Advocacy in Action: February 2026
February 27, 2026
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CSHP is pleased to share an update on the key advocacy and pharmacy practice initiatives that the Professional Practice team has been focused on over the past month.
Drug Shortages Case Management
Drug Discontinuations and Potential Shortages
Insulin Regular Vials
Update (Feb. 18): Supply gap in March / April will be avoided.
Eli Lilly will discontinue Humulin R® 100 units/mL (3 mL and 10 mL vials) by April 30, but a February resupply is secured. Novo Nordisk will continue producing Novolin GE Toronto® vials, with additional supply expected in April. With the Mxyredlin® IV insulin shortage resolved and increased Novo Nordisk production, a March/April supply gap is not expected.
Regular insulin vials are essential for IV hospital use (e.g., hyperkalemia, beta‑blocker or calcium channel blocker overdose, DKA). Pens and cartridges are unsuitable, and ISMP advises against withdrawing insulin from cartridges due to safety risks. CSHP and partners are preparing guidance for managing potential future vial shortages. To support planning for these changes, please note the following upcoming discontinuations and alternatives:
- Eli Lilly will discontinue the following by April 30:
- Humulin® 30/70 (10 mL vial)
- Humulin® N (10 mL vial)
- Humulin® R (10 mL vial)
- Cartridge and KwikPen® formats will remain available.
- Vial alternatives include:
- Novolin® GE 30/70
- Novolin® GE NPH 100 units/mL
- Novolin® GE Toronto 100 units/m L
Supply Updates
Oseltamivir (Tamiflu®) powder for suspension
Update (Feb. 4): Supply constraints ongoing, importing foreign supply.
Oseltamivir suspension is expected to remain in very short supply for the rest of this flu season due to higher‑than‑anticipated demand. Capsule supply is still expected to meet overall needs, though available buffers have narrowed since late December and early January. Health Canada is working to import foreign supply of the oral suspension and will continue to closely monitor capsule availability. For mitigation strategies, refer CSHP and CPhA guidance on conserving oseltamivir capsules.
Tier 3 Shortages
Benzathine Penicillin G (Bicillin L-A®) Injection
Update (Feb.18): Further resupply delayed.
The Tier 3 shortage of Pfizer’s benzathine penicillin G (Bicillin L‑A® 1,200,000 IU / 2 mL), originally expected to be resolved by late December, has been updated with a new anticipated resupply date of April 3.
In the meantime, Health Canada has imported the Portuguese‑authorized benzathine benzylpenicillin product Lentocilin S® 1200 (1,200,000 IU / 4 mL). Lentocilin S® contains the same active ingredient, strength, and intramuscular route as Bicillin L‑A®, but differs in formulation, dosage form, reconstitution needs, and presentation.
For further guidance, please refer to this Health Product Risk Communication and PHAC’s guidelines for Interim Syphilis Treatment.
Cyclophosphamide Injection – NEW!
Cyclophosphamide for injection is anticipated to remain in critical shortage until at least May/June. All three manufacturers—Baxter, Sterimax and Andone—are reporting current or anticipated shortages across all vial sizes. Health Canada is assessing options to import foreign supply.
Insulin Human in 0.9% Sodium Chloride Sterile Solution for Intravenous Infusion, 1 Unit/mL (Myxredlin®)
Update (Feb. 6): Tier 3 shortage status removed.
Ready-to-use Intravenous (IV) regular insulin (Myxredlin®), previously classified as Tier 3 shortage, was removed from Health Canada’s tier in shortage on February 6.
Ropivacaine Hydrochloride Injection
Update (Feb. 11): Extended shortage dates.
Both Ropivacaine® (Fresenius Kabi) and Naropin® (Aspen Pharmacare) have reported shortages of ropivacaine hydrochloride bags and ampoules. Fresenius Kabi’s supply issue has been resolved, but Naropin® 10 mg/mL (10 mL ampoules) remains delayed until the end of May. To mitigate the shortage, South African‑authorized Aspen 10 mg/mL ropivacaine 10 mL ampoules have been imported, and Health Canada is exploring options for additional foreign‑authorized supply as needed.
Vasopressin (Vasopressin®) Injection – NEW!
Vasopressin® (Fresenius Kabi) Injection 20 units/mL (1 mL vial) is expected to enter a shortage starting in March. While Sandoz markets a 20 units/mL, 5 mL vial (Sandoz Vasopressin) and can meet some demand on a mL basis, its larger vial size may lead to product wastage. Heath Canada has added Vasopressin® to the Tier 3 shortage list and is exploring foreign‑authorized supply options.
Strategic Collaborations
BC Centre for Substance Use (Feb. 5)
CSHP has joined a National Steering Committee led by BC CSU looking to develop a white paper focused on expanding the role of nurses and pharmacists in substance use care, starting with opioid agonist treatment (OAT). Several promising interprofessional models from across Canada were highlighted. Draft findings and preliminary recommendations will be circulated for review ahead of the next meeting.
Canadian Drug Agency (Feb. 12)
CSHP continues to participate in CDA-AMC’s International Trade Policy Roundtable on global trade dynamics and their impact on Canada’s drug system. Recent discussions included U.S. trade developments, supply chain resilience, early-warning systems for shortages, and potential “Made in Canada” policy options to strengthen domestic capacity. Participants identified cross-sector opportunities to improve supply resilience, support life sciences growth, and enhance patient access. Further discussions are planned for this spring.
ASOP Meeting (Feb. 19)
CSHP participated in the ASOP Canada meeting, where a policy brief was outlined the diversion of Health Canada–approved medications to U.S. consumers via online outlets, certain licensed pharmacies, brokers, and Alternative Funding Programs. Amid ongoing shortages, these cross‑border sales raise concerns about patient access, safety, and oversight.
ASOP is proposing a pan‑Canadian bylaw—modeled on Saskatchewan’s permit restrictions—to prohibit advertising and shipping medications outside Canada. Feedback is being collected before further engagement with provincial regulators and federal officials.
Consultations
CSHP has participated in the following consultations:
We are continuing to work on our response for the following consultation:
To catch up on CSHP advocacy news, click here.
Have a question about Advocacy in Action or CSHP's advocacy and consultation work?
Reach out to our professional practice team!