'It's a mess': Calgary pharmacists scrambling to help patients amid nationwide painkiller shortage
Health Canada issued a notice this week warning that medications combining acetaminophen with codeine or oxycodone are in short supply. The shortage affects several widely used painkillers, including multiple strengths of Lenoltec (Tylenol 1, 2, 3 and 4).
Acetaminophen with oxycodone is marketed in Canada by Teva Canada Limited, Apotex Inc. and Laboratoire Riva Inc. According to Health Canada, Teva is reporting a shortage due to manufacturing disruptions, while Apotex and Riva are facing shortages driven by increased demand.
Acetaminophen with codeine is sold in different formats by Teva, Riva and Pharmascience Inc. Teva has reported shortages of Lenoltec, while Riva and Pharmascience are not officially short but cannot meet the surge in demand caused by Teva's supply issues, the notice states.
'As a result, acetaminophen with codeine or oxycodone may not always be available,' Health Canada said.
At Luke's Drug Mart in Bridgeland, pharmacist David Brewerton said patients are 'frantic' as pharmacists work to mitigate the fallout of what he called a 'serious' shortage.
'We can't fill what we would like to be able to fill,' he said, noting the pharmacy only has 'tiny amounts' of Lenoltec in all strengths. 'We're looking anywhere from late August into October to get stock back in.
'We won't take a (prescription) transfer because we don't even have enough to supply the people that we're already supplying,' he said.
'It's a mess.'
Brewerton noted the shortage is not new and has been going on for several months, forcing pharmacists to find solutions to mitigate the fallout.
'We've been finding workarounds in the majority of cases,' he said. 'Sometimes there are alternatives that we can put together that will match it.
'In other cases… there might be a different painkiller that they could use that would treat the same pain.'
Pharmacists making adjustments, government looking for supply
He notes drug shortages are not new, but said this one underscores the risks of relying heavily on a single manufacturer.
'The vast majority of the products we're talking about being short … is coming out of one company,' he said. 'If they're having a problem with what appears to be one particular ingredient that goes into making all those different types of tablets.. (and) suddenly they all go short, it's a domino effect.'
He said the causes of drug shortages are 'incredibly varied' – from manufacturing disruptions to ingredient issues to worker strikes – and are difficult to predict. Diversifying supply, he said, is the best long-term safeguard.
'You want to diversify, so if there's a problem you're making up for it elsewhere,' he said.
Health Canada said addressing the shortage is 'a top priority.'
'We recognize the importance of having acetaminophen with codeine or oxycodone products available for patients,' the notice states. 'We're communicating with health care providers, provincial and territorial governments, and distributors to coordinate the sharing of information about this shortage.
'We're also working with manufacturers and stakeholders to monitor the supply of acetaminophen with codeine or oxycodone and looking at options for increasing access to these products.'
The Canadian Pharmacists Association has released a clinical guide to help pharmacies manage the shortage.
In the meantime, local pharmacists like Brewerton are doing what they can to keep patients comfortable.
'Every pharmacist is having to deal with that right now. And we're all working on what we can do to make up whatever we need to do for patients,' he said. 'We'll do our best.'
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