Grinding out local solution amid national medication shortage

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This article was published 06/09/2022 (1181 days ago), so information in it may no longer be current.

As the nationwide cold and flu medication shortage continues, some in Manitoba are turning to in-house alternatives from their local pharmacist.

Some over-the-counter cold medicines, including children’s Tylenol and Advil, have been in short supply for months due to supply chain issues and high demand. At Tache Pharmacy in Winnipeg, its stock of Tylenol has just run out but it is working around it.

“We just did a… renovation of our lab, so we have a brand new lab upstairs in our building that we make all sorts of products with,” pharmacist and Tache Pharmacy manager Robyn Small said Tuesday.

“So if anything goes on a shortage or manufacturer back order, then usually we’re trying to provide for that shortage by making it from scratch.”

A handful of Manitoba pharmacies are fitted with labs that allow them to provide compound medications: medicines that are not brand name, instead made by the pharmacist with the active ingredients being identical and non-active ingredients being similar.

For Tylenol, for example, the medication would contain acetaminophen and have dosage requirements determined by the pharmacist. What may be different are aspects such colours or dyes used in the brand name medication, binding agents, and the compound’s shelf life is typically much shorter.

Tache Pharmacy hasn’t had to begin making compound versions of Tylenol and Advil, because it had stock of the brand name versions up until last week. It plans to provide compound options to patients on a case-by-case basis, Small said.

“It’s not something you’d set on the shelf for a year or two, like what a commercially-available product is, we’re bound by a lot stricter regulations when we make it from scratch,” she said.

“What we’ve been just telling people is if you can’t find it elsewhere, just give us a call back and we’ll make it specifically for you.I don’t think we’ll be able to have the luxury of just making a whole bunch and having it sit on the shelf.”

It’s a “relatively uncommon” response to a shortage Pharmacists Manitoba practice adviser Tim Smith said has hit the province a little later than much of the country, but still hit hard.

“It seems to be getting worse before it’s going to get better. When the stories first started hitting national media, some products were in and out of supply here (in Manitoba) but it hadn’t really hit a critical mass at that point,” Smith said.

“But since then, we’ve really seen that the overwhelming majority of acetaminophen and ibuprofen products are no longer available, particularly those products intended for children.”

Compound prescriptions are more commonly seen in topical pain creams (as a replacement for oral treatments) or hormone replacement therapy. In that essence, it’s not a new process at all, and supply chain issues have been impacting Manitoba’s pharmaceutical industry for years, advocates said.

However, with supply chain disruptions having skyrocketed as a result of the COVID-19 pandemic, the general public may be forced to become more aware of the benefits of compound prescriptions, Smith said.

“I’d say what’s really captured the public imagination here is that everyone knows Tylenol and Advil, and especially because it impacts children’s formulations, I think that’s what’s really brought it onto the radar for people,” he said.

malak.abas@freepress.mb.ca