There are growing concerns about an ongoing nationwide shortage of pain medications like Tylenol for children in Canada, as the annual flu season and a potential wave of COVID-19 loom.
Since the summer, infant and children’s acetaminophen and ibuprofen products have been in limited supply in retail outlets, pharmacies and hospitals across Canada.
With the start of fall and winter season up ahead when respiratory viruses typically surge, Canadian parents may have to explore other ways to manage their kids’ pain and fever as supply continues to fall short of high demand, experts say.
“Not having a product to treat a fever itself will affect a large part of the larger childhood population because we’re seeing it across the country. We’re seeing it in all cities,” said Barry Power, editor-in-chief at the Canadian Pharmacist Association (CPhA) and a pharmacist in Ottawa.
Health Canada says the shortage is due to unprecedented demand, as pediatricians noted an unusually early rise in viral illnesses over the spring and summer months this year.
As the problem persists, more kids are filling up emergency departments and many families are requesting prescriptions for relief medications, said Dr. Anna Banerji, a pediatric infectious diseases specialist at the University of Toronto.
“It’s not an ideal situation,” she said because of the strain it is putting on an already overstretched health-care system.
“To tie up a clinic or an emergency department asking for fever-reducing medications, that makes the wait very long in a system that’s really at capacity if not exceeding capacity.”
What parents need to know
Acetaminophen, which is found in products such as Tylenol or Tempra, and ibuprofen, which goes in Advil or Motrin, are typically given as a “comfort measure” to children when they have a fever, sore throat or aches and pains, Power said.
In addition, ibuprofen is also an anti-inflammatory which helps reduce swelling, bruising, redness and other symptoms following an injury.
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Both are over-the-counter medications that do not require prescriptions and are sold in the form of liquids, chewable tablets, and drops for children and infants.
These antipyretics are considered the mainstay of treatment for viral illnesses, as they help with pain or fever.
In most cases among children, medications are not needed as the fever goes away within 24 hours or so, Power said.
But there are also a number of ways to manage the symptoms at home without medicines.
Banerji advised giving the child a lukewarm bath and fanning them to try to bring their body temperature down.
Other home remedies include giving ice water, ice chips or freezies to children who are old enough to help manage their fever — and also making sure they have enough fluids, Power said.
Parents should also ensure that the environment is not too warm, for instance by reducing the number of layers of clothing on their child.
Depending on the child’s age, size and ability to swallow, another option to consider is providing smaller doses of the adult medication that are in solid forms such as tablets and capsules. These can be split or crushed for consumption.
For this, parents can work with their children to start taking tablets and capsules instead of relying on liquid products, Power said.
But there is a risk of overdosing, which is why he encouraged parents to talk to their pharmacist or health-care provider before giving them.
“There are ways of compounding medications, but you have to make sure that it’s the right dose,” Banerji said. “Otherwise, you could be overdosing the child and it could be dangerous.”
In a tip sheet, the CPhA discouraged using aspirin to treat a child’s fever as it “can increase the risk of a serious illness called Reye’s Syndrome when used during various viral infections.”
In serious illnesses, when the fever lasts for more than 48 to 72 hours, the child has neck pain, rash or a change in their level of consciousness, medical care should be sought more diligently, Power said.
As the shortage persists, both the Canadian Paediatric Society as well as the CPhA say parents should buy only what is needed so there is enough supply to go around for others who might require it.
With cases of COVID-19 starting to creep back up again in Canada, staying up-to-date with vaccinations both for the coronavirus and other viral illnesses will help in keeping children from getting sick in the first place this fall and winter, experts say.
What is being done?
Health Canada said last week it’s working directly with manufacturers to rectify the ongoing shortage, but warned that intermittent supply will continue to be an issue at retail locations for the time being.
Health Minister Jean-Yves Duclos said Friday that he had spoken personally with several manufacturers, including Johnson & Johnson, Haleon and PharmaScience, and he was made aware that production had ramped up two-fold or three-fold.
“They have assured me that the supply will keep increasing over the next few weeks and months to restock the inventory that has been low over the last few months and weeks,” he told reporters on Oct. 7.
Emergency orders and regulations are also available to facilitate the production and imports of products that are usually not necessary in the country, Duclos said.
“As the health of infants and children remains our top priority, all options to solve this shortage are on the table.”
Johnson & Johnson Inc, the maker of Tylenol, said it continues to experience increased consumer-driven demand for certain products and markets.
“We are taking all possible measures to ensure product availability,” the drugmaker told Global News in an email Wednesday.
Haleon, which produces Advil, also said it was working hard to increase production in response to the unprecedented demand amid a “significant rise in viral illnesses”.
“We are encouraging consumers to only buy what is needed so that all parents and caregivers can access the products they need to treat their loved ones,” a spokesperson for Haleon said.
“If you aren’t able to find the Advil product you’re looking for, we encourage you to connect with your healthcare professional for guidance on alternative formats or other pain relief options that may be appropriate.”
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