Medication Backorders

Testosterone injection is commonly used for testosterone replacement therapy in individuals with low testosterone levels. Both cypionate and enanthate forms are on backorder until at least the end of January 2025. Oral and transdermal options are available with varying dosing schedules. Injectable testosterone can only be compounded by sterile compounding pharmacies, while oral and transdermal forms can be compounded by select non-sterile compounding pharmacies with an appropriate prescription. Contact your physician or pharmacy to explore alternatives.

Imiquimod topical cream is used to treat specific skin conditions such as actinic keratosis, superficial basal cell carcinoma, and external genital warts. All strengths of this medication are currently on backorder until at least early January 2025. In the interim, Imiquimod can be compounded by select compounding pharmacies. Please reach out to your physician or pharmacy to explore options, or contact Nanogram Pharmacy directly.

Phenobarbital elixir is used to manage seizure disorders in children and adults, particularly for those requiring precise liquid dosing. This medication is expected to return in early January 2025. Select pharmacies can compound this medication in the interim. Please consult your physician or pharmacy for compounding options.

Mefenamic acid is a nonsteroidal anti-inflammatory drug (NSAID) used to manage mild to moderate pain, including menstrual cramps. The 250mg capsules are expected to return in January 2025. Some pharmacies may have stock remaining, and Nanogram Pharmacy has sufficient stock at this time. However, the powder for compounding is unavailable, but alternative options may exist. Please consult your physician or pharmacy to determine the best course of action.

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 unavailable in Canada until at least early 2025. Various brands of nystatin oral suspension are available via prescription. During the shortage of nystatin cream, 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.

Moxifloxacin is a broad-spectrum antibiotic used to treat various bacterial infections, including respiratory tract infections (such as pneumonia and chronic bronchitis), sinusitis, skin and soft tissue infections, and intra-abdominal infections. Pharmacies may have remaining stock of the oral tablets, and Nanogram Pharmacy currently has ample stock of this medication. If alternatives are not suitable, this medication can also be compounded by select compounding pharmacies during the shortage. Reach out to your physician or pharmacy for options.

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-2025. There is intermittent US supply of Prazosin available to Canadians during the backorder. It can be compounded during the nationwide shortage for patients who require it and if no other supply is available. 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 intermittent 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. Only minoxidil 10mg tablets are available, while 2.5mg remain 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.

Sulfamethoxazole/Trimethoprim oral suspension is commonly used to treat bacterial infections, including those affecting the urinary tract, respiratory system, gastrointestinal system, and skin, such as infections caused by Staphylococcus aureus. It is often prescribed for children or individuals who cannot swallow tablets. Currently, this medication has no anticipated date of return to the Canadian market. Sulfamethoxazole/Trimethoprim oral suspension can be compounded by select compounding pharmacies. Please contact your physician or pharmacy for options, or reach out to Nanogram Pharmacy directly.

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 has been discontinued from the Canadian market. 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.