A spray used to help Canadians suffering from angina, a type of chest pain caused by reduced blood flow to the heart, is in short supply and may dry up in the near future, according to experts.
Health Canada on Friday released a statement warning that nitroglycerin spray is in short supply across the country due to supply issues with raw materials used to make it as well as an increase in demand.
The prescription medication is used to treat pain during an episode of angina for people who have coronary artery disease, Health Canada said.
“Nitroglycerin spray is an important and widely used product. Health Canada recognizes that this shortage is concerning for people who use it to treat pain from angina,” Health Canada told Global News in an email on Monday.
Availability of the medication is expected to be limited during the spring, the federal health regulator added.
Is there a substitute for nitroglycerin spray?
Barry Power, editor-in-chief at the Canadian Pharmacist Association (CPhA), said nitroglycerin spray prescriptions are “fairly common” and a lot of patients carry it with them as a way to help treat chest pain on the spot. He added that there isn’t an equal substitute for the medication in wake of the shortage.
The closest substitute for the spray would be the nitroglycerin tablets, which were the standard product 20 to, 25 years ago, he said. But the tablets are also in short supply as they are not used as much.
“You pop the tablet under your tongue, and it dissolves and gets absorbed. So the spray works essentially the same way, but it’s a lot easier to administer, If you’re having chest pain, you have to open the teeny tiny little bottle that the tablets come in and it can be difficult to do,” Power said.
Pharmacies are now limiting the medication to one spray per person, he added. In the past, he said a lot of patients would get two at the pharmacy — one to keep at home and another to keep on them.
Another way to preserve existing supply is an extension of product expiry dates, Health Canada said.
Currently, there are several sprays that have been approved for an extended expiry date, which can be read on the recalls-rappels.canada.ca website.
Despite the expiry date extension, Power warned there may be a situation in the near future where nitroglycerin is not available.
“If the pharmacy is right out, they may be able to give some idea as to when they’re expecting resupply from the wholesaler,” he said, adding that if this does happen, a patient should speak with their doctor.
When will the nitroglycerin shortage end?
The shortage of the spray should resolve itself by the summer, Power said.
“There is some supply expected by the end of April and more coming in June,” he said.
Health Canada said is also working with manufacturers to see if there is an international supply that it could bring in to help with the shortage.
“All drug shortages are concerning. In most cases, nitroglycerin does not prevent anything from happening, it relieves pain, so if somebody is having chest pain and they stop their activity, it will quite often resolve without using anything,” Power said.
“If it does not, then they do need to seek urgent care.”