What about my regular medications?

PRESCRIPTION REFILLS

We certainly don't want you to run out of your regular medications.

While providing large quantities of pain and sleep medications is not advisable and not possible, you can discuss any changes to your pain needs with your regular family physician.

For all other prescription refills, please ask your pharmacist to send us a fax, and we'll do our best to refill this as quickly as possible. Due to the high volume of requests, please be patient with us, since we have to prioritize which medications get refilled first, eg. asthma inhalers.

ONE MONTH SUPPLY

Pharmacies are closely monitoring their medication supplies; it's possible that your pharmacy may only be able to dispense your medications one month at a time, regardless of what your doctor wrote on the prescription.

This is to maintain supplies, enough for everyone, and to ensure no-one goes without their regular medications.

STOCKPILING

Large-scale efforts are being made by pharmacies and the government to maintain supplies.

It's more of a risk to the people in your neighbourhood and community if you stockpile medications. 

For example, there is a definite shortage of Tylenol at the moment, and depending on the day and the store, diapers and baby formula stock can be hard to find.... if you find some, please DON'T take multiple bottles/boxes - leave some for other people, they might need it far more than you.

WHAT ABOUT ANTI-INFLAMMATORIES ?

There are reports of certain medications contraindicated during a COVID-19 infection. 

If you are not ill, please don't change or stop your medications; rather talk to you pharmacist or family physician.

As for non-steroidal anti-inflammatory drugs or NSAID's, eg. ibuprofen (Motrin, Advil) and naproxen (Aleve), evidence is conflicting, so we feel it's best to discuss this with you personally.

In Europe, there is currently no scientific evidence establishing a link between ibuprofen and worsening of COVID‑19.

SOURCE: https://www.ema.europa.eu/en/news/ema-gives-advice-use-non-steroidal-anti-inflammatories-covid-19

As of 19 March 2020, the World Health Organization has updated its advice on the official Twitter account: "Based on currently available information, WHO does not recommend against the use of ibuprofen."

SOURCE: https://twitter.com/WHO/status/1240409217997189128?ref_src=twsrc%5Etfw%7Ctwcamp%5Etweetembed%7Ctwterm%5E1240409217997189128&ref_url=https%3A%2F%2Fwww.sciencealert.com%2Fwho-recommends-to-avoid-taking-ibuprofen-for-covid-19-symptoms 

However, the WHO has in the past recommend avoidance for other infections, eg. Dengue fever.

SOURCE:  https://www.who.int/ith/updates/20121012/en/

So look, until we know more, if you have to take something for pain or fever when you're ill.... when in doubt, take Tylenol first.

WHAT ABOUT BLOOD PRESSURE MEDICATIONS ?

Again, there's conflicting evidence, and if you're not sick it could be worse for you if you stop your blood pressure pills.

Please speak to your pharmacist and/or your family physician first.

Specifically in the news are ACE-inhibitors (Angiotensin-converting enzyme inhibitors, eg. perindopril, ramipril, enalapril, lisinopril, quinapril and trandolapril) and ARB's (Angiotensin II receptor blockers, eg. candesartan, irbesartan, losartan, olmesartan, telmisartan and valsartan.

The European Society of Cardiology (ESC) Council on Hypertension announced their stance in a positioning statement on March 13, and the American College of Cardiology (ACC), American Heart Association (AHA), and Heart Failure Society of America (HFSA) published a joint statement days later on March 17

Current recommendations from the American Heart Association, Hypertension Canada and the Canadian Cardiovascular Society advise to NOT stop these medications. 

SOURCES:

https://newsroom.heart.org/news/patients-taking-ace-i-and-arbs-who-contract-covid-19-should-continue-treatment-unless-otherwise-advised-by-their-physician

https://hypertension.ca/wp-content/uploads/2020/03/2020-30-15-Hypertension-Canada-Statement-on-COVID-19-ACEi-ARB.pdf

http://www.ccs.ca/images/Images_2020/CCS_CHFS_statement_regarding_COVID_EN.pdf

WHAT ABOUT FEVER ?

We recommend treating any fever over 38 degrees Celcius (100.4 Fahrenheit), especially in younger children under the age of 2. The current medical guidelines recommend acetaminophen (eg. Tylenol) instead of non-steroidal anti-inflammatory drugs (NSAID's, eg. Motrin, Advil). We also know that there are significant shortages right now, especially for Tylenol, so if you or your child has a significantly high fever over 38 C/100.4 F that just won't break, rather treat it with Advil or Motrin and follow-up with us (benefit vs. risk scenario, ie. it's riskier to let your baby or toddler run a high fever). See the page titled "What if my kid is sick" for more information on fever.

WHAT IF MY MEDICATIONS HAVE EXPIRED ?

We recommend you go through your medicine cabinet and throw away any expired medications, and plan in advance.

Exemptions...

However, if you have allergies and need your EpiPen and it's expired, rather use your EpiPen, get to the nearest hospital, and sort out refills after that. Don't delay allergy treatments.

If you have asthma, and you need your inhaler but you realize that it's expired, still use that inhaler if you really need it, but then follow-up with us as soon as possible, and/or ask your pharmacist for a refill.