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

Hydromorphone immediate-release tablets

Canada is experiencing supply constraints affecting hydromorphone immediate-release (IR) 1 mg and 2 mg tablets. The supply constraints are related to manufacturing and supply challenges affecting multiple manufacturers of these strengths.

Current information suggests that supply constraints may continue through August and September and could persist beyond initially anticipated resolution timelines. While supply of 4 mg and 8 mg hydromorphone IR tablets remains stable, demand for the lower-strength tablets is significantly higher, and these products may not fully offset the expected supply gap.

Health Canada is monitoring the situation and continues to work with manufacturers and stakeholders to assess product availability.

Information and resources

To support pharmacists during these anticipated supply constraints, CPhA, in collaboration with the Canadian Society of Healthcare-Systems Pharmacy (CSHP), has developed a clinical resource with recommendations for patient management, conservation strategies and therapeutic alternatives.

Cyclophosphamide 

There is an ongoing shortage of cyclophosphamide for injection in Canada. All three manufacturers supplying the Canadian market—Baxter, Sterimax and Andone Pharmaceuticals—are reporting shortages across multiple vial sizes, and the shortage is expected to continue into the spring. On February 20, 2026, Health Canada declared a Tier 3 drug shortage and is working with manufacturers and stakeholders to monitor and mitigate the situation, including the importation of foreign-authorized products.

Information and resources

CPhA, the Canadian Society of Healthcare-Systems Pharmacy (CSHP) and the Canadian Association of Pharmacy in Oncology (CAPhO), have developed a clinical resource to support pharmacists and other health-care professionals in managing this shortage.

Menopausal Hormone Therapy 

There are currently supply challenges affecting some estrogen transdermal patches in Canada. Health Canada is in contact with manufacturers and is closely monitoring the supply situation. Increased demand for menopausal hormone therapy products has contributed to intermittent shortages of some patch products.

Alternative products remain available, including patches from other manufacturers as well as alternative formulations such as transdermal gels, vaginal creams and tablets.

Information and resources 

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

Oseltamivir (Tamiflu) suspension

With the increase in cases of influenza, demand for oseltamivir (Tamiflu) suspension formula has increased. In anticipation of potential supply constraints in the coming weeks, efforts should be made to conserve suspension supply where possible. 

Oseltamivir capsules remain in good supply and there is no indication of a broad or system-wide shortage. While we expect children’s hospitals to be the most affected, community pharmacists may also encounter this issue, particularly those not located near a tertiary children’s hospital. There may also be impacts for pharmacies serving long-term care or other populations with swallowing difficulties.

Vaccination remains the most effective method for preventing influenza and its complications during respiratory virus season.

Information and resources

CSHP and CPhA have developed a clinical resource to support health professionals in managing patients prescribed oseltamivir during any potential supply constraints for the suspension formulation: 

Ipratropium solution for nebules

Health Canada has declared a Tier 3 shortage of ipratropium nebules. Both Teva and Pharmascience are reporting shortages due to manufacturing disruptions and supply is constrained across the country. Intermittent shortages and supply gaps are projected to last into 2026.

Health Canada is monitoring the situation closely and assessing the supply of related products.

Information and resources

CPhA and medSask have developed a clinical resource to support health professionals in managing patients prescribed ipratropium bromide during the shortage.

Spironolactone

Health Canada has declared a Tier 3 shortage of spironolactone tablets.

Spironolactone is marketed by Teva Canada Ltd, Jamp Pharma Corporation, Mint Pharmaceuticals and Pfizer Canada ULC in 25 mg and 100 mg strengths.

Teva Canada Ltd and Mint Pharmaceuticals are reporting shortages because of manufacturing disruptions, and Pfizer Canada ULC is reporting a shortage because of increased demand. As a result, Spironolactone may not always be available.

Additional resupplies are anticipated in October and November; however, ongoing demand and substitution between strengths may continue to strain availability. Health Canada is working with manufacturers and others to monitor and mitigate the shortage. See Health Canada’s supply notice for more information.

Information and resources

A clinical resource has been developed to support health professionals in managing patients prescribed spironolactone during the shortage.

Lomustine discontinuation

In Canada, Lomustine is marketed by Bristol Myers Squibb (BMS) under the brand name CeeNU in 10 mg and 40 mg capsules. BMS has announced it will be discontinuing the drug in Canada. To help mitigate the impact of this discontinuation, Health Canada worked with BMS to extend the allowable shelf-life for the current inventory of CeeNU. Health Canada is also working with manufacturers and stakeholders to identify strategies to ensure access to Lomustine for Canadian patients following discontinuation of CeeNU (Lomustine), including importation. See Health Canada’s supply notice for more information.

Information and resources

Peginterferon alfa-2a (Pegasys) 

There continues to be a shortage of Canadian-authorized Pegasys (peginterferon alfa-2a) injection in Canada. Given the serious risks this shortage presents to patients in Canada who have been prescribed interferon-based therapy for treating myeloproliferative neoplasms (MPNs), Health Canada has permitted the exceptional, temporary importation and sale of similar but not identical products:

  • Health Canada has authorized the exceptional importation of EU-authorized PEGASYS (peginterferon alfa-2a). Available supplies are expected to be adequate to meet full market demand.
  • Health Canada had previously authorized the exceptional importation of US-authorized BESREMi (ropeginterferon alfa-2b). Supplies are expected to remain available to allow patients already initiated on the drug to continue treatment.

Canadian-authorized PEGASYS is not expected to be available until the end of June 2026.To support your patients during this shortage:

  1. Do not initiate new patients on Pegasys.
  2. Do not order or dispense large quantities of Pegasys.
  3. For patients MPNs, consider alternative medication as per guidance from the Canadian MPN Network: Guidance on transition is available here.
  4. Cutaneous T-cell lymphoma (CTCL) patients and pregnant patients should not be switched to Besremi. Pegasys remains the preferred interferon in this population as per guidance from the Canadian MPN Network.
  5. If a patient cannot be switched to Besremi, it is crucial to optimize dosing by using the lowest effective dose as per the Canadian MPN network.
  6. Please note that there are differences in the Besremi and Pegasys syringe format. Besremi is only available in a single dose pre-filled syringe with a manual safety needle cap. Counselling patients when converting patients will be required.

Further information about the shortage and guidance for health-care professionals can be found below.

Information and resources

Hypurin (porcine insulin) discontinuation

Wockhardt UK, the only current, global supplier of porcine insulin has informed Health Canada that it will no longer supply porcine insulin products for the Canadian market. Health Canada is working with the importer to monitor the remaining supply and is exploring ways to extend the availability of animal-sourced insulin by importing a UK-authorized supply that expires May 2026. No additional inventory of these drugs will be available after this inventory has been depleted. See Health Canada’s supply notice for more information.

Information and resources

CPhA, the Canadian Society of Healthcare-Systems Pharmacy (CSHP) and the Canadian Society of Endocrinology and Metabolism (CESM) have developed the following resource to help support pharmacists and other health-care providers manage the discontinuation.

Lithium carbonate

Canada has been experiencing shortages of lithium carbonate since summer 2024, predominantly impacting 300mg oral lithium products. A tier 3 shortage was declared on July 25, 2024. Health Canada continues to closely monitor the supply situation.

Information and resources

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

Other links and resources