Tier 3 drug shortages
Tier 3 shortages are those that have the greatest potential impact on Canada's drug supply and health care system. Medical necessity and low availability of alternative supplies, ingredients or therapies determine the degree of impact.
The Tier Assignment Committee (TAC) includes federal, provincial and territorial governments, health care professionals and industry stakeholders. TAC makes recommendations on the tier assignment of actual and anticipated drug shortages based on:
- a review of the information gathered on the drug shortage
- a thorough discussion of the potential impact of the shortage
- a discussion of next steps to be taken to mitigate the impact of the shortage
Drugs in or at risk of Tier 3 shortages may be eligible for exceptional importation and sale. For more information, please consult the Guide to the exceptional importation and sale of drugs in response to drug shortages (GUI-0148).
Drugs that are allowed to be imported and sold in order to mitigate a critical shortage are found on the List of drugs for exceptional importation and sale.
| Drug (Active Ingredient) | Date of Tier 3 Determination | TAC Committee Membership | Used in the treatment of COVID-19 and/or related conditions (Yes/No) |
|---|---|---|---|
| Dexrazoxane | March 8, 2023 | Health Canada, British Columbia - Ministry of Health representing Provincial and Territorial Drug Shortage Task Team, Canadian Medical Association, Canadian Society of Hospital Pharmacists, Canadian Association of Provincial Cancer Agencies | No |
| Nitroglycerin Spray 0.4 MG/ACT | February 28, 2023 | Health Canada, British Columbia - Ministry of Health representing Provincial and Territorial Drug Shortage Task Team, Canadian Medical Association, Canadian Cardiovascular Society | No |
| Ketamine | February 23, 2023 | Health Canada, British Columbia - Ministry of Health representing Provincial and Territorial Drug Shortage Task Team, Canadian Medical Association, Canadian Society of Hospital Pharmacists, Canadian Anesthesiologists' Society | No |
| Amoxicillin – Oral Suspension | November 17, 2022 | Health Canada, British Columbia - Ministry of Health representing Provincial and Territorial Drug Shortage Task Team, Canadian Medical Association, Canadian Society of Hospital Pharmacists, Canadian Pharmacists Association, Canadian Paediatric Society | No |
| Amoxicillin and Clavulanic Acid – Oral Suspension | November 17, 2022 | Health Canada, British Columbia - Ministry of Health representing Provincial and Territorial Drug Shortage Task Team, Canadian Medical Association, Canadian Society of Hospital Pharmacists, Canadian Pharmacists Association, Canadian Paediatric Society | No |
| Haloperidol Tablets - 0.5 mg, 1 mg, 2 mg, 5 mg, 10 mg | November 9, 2022 | Health Canada, British Columbia Ministry of Health representing the Provincial and Territorial Drug Shortage Task Team, Canadian Medical Association, Canadian Society of Hospital Pharmacists, Canadian Psychiatric Association | No |
| Ophthalmic Steroids - Prednisolone 1% | October 14, 2022 | Health Canada, British Columbia Ministry of Health representing the Provincial and Territorial Drug Shortage Task Team, Canadian Medical Association, Canadian Society of Hospital Pharmacists, Canadian Ophthalmological Society | No |
| Ophthalmic Steroids - Dexamethasone 0.1% | October 14, 2022 | Health Canada, British Columbia Ministry of Health representing the Provincial and Territorial Drug Shortage Task Team, Canadian Medical Association, Canadian Society of Hospital Pharmacists, Canadian Ophthalmological Society | No |
| Ophthalmic Steroids- Difluprednate 0.05% | October 14, 2022 | Health Canada, British Columbia Ministry of Health representing the Provincial and Territorial Drug Shortage Task Team, Canadian Medical Association, Canadian Society of Hospital Pharmacists, Canadian Ophthalmological Society | No |
| Thallium, Thallous Chloride TI-201 Injection | October 7, 2022 | Health Canada, British Columbia Ministry of Health representing the Provincial and Territorial Drug Shortage Task Team, Canadian Medical Association, Canadian Society of Hospital Pharmacists, Canadian Association of Nuclear Medicine | No |
| Fludarabine Phosphate, 10 mg, Oral Tablets | September 14, 2022 | Health Canada, British Columbia Ministry of Health representing the Provincial and Territorial Drug Shortage Task Team, Canadian Medical Association, Canadian Society of Hospital Pharmacists, Canadian Association of Provincial Cancer Agencies | No |
| Vigabatrin, powder for oral solution | August 26, 2022 | Health Canada, British Columbia Ministry of Health representing Provincial and Territorial Drug Shortage Task Team, Canadian Medical Association, Canadian League Against Epilepsy | No |
| Acetylcysteine Solution | November 15, 2022 | Health Canada, British Columbia Ministry of Health representing the Provincial and Territorial Drug Shortage Task Team, Canadian Medical Association, Canadian Society of Hospital Pharmacists, Canadian Association of Poison Centres and Clinical Toxicology | No |
| Acetylcholine Chloride - Miochol E | January 24, 2023 | Health Canada, British Columbia - Ministry of Health representing Provincial and Territorial Drug Shortage Task Team, Canadian Medical Association, Canadian Society of Hospital Pharmacists, Canadian Ophthalmological Society | No |
| Asparaginase - Erwinase | July 16, 2020 | Health Canada, Ontario Ministry of Health representing the Provincial and Territorial Drug Shortage Task Team, Canadian Medical Association, Canadian Society of Hospital Pharmacists, Canadian Association of Provincial Cancer Agencies | No |
| Physiologic Irrigating Solution – BSS Sterile Irrigating Solution | February 2, 2023 | Health Canada, British Columbia - Ministry of Health representing Provincial and Territorial Drug Shortage Task Team, Canadian Medical Association, Canadian Society of Hospital Pharmacists, Canadian Ophthalmological Society | No |
| Calcitonin - Calcimar | January 30, 2023 | Health Canada, British Columbia - Ministry of Health representing Provincial and Territorial Drug Shortage Task Team, Canadian Medical Association, Canadian Society of Hospital Pharmacists, Canadian Rheumatology Association, Canadian Society of Endocrinology and Metabolism | No |
| Carbachol - Miostat | January 24, 2023 | Health Canada, British Columbia - Ministry of Health representing Provincial and Territorial Drug Shortage Task Team, Canadian Medical Association, Canadian Society of Hospital Pharmacists, Canadian Ophthalmological Society | No |
| Cefprozil, Cefuroxime, Cephalexin, Azithromycin, Clarithromycin – Oral Suspension | December 5, 2022 | Health Canada, British Columbia - Ministry of Health representing Provincial and Territorial Drug Shortage Task Team, Canadian Medical Association, the Canadian Society of Hospital Pharmacists, the Canadian Pharmacists Association, and the Canadian Paediatric Society | No |
| Eptifibatide Injection | November 14, 2022 | Health Canada, British Columbia - Ministry of Health representing Provincial and Territorial Drug Shortage Task Team, Canadian Medical Association, Canadian Society of Hospital Pharmacists, Canadian Neurological Sciences Federation | No |
| Hydralazine Injection | November 26, 2021 | Health Canada, British Columbia Ministry of Health representing the Provincial and Territorial Drug Shortage Task Team, Canadian Medical Association, Canadian Society of Hospital Pharmacists, Canadian Cardiovascular Society |
No |
| Methotrimeprazine Hydrochloride Injection | February 17, 2022 | Health Canada, British Columbia Ministry of Health representing the Provincial and Territorial Drug Shortage Task Team, Canadian Medical Association, Canadian Society of Hospital Pharmacists, Canadian Society of Palliative Care Physicians |
No |
| Lorazepam Injection 4 mg/mL | September 20, 2022 | Health Canada, British Columbia Ministry of Health representing the Provincial and Territorial Drug Shortage Task Team, Canadian Medical Association, Canadian Society of Hospital Pharmacists, Canadian Psychiatric Association | Yes |
| Eluxadoline - Viberzi | September 20, 2022 | Health Canada, British Columbia Ministry of Health representing the Provincial and Territorial Drug Shortage Task Team, Canadian Medical Association, Canadian Pharmacists Association, Ontario Association of Gastroenterology | No |
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