Cold and flu season has arrived, but some over-the-counter remedies are in short supply in this province.
Products like NeoCitran and Buckley's cough syrup are absent from many pharmacy shelves.
"Probably a couple of months now, I think, it's been out from the manufacturer," said Stephanie Freake, who works at a pharmacy on Topsail Rd in St. John's.
The Secretary-Registrar of the Newfoundland and Labrador Pharmacy Board Don Rowe says in this particular case, the shortage stems from quality control issues which led the US Food and Drug Administration to stop production at the Nebraska-based factory that supplies these products to all of Canada.
But he says this is far from the only case of shortages in the province.
"In the last couple of years, pharmacists will order drugs for their supply in the store," explained Rowe. "The order comes in and you'll get a number of items not available."
And while a lack of cold remedies might hurt people suffering from the sniffles, shortages of more critical drugs, such as antibiotics and heart medication, are raising serious concerns.
Rowe said there's no single reason for the scarcity. In some circumstances, the issue is a shortage of raw materials, says Rowe, while other drugs may be discontinued when they don't make big profits.
"On the national level, the Canadian Pharmacists Association is trying to pinpoint what the factors are that are causing this," he said. "What can be changed? What can government do? What can manufacturers do? What can pharmacists do? No easy answers."
Mount Pearl physician Dr. Lydia Hatcher first became aware of the problem when she prescribed eye drops that worked really well for a patient.
But when the person went for a refill, the pharmacist said the brand was no longer in stock.
Hatcher offered the individual a substitution, but the new treatment was more potent, with a higher risk of side effects.
The situation then repeated itself with several other patients and medications.
"For me, it got quite scary as a family doctor when I wrote a prescription for penicillin," said Hatcher, who described the drug as one of the most common antibiotics for illnesses such as strep-throat.
"I had a call from the pharmacist saying it's not available, and I'm thinking and saying, 'you're kidding me, right? This is not happening.'"
A few months ago, when another patient unsuccessfully tried to fill a prescription for a pain drug, Hatcher checked with the manufacturer. The company told her there was a problem with the supply, but didn't explain why.
"What if it's going to happen to a drug that there isn't an easy substitution for?" pondered the family doctor. "What are these patients going to do?"
A study published by the Canadian Pharmacy Association in 2010 listed the same types of problems.
A subsequent report released this spring by a joint committee of physicians and pharmacists in Quebec suggested drugs, like water, are exceptional consumer products, meriting specially-tailored controls. For example, if a company knows it's going to stop making a certain medication, it should be required to let the public know.
Meanwhile, the Canadian Cancer Society recommended the federal government take measures to address the problem, such as an early warning system and obliging pharmaceutical companies to advise the public of medications that are unavailable.
Manufacturers don't expect the situation to improve.
"We've had a massive amount of shortages in pharmaceutical products," said Ed LeDrew of Newquest Distribution, a drug wholesaler in the province.
"It's big, but it's only going to get bigger."
LeDrew expects to see shortages in everything from steroids to pain medication to cancer drugs.
When asked by CBC News how consumers should cope with the lack of drugs, LeDrew responded with dark humour.
"Don't get sick," he joked.