SickKids Hospital said Tuesday that a recent letter sent to parents and caregivers about possible complications getting some children's over-the-counter fever and pain medicine was not meant to suggest that prescriptions would be required for all liquid acetaminophen and ibuprofen.
The Toronto hospital says Monday's letter was not meant for the general public but was a reminder to parents and caregivers of its patients to get a prescription for those drugs — sold under the brand names Tylenol and Advil — from their SickKids doctor "to help ensure access."
Though normally available over the counter, because of what the hospital called a nationwide shortage, some drug stores might only have those drugs in "large quantities that must be dispensed by a pharmacist" for at-home use, the hospital said. Having a prescription makes it easier for pharmacists to dispense the drugs.
SickKids assured parents if a child is staying overnight at the hospital they will receive the medication they require for pain or fever.
Likewise, the Children's Hospital of Eastern Ontario says it has taken steps to ensure pain medication is available for patients during their stay.
Pharmacies across Canada are dealing with a shortage of children's acetaminophen and ibuprofen products, and of some cold and flu medications, and are uncertain when they might be back in stock. Manufacturers say the shortages are the result of higher-than-normal demand and supply chain issues.
Prescriptions not mandatory
In a statement to CBC News on Wednesday afternoon, Health Canada reiterated that those products do not require a prescription for purchase.
A spokesperson said the agency was working with manufacturers, the Canadian Pharmacists Association, and provinces and territories to mitigate shortages, adding that those measures "may include regulatory measures," without providing further detail.
Health Canada urged the public not to stockpile the medications.
Ontario Health Minister Sylvia Jones on Wednesday told CBC News that the province was monitoring the situation "to make sure that there aren't shortages that are going to impact in a wider way across Ontario."
The Ontario Pharmacists Association (OPA) says, in general, getting a prescription for children's liquid pain and fever medications is a good idea, though not mandatory.
OPA vice-president Jen Belcher says a prescription helps the pharmacist ensure the right dosage is dispensed to the individual child, based on their age and weight.
WATCH | Prescriptions make a difference:
"Ultimately, it's probably worth a conversation with your primary care provider, as well as with your pharmacist, to see what their individual pharmacy situation is," Belcher said.
"Having a prescription gives more clear instructions ... to the pharmacy on how much to give and what's appropriate for that patient."
Advil manufacturer GSK Canada said in a statement it is "working tirelessly" to meet demand while Tylenol manufacturer Johnson & Johnson told CBC News it was "taking all possible measures to ensure product availability." Neither company gave details on when more stock would be available in Canada.
Alternatives for kids
SickKids says parents could consider purchasing other forms of acetaminophen or ibuprofen for their child. Those options include:
Acetaminophen suppositories (there is no ibuprofen equivalent).
Cutting or crushing regular tablets.
The hospital is recommending parents discuss proper dosing with a pharmacist or health-care provider if using one of these methods.
Kyro Maseh, owner of Toronto's Pharmasave Lawlor, says his pharmacy has been experiencing a shortage of liquid Tylenol for several months.
Maseh says while his pharmacy still has liquid Advil, the lack of Tylenol has made it more difficult for clients.
"It's definitely very frustrating for a lot of parents. From our end we try to mitigate it as much as possible," he told CBC Radio's Metro Morning on Tuesday.
"It's already hard enough getting a medication for a child — I know that first hand. For you to not even find that medication, it becomes even more difficult."
LISTEN | Parents frustrated by shortages: