Drug shortages are an ongoing concern within the Canadian health-care system, affecting as many as 1 in 4 Canadians. It’s estimated that pharmacists spend as much as 20% of their time navigating these shortages: notifying patients and their health care teams, tracking down supply, finding alternatives, and recommending and/or making drug therapy changes.
There is currently a severe shortage of nitroglycerin spray in Canada because of raw material supply issues for manufacturers. Increased demand for nitroglycerin tablets (which have been the only available alternative) has now also led to a shortage of tablets. Supply is expected to be extremely limited until July or August.
This shortage is a significant concern for people who use nitroglycerin spray to treat heart-related chest pain. During this shortage, please do not discard any expired nitroglycerin spray products. Specific lots of Mylan-Nitro Sublingual Spray have had their expiry dates extended by one year:
If you have a nitro spray at home and its expiry date cannot be extended, please talk to your doctor about whether other options need to be considered. Sublingual tablets may be an option for some individuals, and it may also be possible to optimize treatment with certain cardiac medications (beta blockers, calcium channel blockers), as well as nitroglycerin patches, where appropriate. In addition, your doctor may be to advise you on strategies for avoiding/managing chest pain.
As pharmacists, we have been asked to limit dispensing of these products. However, none are available. Rest assured that we are making every effort to secure a supply for our patients.