Approximately 8,000 Quebec cardiac patients are at risk of ending up in the hospital emergency room as a result of a shortage of a critical heart medication called sotalol – a drug that keeps their hearts beating steadily.
Quebec heart specialists are warning that there are no viable substitutes or alternatives to sotalol because it is the only treatment to manage certain cardiac arrhythmias, particularly atrial fibrillation which is a condition difficult to stabilize.
Sotalol is disappearing from local Quebec pharmacies and pharmacists are sending fax messages to cardiologists warning that their supplies will eventually be depleted entirely. Pharmacists are asking cardiologists to switch patients to another beta blocker medication, but cardiologists are saying switching is simply not an option because doing so can cause debilitating side effects or even death.
A letter on November 15 by the Quebec Health Insurance Board (RAMQ) confirmed that manufactures and suppliers such as Apotex, Cobalt, Jamp, Novopharm, Pharmel, Pharmascience, Pro-Doc, Riva and Sivem, have all run out of sotalol.
Furthermore, there is no explanation by drug manufacturers as to why the supply has dropped in a generic drug that is supplied by several companies.
Health Canada and RAMQ indicate the problem may be an issue with manufacturing, distribution or delivery, or the lack of availability of a key active ingredient.
What is more frustrating is that manufacturers are not required to inform pharmacies of the reason for the shortage, but only indicate that there are alternatives to the medication. But, heart specialists emphasize there are no suitable replacements for sotalol.
Shortages in medications are not exclusive to Quebec. Canadian patients often face shortages in medications used to treat cancer, epilepsy and psychosis, for example.
Cardiologists are calling for a contingency plan to ensure certain drugs don’t have backorders to ensure patients get their critical medications regularly.
Health Canada confirmed that it recognizes the issue and is doing its part to address the problem so that there are no future drug shortages with sotalol and other medications.