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Shortage of key heart medication — nitroglycerin spray — sparks worry in Alberta

Shortage of key heart medication — nitroglycerin spray — sparks worry in Alberta

CBC
Tuesday, March 21, 2023 10:11:41 PM UTC

A tight supply of a fast-acting heart medication is causing concern for Alberta patients and health-care providers as a shortage looms across the country.

Nitroglycerin spray is used under the tongue to treat pain, known as angina, and improve blood flow to the heart in people with coronary artery disease.

Health Canada issued a public advisory on Friday, saying it expects supply of the drug will be limited in hospitals and community pharmacies during the spring.

The shortage is classified as Tier 3, meaning it has the most potential to impact the country's drug supply and health system.

"Alberta has a limited supply at the manufacturer and wholesale level," Alberta Health spokesperson Charity Wallace said in a statement emailed to CBC News.

"It is anticipated that supply will be constrained for the next few weeks, possibly months, with some improvement expected in the summer."

According to the Health Canada advisory, three manufacturers — Mylan, Sandoz and Sanofi — are reporting shortages due to increased demand or supply issues with the raw materials. 

"I'm very concerned," said Dr. Anmol Kapoor, a cardiologist in Calgary. He's already hearing from patients who are having trouble refilling their nitroglycerin prescriptions.

"It's not as easy as it was before, so that is contributing to a lot of anxiety and a lot of caution."

Kapoor is now telling patients that if they don't have a bottle of nitro spray and they have chest pain, they should call 911 right away.

"It's certainly something that could be a major issue," said Dr. Steve Tilley, a Red Deer cardiologist, who is watching the situation closely but has yet to hear from affected patients.

"I think at this stage we need to advocate. There may be some lead time until it impacts patients. [Are] there things that could be done in the meantime to mitigate this problem? I hope that's being worked on behind the scenes."

In its public advisory, Health Canada said it's working to conserve existing stock, speed up shipments to hospitals and pharmacies and access alternatives.

It's also extended the expiry dates for some nitroglycerin sprays.

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