The College has become aware of instances of pharmacies requesting prescriptions for over-the-counter children’s medication. Although some prescribers may choose to provide prescriptions for their patients due to supply chain disruptions of over-the-counter acetaminophen and ibuprofen, these drugs do not require a prescription.
It is the College’s expectation that pharmacists do not refer parents or caregivers to other healthcare professionals to receive a prescription for over-the-counter children’s medication.
Registrants who are experiencing supply chain disruptions in their pharmacy are encouraged to collaborate with their pharmacy peers to identify alternative sources if possible (i.e. a local pharmacy with the medication in stock) and, in the interest of patient care, provide that referral to parents or caregivers. Additionally, pharmacy professionals should use their knowledge, skills and judgment to advise on appropriate alternatives based on the individual circumstances. This may include chewable tablets, suppositories, or cutting or crushing a regular (adult) tablet.
Compounding should only be considered when other options have been exhausted, considering the needs of the patient, NAPRA’s compounding standards and Health Canada’s Policy on Manufacturing and Compounding Drug Products in Canada (POL-0051).
Compounding is a high-risk activity, requiring diligent adherence to standards and quality controls to make a preparation that is safe for the patient and to minimize the risk of an incident. The College has confirmed with Health Canada and NAPRA that a prescription is not required; however, documentation on the patient record must demonstrate the patient-pharmacist relationship and support the pharmacist’s assessment of the patient and rationale that compounding is appropriate.
The Canadian Pharmacists Association has created a resource page regarding the supply challenges affecting pediatric formulations of both acetaminophen and ibuprofen products, including a patient tip sheet for parents.