.

Pharmacists may help minimize the shortages:

Last updated Jun 14/23

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

Beclomethasone Aqueous nasal spray

Apotex estimating availability for late Oct/23.  Mylan is indeterminate.

For therapeutic alternatives, see RxFiles Intranasal corticosteroids. RxFiles is available through SHIRP.

Last updated: Sep 14/23

Betamethasone sodium phosphate - betamethasone  acetate injection

Celestone® Soluspan®  is shorting. Estimated availability: mid-Nov/23

For therapeutic alternatives, see CPS (subscription) - Corticosteroids: Systemic. CPS is available through SHIRP

Last updated: Sep 11/23

Betamethasone valerate topical lotion

Ectosone regular lotions are shorting. Estimated availability: 

  • 0.05% - Jan/24
  • 0.1% - Feb/24. 

No other brands are marketed

Alternatives :

Last updated: Sep 21/23

Budesonide nasal spray

The 100 mcg nasal spray is shorting with indeterminate availability.


  • 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

McKesson has Pulmicort 0.125mg & 0.25mg/ml nebules in stock!

All brands and strengths of budesonide for nebulization are shorting. Teva is estimating availability - mid-Oct/23. 


Last updated: Sep 21/23

Buprenorphine Implant

Probuphine®  80mg implant has been discontinued.

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: Jul 5/23


Cefadroxil oral capsule

All brands are shorting. Estimated availability: mid-Oct/23

For alternative antibiotic options see indication in Bugs & Drugs

Last updated: Sep 11/23

Cefuroxime oral suspension

Ceftin® suspension is shorting. Estimated availability: mid-Oct/23. No other brands are marketed.


  • 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: Jul 13/23

Ciprofloxacin XL tablets

PMS-Ciprofloxacin XL 500mg oral tablets are shorting with indeterminate availability. No other brands are marketed.

  • The XL tablets are indicated solely for urinary tract infections
  • Ciprofloxacin regular 250mg & 500mg tablets remain available.
  • For alternative UTI treatments, see Bugs & Drugs

Last updated: Sep 23/23

Clindamycin 1%/benzoyl peroxide 3% & 5% gels

All formulations/brands shorting. Availability:

  • Clindoxyl™ ADV, and Taro-Clindamycin 1%/Benzoyl peroxide 5% gel (DIN 02440180) - Oct/23
  • Clindoxyl™ - Jan/24
  • Benzaclin® and Taro-Clindamycin 1%/Benzoyl peroxide 5% gel kit (DIN 02464519) - indeterminate

Benzaclin® and Taro-Clindamycin 1%/Benzoyl peroxide 5% gel kit (DIN 02464519) are interchangeable

Clindoxyl™ and Taro-Clindamycin 1%/Benzoyl peroxide 5% gel  (DIN 02440180) are interchangeable.

Although the medicinal ingredients are identical, Clindoxyl™ and it's generic are not interchangeable with Benzaclin® and it's generic. This is due to the difference in base formulations. They also differ in cost, pack size and storage requirements.


Last updated: Sep 13/23


Clomid® and Serophene® - discontinued                          

Compounded by compounding pharmacy or pharmacological alternatives - see  PDF

Cloxacillin oral suspension

Estimated availability: end of Sep/23


  • The oral capsules are available, however, the manufacturer - Teva Canada - has no data supporting absorption, safety & efficacy if the capsule is opened.
  • Compounding pharmacies do have a formula for cloxacillin liquid, however, the BUD is only 36 hours.
  • See Bugs & Drugs for alternative antibiotic options

Last updated: Aug 28/23


Colestid® granules and tablets are shorted. No date given for availability. 


Last updated: May 22/23

Collagenase topical ointment

Santyl ointment - indeterminate availability. No other brands marketed.

Santyl ointment is a topical enzymatic debriding agent used in dermal ulcers and severe burns. Consult wound care specialist for alternatives.

Last updated: Aug 21/23

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


Diazepam gel - rectal

Diastat® rectal gel is shorting with estimated availability of Oct 30/23. No other brands are marketed.


  • Medisca lists a compounding formula for a rectal gel. Compounding pharmacies are able to supply.
  • Pharmacist's Letter (subscription) - Giving Meds by Alternative Routes has information on rectal administration of diazepam and lorazepam injection and on intranasal use of midazolam injection for seizure control.

Last updated: Aug 25/23

Diphenoxylate tablet

Lomotil® 2.5mg tablets are on short. Estimated availability: late Oct/23

For therapeutic alternatives see CPS (subscription) - Diarrhea. CPS is available through SHIRP.

Last updated: Aug 25/23


Eprosartan and Eprosartan/HCTZ oral tablets

Teveten®  and Teveten® Plus have been discontinued by the manufacturer. No other brands of eprosartan are marketed.

See medSask's ARB comparison table for suitable alternatives.

Last updated: Sep 7/23

Erythromycin base oral tab/cap

AA-Erythro 250mg and Eryc® 333mg have been discontinued.

No other oral erythromycin products are marketed.


  • bulk powder is available for compounding
  • see Bugs & Drugs for therapeutic alternatives

Last updated: Apr 28/23

Estradiol transdermal patch

Several brands/strengths of estradiol patches are currently shorting.

  • Estradot®  and Sandoz-estradiol patches are interchangeable
  • Oesclim® , Estradot®  and Climara® patches are NOT considered interchangeable by the SK drug plan. 
  • Climara® patches are changed once weekly; Oesclim® & Estradot® are changed twice weekly.
  • cutting transdermal patches is not recommended.  However, if NO OTHER OPTIONS,  limited data indicates cutting matrix patches in half is safe
  • Estradiol gel is another transdermal option
  • See RxFiles Postmenopausal Therapy for more information. RxFiles is available through SHIRP.

Last updated: Aug 21/23

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.

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.

Folic acid 5mg tablet

All brands are shorting. AA estimated availability: Dec/23

The 1mg tablets are in stock and DPEB has added the WNP, VTH, WAM, JAM brands to the Formulary for a period of six (6) months from June 7, 2023 to December 31, 2023. 

NOTE: The listing of folic acid 1mg tablets is intended to replace folic acid 5mg tablets for those individuals requiring a therapeutic dose of folic acid. If supplies of folic acid 5mg tablets become available during this six-month period, pharmacies should resume dispensing the 5mg dosage form, and the 1mg tablet listing will be discontinued. If the shortage continues to exist at the end of the six-month period, 1mg tablets will continue to be listed.

Last updated: Sep 1/23

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. 


09 May 2023

Framycetin, gramicidin,​dexamethasone eye/ear drops 

See Sofracort® eye/ear drops

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.

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

Hydrocortisone sodium succinate (Solu-Cortef®

This has been deemed a Tier 3 drug shortage. Tier 3 drug shortages are those that have the greatest potential impact on Canada's drug supply and health care system. 

Various vial sizes are reported as shorted with resupply dates in July, 2023. Some formats may be available by allocation. Contact Pfizer 1-888-999-8750; ALLOCATION@PFIZER.COM 

Until further notice, the SK Drug Plan & Extended Benefits Branch has temporarily added Solu-Cortef®, 500 mg vials to Full Formulary status.

See English or French documents for conservation strategies and alternatives.

Last updated: July 27, 2023

Hydrocortisone 1%/ Pramoxine 1% rectal foam (Proctofoam-HC®)

Proctofoam-HC® is being shorted - no availability date given.


Last updated: Aug 5/22

Indacaterol Breezhaler®

Onbrez® Breezhaler® has been discontinued by the manufacturer. There are no other products containing indacaterol alone.


  • 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

Ipratropium nasal spray

PMS-Ipratropium 0.03% nasal spray is shorting. Estimated availability: mid-Nov/23. 

AA ipratropium 0.06% (Ipravent) nasal spray is available.  It is not a benefit under the SK drug plan, however, it is a benefit under NIHB.

See CPS - Allergic Rhinitis for therapeutic alternatives. CPS is available through SHIRP.

Last updated: Sep 21/23

Iron dextran injection

Dexiron has been discontinued

For alternatives see PDF


Locacorten® Vioform®  (clioquinol 3%/flumethasone pivalate 0.02%) topical cream

Estimated availability: late-October/23

Other antifungal/corticosteroid creams include Vioform® HC and Lotriderm®  cream.

Last updated: Sep 23/23 

Medroxyprogesterone oral tablets

McKesson has Apotex 2.5 and 5 mg tablets in stock

All strengths/brands of medroxyprogesterone (with the exception of the 100mg) tablets are on short.

See PDF for therapeutic alternatives. Until further notice, the SK Drug Plan & Extended Benefits Branch has temporarily opened micronized progesterone (Prometrium® and listed generics) to Full Formulary status.

Last updated: Sep 22/23

Metadol®-D liquid

There have been intermittent periods in which Metadol®-D is not available. The manufacturer states it is not in a shortage situation; however, it is experiencing a higher than normal demand. Stakeholders are working with the manufacture to ensure available product is distributed equitably.

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).


  • 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 31/23

Methotrimeprazine Injection

Nozinan 25mg/ml Injection is on allocation: CONTACT SANOFI CUSTOMER SERVICE LAVALCS@SANOFI.COM


  • 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.


  • 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

Mexiletine oral capsules

Mexiletine 100mg capsules are shorting. Estimated availability: late Oct/23

  • the 200mg capsules are in stock
  • mexiletine is indicated for specific types of ventricular arrhythmias and is used off-label for neuropathic pain. Consult with specialist regarding a suitable substitute.

Last updated: Sep 13/23

Minoxidil tablets

Loniten® 2.5mg & 10 mg tablets are shorted with indeterminate availability.

No other brands manufactured.


  • minoxidil powder is stocked by McKesson therefore potential for compounding

Last updated: Oct 7/22

Nitrofurantoin oral

Shortages of all brands/formulations. Estimated availability:

  • Teva-nitrofurantoin 50mg capsules: early Oct/23
  • PMS-nitrofurantoin 100 mg BID capsules: late-Oct/23
  • Teva-nitrofurantoin 100 mg capsules: early Dec/23
  • AA nitrofurantoin 50 & 100mg tablets: indeterminate

See Bugs & Drugs: Urinary Tract Infections for therapeutic alternatives. 

Last Updated: Sep 21/23

Nitroglycerin sublingual 

All brands of the sublingual spray are shorting. 

Nitrolingual® spray is now on allocation. Contact Sanofi for questions on this: lavalcs@sanofi.com 

The shortage of the spray is leading to increased demand for and sporadic 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: Jul 13/23

Ofloxacin ophthalmic drops

Ocuflox® ophthalmic drops are shorting - estimated availability: mid-Oct/23


Last updated: Sep 21/23

Olsalazine 250 mg capsule

Dipentum®  250 mg capsules shorting with indeterminate availability. No other strengths or brands are marketed.


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.


  • 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


Penicillin G - benzathine

Bicillin® L-A is on allocation. 

This is a preventative allocation due to a shortage in the US - no current shortage in Canada.  If you have questions or need to increase your allocation, contact Pfizer at 1-888-999-8750 or allocation@Pfizer.com 

Last updated: Jul 7/23

Periciazine oral

Neuleptil® capsules are shorting with indeterminate availability. 

Neuleptil® oral solution 10mg/ml is now in stock

For therapeutic alternatives, see CPS (subscription): Phenothiazines: CPhA monograph. CPS is available through SHIRP

Last updated: Aug 28/23

Permethrin 5% topical 

Availability for Nix® Dermal Cream: indeterminate

Availability for Kwellada®-P lotion: mid-Nov/23

Therapeutic alternatives:

  • Note: lower strengths of permethrin are not effective as scabicides.
  • Primary use of permethrin is for the treatment of scabies.  Alternatives to permethrin are limited to oral ivermectin, topical ivermectin, topical sulfur ointment and crotamiton.
    • oral and topical ivermectin have demonstrated efficacy and are used off-label for this indication.  Both are expensive. 
      • oral ivermectin (Stromectol®) dosage: 200 mcg/kg orally as a single dose with a repeat dose two weeks later
      • ivermectin (Rosiver®) 1% cream: apply to entire body and wash off after 2 hours; repeat in 1 week.
    • topical sulfur ointment 5-10% needs to be compounded, has an unpleasant odor and is messy to apply. It is often used in pregnancy, chest/breastfeeding and in pediatrics because of its low risk of toxicity.  
      • not as expensive as other treatments & is a benefit under NIHB
      • apply once daily after a bath and leave on for 24 hours for five to seven days.
    • crotamiton is an option, however, no preparations or bulk powder are available
  • RxFiles and CPS have information on scabies treatment. Available for free through SHIRP for SK health care providers

Last updated: Sep 21/23

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.   Earliest estimated availability: Jan/24

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.

  • See PDF regarding use for hypertension and PTSD.
  • Therapeutic alternatives for most other indications can be found in the CPS: Alpha1 Adrenergic Receptor Antagonists. CPS is available through SHIRP.
  • Some compounding pharmacies have been compounding capsules.

Last updated: Jul 13/23

Prednicarbate 0.1% ointment

Dermatop® 0.1% ointment has been discontinued.

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


see Hydrocortisone 1%/ Pramoxine 1% rectal foam

Progesterone effervescent vaginal tablet

Endometrin®  is shorting with indeterminate availability

  • Crinone® vaginal gel or micronized progesterone capsules inserted vaginally might be suitable alternatives. Consult with fertility specialist

Last updated: Sep 7/23

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 long-acting capsule

All strengths of Inderal®-LA have been discontinued by the manufacturer. 

Lupin-propranolol LA capsules are now marketed in Canada. McKesson has the 60, 80,120 & 160mg in stock!

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 27/23



Quinagolide (Norprolac®) has been discontinued.

For alternatives see PDF


McKesson has PMS-quinapril 20mg in stock

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: Jun 22/23

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

Rivaroxaban oral suspension

Xarelto®  1mg/ml oral suspension - indeterminate availability. No other brands are marketed.

The tablets can be crushed and mixed with applesauce.

Last updated: Sep 14/23

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

Scopolamine transdermal patch

Transderm V transdermal patches have been discontinued by the manufacturer. 

See therapeutic alternatives for select indications.

Semaglutide subcutaneous injection

Novo-Nordisk is advising of intermittent shortages lasting until early October of Ozempic® in the 1mg pen format.

McKesson has developed specific instructions for ordering Ozempic® pens that deliver 0.25 mg/0.5 mg doses (item #166390) and Ozempic® pens that deliver 1 mg doses (item #165991) found here (make sure to be logged in to PharmaClik before opening).

Alternative GLP-1RAs for diabetes and how to switch can be found here. Therapeutic alternatives for obesity are here.

Last updated: Sep 14/23

Sitagliptin/metformin XR 50/1000mg

All brands of sitagliptin/metformin XR 50/1000mg tablets are shorting with estimated availability: mid-Oct/23.   All other strengths of XR tablets and all strengths of the immediate release (IR) tablets remain in stock.  See table below for equivalent regimens.


Recommended dosage:

eGFR > 45 ml/min                     

Recommended dosage:

eGFR 30-45 ml/min                       

sitagliptin/ metformin XR 50/1000mg2 tablets once daily1 tablet once daily
sitagliptin/ metformin IR 50/1000mg1 tablet twice dailynot recommended

sitagliptin 50mg PLUS

 metformin 1000mg ER

2 tablets once daily. 

2 tablets once daily

1 tablet once daily. 

1 tablet once daily

sitagliptin 50mg PLUS

 metformin IR 500mg

2 tablets once daily. 

2 tablets twice daily

1 tablet once daily. 

1 tablet twice daily

Last updated: Aug 31/23

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. 

Sofracort®  eye/ear drops

Indeterminate availability

For alternative antibiotic/steroid otic drops, see CPS - Otitis Externa.

For alternative antibiotic/steroid ophthalmic drops, see CPS - Red Eye. Table 4: Anti-Infectives for Red Eye. CPS is available through SHIRP

Note: Ophthalmic drops and ointments can be used in the ear, but otic products CANNOT be used in the eye.

Last updated: Sep 1/23

Soframycin® Nasal Spray

Indeterminate availability


  • 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: Sep 11/23

Somatropin injection

Certain formats and sizes of somatropin are shorted. The Drug Plan and Extended Benefits Branch should be contacted regarding any patients affected by the Norditropin® NordiFlex® shortage who require an alternative product immediately. 

Last updated: Aug 2/23

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 BlepharitisCPS is available through SHIRP.

Sulfamethoxazole /trimethoprim
See Co-trimoxazole

Tamsulosin SR capsules

Tamsulosin SR capsules will not be available until March, 2024. Controlled release (CR) tablets are available. If needing an agent that can be crushed, consider doxazosin or terazosin, making sure to start at low doses and titrate. 

See Alpha1-Adrenergic Receptor Antagonists and Lower Urinary Tract Symptoms & Benign Prostatic Hyperplasia in CPS for dosing and more information. CPS is available through SHIRP

Last updated: Aug 23/23

Tiaprofenic acid oral tablets

Teva-tiaprofenic acid 200mg tablets are shorting. Estimated availability: mid-Oct/23. No other brands are marketed.


Last updated: Aug 28/23

Trazodone oral tablets

All brands/strengths of trazodone tablets are shorting with earliest estimated availability: early Oct/23

For therapeutic alternatives see: RxFiles Sleep Disorders or Depression. RxFiles is available through SHIRP

Last updated: Sep 21/23


AA-trifluoperazine 1, 2, & 5 mg tablets are shorting. Indeterminate availability date.

AA-trifluoperazine 10 & 20mg tablets are available

Last updated: Aug 17/23


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 5 mg (Fibristal) has been voluntarily withdrawn from the market in Canada due to risk of drug-induced liver injury.

See Health Canada's risk communication

Valproic Acid EC Capsules

Valproic Acid EC 500mg capsules shorting with availability: late Oct/23


  • 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: Sep 21/23

Verapamil IR tablets

All brands of 80mg tablets are shorting. Apotex is predicting availability: mid-Oct/23


  • Apotex 120mg IR tablets remain available from McKesson, however, Apotex has reported a shortage due to disruption to the manufacturing of the drug.
  • IR capsules can be compounded
  • For therapeutic alternatives, see RxFiles - Calcium Channel Blocker (CCB). RxFiles is available through SHIRP

Last updated: Sep 21/23

Verapamil SR tablets

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.
  • the SR capsules can be compounded
  • For therapeutic alternatives, see RxFiles - Calcium Channel Blocker (CCB). RxFiles is available through SHIRP

Last updated: Aug 28/23

Vigabatrin oral

Sabril® tablets and sachets are shorting with indeterminate availability

For therapeutic alternatives see RxFiles Seizures: Antiepileptics. RxFiles is available through SHIRP

Last updated: Sep 7/23

Documents of Resolved Drug Shortages

Depot Antipsychotic Shortages 

Fludrocortisone (Florinef®) English, French

Hydrocortisone tablets (Cortef(R))  English, French 

Ranitidine shortage