Ask Your Pharmacist

January 11, 2023
Q:

I went to pick up my prescription at my community pharmacy and was informed my heart medication is short from the manufacturer, and it’s unknown when the drug will be available.  What does a person do in this situation? 

A:

Drug shortages in Canada have become an increasingly common and significant challenge over the last decade. One in four Canadian senior citizens is on at least ten prescription medications. Many of these medications are life-saving medications that a patient cannot just stop. In some cases, abruptly stopping the medication may lead to withdrawal symptoms or other negative effects on a patient’s health. 

Medication shortages are a complex challenge and may occur for a variety of reasons including a shortage of raw materials. Quality control issues at the medication manufacturing stage can lead the drug company to voluntarily recall medication production lots and this leads to prolonged production times. Competition between drug companies can also lead to medication shortages. Shortages can also be driven by a substantial increase in demand, as in the current shortage of over-the-counter cold and flu medication.  

Your pharmacy team is very aware of how important it is for you to have stable, consistently predictable access to your prescriptions. If you are going to receive the benefits of medications you have been prescribed, you must have access to take your medications.   

For certain medications, manufacturers are required by law to report anticipated and actual drug shortages and discontinuation. These are publicly available at www.drugshortages.ca 

Upon learning of your drug shortage, the pharmacist will confirm how much supply of medication you have remaining.  She/he will confirm the indication, or reason, you are taking the medication. Sometimes another strength of the same medication is available, and sometimes another brand of the medication is available. You will be counselled if such a change occurs.  

Often, for example with cardiac medications, although your medication is short, there may be "cousin" medications within a drug classification that are an option. A pharmacist can prescribe a therapeutic substitution in this situation to avoid therapy interruption and will monitor you to make sure this transition in therapy happens effectively and safely. If no other options exist, your prescriber will be contacted to collaborate about other treatment options.   

There has been much information in the media recently about over-the-counter and prescription drug shortages, particularly for cold and flu medication. Be sure to pay attention to the source of the information about medication shortages. You can trust the information you receive from your pharmacy team about medication shortages.  

When possible, you will be informed of any expected medication shortages in advance. In cases where the pharmacy receives little or no advanced warning of a shortage from the wholesaler, you can be assured that we will work tirelessly to gain you timely access to your medication. 

Ultimately, your health is largely your responsibility. This means in the case of your medications, making sure that you have refills left and requesting medication refills in a timely manner. If you wait until you are out of medication for a refill, only to find out there is a shortage, you may suffer a gap in your drug therapy.  

If possible, set up your chronic medications for an automatic refill. This way the pharmacy will be better able to predict upcoming drug supply requirements. Although drug plans will not allow you to call in a refill weeks in advance, they will allow refill requests for non-controlled substances to be placed a few days in advance.  

Ask to speak to your pharmacist if you are worried or anxious about a prescription medication drug shortage that affects you. Your pharmacist is available to speak with you at the counselling section of your pharmacy when you pick up your medication. Sometimes solving a medication shortage issue is challenging and requires more than a two-minute interaction. In these situations, you can make an appointment by phone or in person to speak with your pharmacist and have their devoted attention.  

Whenever possible, if your pharmacy team has made attempts to access your medication and there is an issue, we will work with your prescriber and yourself to come up with a reasonable plan before you run out of medication.  

Dr. Kevin Duplisea (PharmD BSc. Pharm, BSc. ACPR) is a pharmacist at Shoppers Drug Mart in Quispamsis, New Brunswick. His opinions expressed in this newspaper are published for educational and informational purposes only, and are not intended as a diagnosis, treatment or as a substitute for professional medical advice, diagnosis or treatment. Send your questions to AskYourNBPharmacist@gmail.com.