As of July 1, 2023, approved regulatory amendments to O. Reg 202/94 (General) of the Pharmacy Act, 1991 authorized Ontario’s Part A pharmacists, registered pharmacy students and interns to administer substances listed in the regulations by injection and inhalation for purposes other than patient demonstration and education.
This expansion of scope enables pharmacy professionals with injection training to better support their patients with the routine injection or inhalation of medications. This will benefit patients being treated for conditions including osteoporosis, diabetes, or rheumatoid arthritis who may have difficulties with self-injection or who fear needles, or those who may require inhaled medications for conditions such as asthma.
Resources
- Administering a Substance by Injection Guideline
- Schedule 1 injectable substances
- Administering a Substance by Inhalation Guideline
- Schedule 2 inhaled substances
- Administering a Substance by Injection or Inhalation: An Overview for Pharmacists
- Administering a Substance by Injection: An Overview for Pharmacy Technicians
Frequently Asked Questions
- Part A pharmacists, registered pharmacy students and interns with injection training are authorized to administer substances listed in O. Reg. 202/94 by injection (Schedule 1) and inhalation (Schedule 2) for treatment purposes to assist patients with managing their medication therapy
- The substances listed in Schedules 1 and 2 were updated and the AHFS Classifications were removed
- Some substances are still limited to the purpose of patient education and demonstration only
- Some substances are still limited to I.M. and S.C. routes of administration
- Substances that are administered intranasally, for emergency use, or are no longer marketed in Canada, were removed
- The I.V. route of administration via an established central or peripheral venous access device was added
- Pharmacists cannot initiate venous access
- Administration must be done in collaboration with a physician or nurse practitioner
- Additional training and skills assessment must be completed to demonstrate competency
Schedules 1 and 2 were first enacted in October 2012 and updates to the list of substances came into effect on July 1, 2023. These updates were in response to the Minister of Heath’s request in May 2019, for which the Board approved and submitted the regulatory amendments in November 2019. As such, any substances marketed in Canada after this date were not considered. As part of the consultation process, a number of organizations, including professional associations and regulatory bodies were consulted, along with subject matter experts in pharmacy, medicine and public health. Details of the College’s open consultation, which closed on October 26, 2019, can be found on the College’s Expanding Scope of Practice Consultation webpage.
No. Pharmacists should retain their own documentation as evidence that they have completed theoretical and practical training, as well as an assessment of their competency, prior to engaging in this area of practice. This information can be included in their Learning Portfolio and provided if requested (by a patient, employer, the College, etc.). This information will not appear on the public register, Find a Pharmacy or Pharmacy Professional and the Glossary of Terms has been updated to explain that “Trained to administer injections” means the pharmacy professional has declared completion of an OCP-approved injection training course to administer subcutaneous (SC) and intramuscular (IM) injections. SC injections are administered in the fat layer underneath the skin (for example, insulin). IM injections are delivered into the muscle (for example, a flu shot). The substances a pharmacist or pharmacy technician are permitted to administer by injection are listed in Schedule 1 and Schedule 3 (Vaccines) of Ontario Regulation 202/94.