Medication Backorders

Cholestyramine is a bile acid binding agent, which is a medication used to lower cholesterol levels in your blood. It combines with bile acids in the intestines and removes them from the body via feces. This forces the body to use cholesterol to make more bile, thereby lowering the body’s cholesterol. In conjunction with proper diet cholestyramine can help keep cholesterol in check, It works like a sponge in your digestive system, helping your body remove excess cholesterol. This can reduce your risk of heart disease and other cholesterol-related health issues. Cholestyramine has also been used off-label to reduce diarrhea in Crohn’s Disease.

All brands of cholestyramine are currently unavailable in Canada due to manufacturer backorders with an earliest availability date of May 2024. Many pharmacies, including Nanogram Pharmacy may have some supply remaining of this medication. The only other bile acid binding agent (also known as a bile acid sequestrant) currently available is colesevelam. During a manufacturer backorder, cholestyramine can be compounded. Please reach out to your physician or pharmacy for options.

Tamsulosin is used to treat lower urinary tract symptoms associated with benign prostatic hyperplasia. It selectively relaxes the smooth muscle tissue in the bladder neck and prostate resulting in improved urine flow. Tamsulosin is not intended for use as an anti-hypertensive medication. Tamsulosin comes as both a controlled release tablet and sustained release capsule. Both forms are on manufacturer backorder in Canada with an expected date of return of mid-March 2024. Please reach out to your physician or pharmacy for options or to find a pharmacy that has this product in stock or can compound this medication.

Nystatin cream can be used both topically or vaginally to treat fungal or yeast infections, primarily those caused by yeasts in the Candida strain. These infections can present anywhere on the body, but are more common in warm moist areas such as under the diaper in infants, in the mouth (called oral thrush when it is present in the mouth) or throat, vaginally, groin, armpits or under the breasts.

Currently, nystatin cream is on manufacturer backorder in Canada until at least mid-July 2024. During this time, pharmacies that are able to compound this cream will be able to do so. There may also be other topical medications which can help with this condition. Please reach out to your physician or pharmacy for options, or reach out to Nanogram Pharmacy directly.

Mounjaro® (tirzepatide injection) is indicated for once-weekly administration as an adjunct to diet and exercise to improve glycemic control for the treatment of adult patients with type 2 diabetes mellitus. White tirzepatide has an approved indication for weight loss in other countries, it has not been approved by Health Canada for this indication but it has been used off-label for this purpose. There is no option to compound tirzepatide, but other alternative medication options exist. Tirzepatide is not on manufacturer backorder, however demand is outpacing supply. Please reach out to your physician or pharmacy for options or to be contacted when tirzepatide becomes available.

Efudex® 5% is a cream indicated for the topical treatment of pre-cancerous or superficial basal cell carcinoma. This product interferes with cell growth. This medication should be used exactly as prescribed. Efudex® does not have a generic version in Canada. Efudex® is currently on manufacturer backorder in Canada with an anticipated date of return of mid-July 2024. Many pharmacies, including Nanogram Pharmacy may have some supply remaining.

Prazosin is Health Canada approved to treat mild to moderate hypertension (high blood pressure). However it is also used off-label to treat nightmares associated with post-traumatic stress disorder and Raynaud’s syndrome. The Canadian supply of prazosin is currently on manufacturer backorder across Canada and is expected to return mid-2024. It can be compounded during the nationwide shortage for patients who require it. Please reach out to your physician or pharmacy for options.

All purpose nipple ointment (APNO) is a common medication used by breastfeeding mothers for sore or cracked nipples. The formula was developed by pediatrician and breastfeeding expert Dr. Jack Newman. This is a prescription product and your maternity doctor, pediatrician or midwife will be able to decide if this is an appropriate product for you. APNO is composed of 3 different medications: an antibiotic which helps heal nipples and prevent an infection, an antifungal which helps to prevent and fight fungal infections, and a topical corticosteroid to bring down pain and swelling. This medication is only available through pharmacies who are able to compound this product. At Nanogram Pharmacy, we compound APNO pursuant to a prescription. There may be a pharmacy in your local area which can compound this medication for you. Please reach out to your physician or pharmacy for option

Ciclopirox 1.5% shampoo is a topical treatment and preventative treatment for dandruff or the treatment of seborrheic dermatitis in where yeast M. furfur is involved. This product has been discontinued in Canada and is only available through select pharmacies able to compound this medication. Please reach out to your physician or pharmacy for options, or contact Nanogram Pharmacy directly.

Semintra® (telmisartan oral solution) is a veterinary use only medication indicated for feline hypertension. This medication is currently on backorder in Canada. During a manufacturer backorder, compounding pharmacies are permitted to make equivalent therapeutic options. Speak to your veterinarian about options during the backorder.

Oral minoxidil is indicated for the treatment of severe hypertension (high blood pressure) that produces symptoms or is associated with target organ damage. Generally minoxidil is recommended when hypertension is not manageable with maximum therapeutic doses of a diuretic (blood pressure medication that removes fluid from the body) and two other blood pressure medications. Loniten® is the only commercially available oral minoxidil in Canada. Oral minoxidil is also used off-label for hair growth. It is currently on long-term manufacturer backorder with indeterminate availability. It can be compounded during the nationwide shortage for patients who require it. Do not discontinue this medication abruptly. Please reach out to your physician or pharmacy for options or contact a pharmacy who is able to compound this product.

Diclofenac cream is a popular topical treatment used for pain and arthritis. It is available over the counter at concentrations of 2.32% or less. Above that concentration topical diclofenac is a prescription in Canada. While the prescription strength is not commercially available, select compounding centers can assist. Regulations have changed across Canada and this product can now only be prepared by select compounding centres.

Ranitidine oral solution is used to reduce stomach acid to prevent heartburn, ulcers, and gastroesophageal reflux disease (also known as GERD). The liquid id commonly used in children or those who cannot swallow tablets.

Ranitidine oral solution has been unavailable in Canada for the last several years and has no expected date of return. This medication can be made at certain compounding pharmacies. Give us a call or send us an email to find out how we can help.

Acyclovir is an antiviral medication that can decrease the length and severity of chickenpox, cold sores around the mouth (caused by herpes simplex virus), shingles (caused by herpes zoster virus) and genital herpes. In people with a weakened immune system, acyclovir can decrease the risk of the virus spreading to other parts of the body.

Acyclovir tablets are readily available across Canada, however the acyclovir oral suspension is on manufacturer backorder until at least mid-April 2024. The oral suspension is usually used in people who have trouble swallowing tablets and children. Please reach out to your physician or pharmacy for options or contact a pharmacy who can compound this product.

Clomiphene citrate was discontinued in Canada in 2017 and is now only available through specialized compounding pharmacy. Clomiphene is an ovulation and sperm stimulating medication commonly used to conceive a child both with or without additional fertility treatments. Clomiphene can be made by select compounding centers and pharmacies. Contact your local pharmacy or physician.

Brand name Pyridium. Phenazopyridine is a urinary tract analgesic that relieves uncomfortable symptoms associated with a urinary tract infection such as pain and burning. Phenazopyridine is a relatively inexpensive medication and can provide targeted relief of symptoms. Currently it is only available through select compounding pharmacy.

Nitroglycerin ointment is no longer commercially available in Canada. It is typically used as a compounded product for pain caused by chronic anal fissures, which is a tear around the opening of the rectum. Nitroglycerin used in this manner helps relax muscles around the anus which reduces pressure in this area and promotes healing.

Meclizine is used for motion sickness and the associated dizziness, nausea and vomiting. It can also be used to help with vertigo caused by inner ear issues. It causes less drowsiness than dimenhydrinate (Gravol). Onset of action for capsules and lozenges is about 60 minutes and effects can last up to 12 hours.

Transderm-V was a popular medication used for motion sickness and was available as a patch left behind the ear for up to 3 days. Transderm-V was discontinued early 2022.

There are numerous ingredients that can be used to reduce or eliminate hyperpigmentation caused by melasma, pregnancy and hormone related effects, age spots and more. Ingredients include hydroquinone, kojic acid, vitamin C, tranexamic acid, tretinoin, niacinamide, corticosteroids and azelaic acid.

When exposed to sunlight or the right conditions, areas of hyperpigmentation can become more prominent. Through the use of prescription or non-prescription ingredients and appropriate base we can target specific areas or types of hyperpigmentation to achieve the desired result. Give us a call or send us an email today to find out how we can help.

This is typically used for ruminants as a replacement for part of the total protein in a ration. Consult a veterinarian for specific dosing instructions for cattle of particular ages and weights. At Nanogram Pharmacy, urea orders typically require 3-4 business days.

Oral neomycin is available only through select compounding centers and pharmacies in Canada. It is sometimes used for in combination with another antibiotic (metronidazole) beginning the day before colon surgery.

In Canada this medication is available in compounded form only as it only exists as a tablet. Clonidine suspension is used in pediatric patients to treat high blood pressure, as part of a treatment plan for attention deficit hyperactivity disorder (ADHD) and for treatment of certain types of pain. Its use in the pediatric population is off-label and children requiring this medication should be followed closely by their physician. Pharmacies able to compound this product must also take due care and attention as this medication has a narrow therapeutic window and requires dosing in micrograms.