Canadian Pharmacists Association
Canadian Pharmacists Association
Login /Register   Français
Menu Item
CPhA Logo
Search pharmacists.ca

Managing current drug shortages

At any given time, there are between 1500 and 2000 active drug shortages in Canada. In many of these cases, pharmacists play an important and effective role in managing shortages at the pharmacy level. Below you will find information and resources related to several current shortages that may have a widespread impact on patients and pharmacies. 

Our role: CPhA works closely with Health Canada and others to represent the pharmacy profession. This includes advocating on pharmacists’ behalf, communicating shortage updates and recommendations, collecting frontline data to help inform allocation and procurement strategies, and developing tools and resources to support pharmacy and patients.

Learn more

Lithium carbonate

There are reported shortages of lithium carbonate in Canada, predominantly impacting 300mg oral lithium products. While at this time demand is being met with 150mg oral capsules, based on the current and forecasted supply situation, supply constraints for both the 150mg and 300mg oral capsules/tablets are expected starting in November 2024 into December 2024. On July 25, 2024, a tier 3 shortage was declared for lithium carbonate. Health Canada is in contact with manufacturers and is closely monitoring the supply situation. Mitigation strategies, including importation of foreign-authorized supply are being explored.

Information and resources

CPhA has developed the following clinical resource to support pharmacists as they help their patients navigate this shortage and available alternatives.

Carbamazepine controlled release (CR) tablets

There is currently a national shortage of carbamazepine CR tablets due to manufacturing disruptions and demand increases. Products impacted include Sandoz-Carbamazepine CR (200mg and 400mg) and Tegretol CR (200mg and 400mg). The shortage is expected to continue throughout the summer. On May 10, 2024, a Tier 3 shortage was declared for carbamazepine CR tablets. There are currently no anticipated shortages of carbamazepine immediate release (IR) tablets.  

Importation/risk communication

To help mitigate the shortage, Health Canada has permitted the exceptional, temporary importation and sale of USA-authorized Carbamazepine Extended-Release Tablets, USP 200 mg and 400 mg, with English-only labels.

The USA-authorized product has the same active ingredient (carbamazepine), strength (200 mg and 400 mg), dosage form (extended-release tablets), and route of administration (oral) as the Canadian-authorized product. However, there are differences in formulation and physical appearance between the USA-authorized and Canadian-authorized products. Healthcare professionals are advised to enhance their monitoring of the safety and effectiveness for the imported drug (See Health Canada risk communication for more information)

Information and resources 

Hormone replacement therapy

There are ongoing supply challenges impacting estrogen transdermal patches and vaginal rings (Estring) in Canada. Health Canada is in contact with manufacturers and is closely monitoring the supply situation. While there is not a clear resolution timeline in place for these shortages, there is currently an adequate supply of alternative products, including transdermal gels, vaginal creams and tablets to compensate for these shortages.

Information and resources 

CPhA has developed the following clinical resources to support pharmacists as they help their patients navigate this shortage and available alternatives. 

Cholestyramine/colestipol/colesevelam  

There is an ongoing national shortage of cholestyramine due to a number of factors, including demand increase and disruptions in the manufacturing of some cholestyramine products. The shortage is expected to continue well into 2024. Alternative products identified include colesevelam and colestipol, which are experiencing significant increases in demand. On January 26, 2024, a Tier 3 shortage was declared for cholestyramine and Tier 3 status was proactively assigned to colestipol. A Tier 3 status was also proactively assigned to colesevelam on February 15, 2024.

Information and resources 

Ozempic and other GLP-1 agonists

Due to high demand around the world, including Canada, supply issues have affected Ozempic (Semaglutide), Trulicity (dulaglutide), and Mounjaro (tirzepatide).

Novo Nordisk reports that the shortage for both Ozempic dose strengths are now resolved and the supply/demand situation for all dose strengths is stable.

Eli Lilly has advised Health Canada that, depending on the strength of the dosage, it expects shortages to end on March 31, 2024, for Trulicity (dulaglutide) and between April 15 and July 1, 2024, for Mounjaro (tirzepatide).

CPhA has been engaged with Health Canada and other partners to support pharmacists during this shortage.

Information and resources 

Tamsulosin 

There is currently a national shortage of tamsulosin hydrochloride. In Canada, tamsulosin hydrochloride oral tablets are marketed by 8 companies, 7 of which are reporting active/anticipated shortages or discontinuations for their products. Intermittent supply gaps can be expected from late March 2024 through April 2024. On January 26, 2024, a Tier 3 status was assigned to tamsulosin. 

Information and resources

Nitroglycerin spray

There is an ongoing shortage of nitroglycerin spray in Canada.  Health Canada, together with its partners, is continuing to look at ways to conserve existing supply, expedite resupplies to hospitals and pharmacies, and access foreign-authorized supply or alternatives, where possible. 

Information and resources 

Other links and resources