Medication Availability for Thyroid Patients in Canada

Last updated September 13, 2005

What do you do when the thyroid medication you depend on isn't available? For thyroid patients in Canada who take T3 or desiccated thyroid, this question is not hypothetical. Patients with hypothyroidism have been discussing this concern in the newsgroup alt.support.thyroid and in various thyroid forums for months. Fortunately, thyroid patients in Canada can still get these medications with prescriptions, just not the same brand names during the temporary shortages.

On this page:

• Background to the shortage of Cytomel and Thyroid in Canada
• Current hypothyroidism medication options in Canada
• Updates about medications in Canada for hypothyroidism
• More information about medications for hypothyroidism

Background to the shortage of Cytomel and Thyroid in Canada

Three main medications or combinations of medication are normally available in Canada to treat hypothyroidism:

• Synthetic T4: mainly the brand names Synthroid and Eltroxin
• Synthetic T3: brand name Cytomel by King Pharmaceuticals and distributed in Canada by Theramed, usually taken in combination with synthetic T4
• Desiccated thyroid: brand name Thyroid by Erfa Canada* (previously by Pfizer, and before that, by Parke-Davis)

* On May 11, Pfizer sold the rights to Thyroid to Erfa Canada, a Montreal-based Canadian company.

Synthetic T4 has no reported supply problems in Canada.

The Cytomel supply situation in Canada

Cytomel is currently back ordered in Canada. The Cytomel availability problem is a manufacturing issue, we've learned from Theramed. Representatives of Theramed and King Pharmaceuticals have told us that they're committed to making these medications available again as soon as possible. They've also informed us that, contrary to some rumours online, Cytomel has not been discontinued in Canada.

On July 25, Theramed informed us that they have just received a shipment of Cytomel 25 mcg in their Mississauga, Ontario warehouse. They anticipated shipping this Cytomel to their wholesalers by about July 29 to fill back orders. They do not foresee further shipments of Cytomel this year, however.

The Thyroid supply situation in Canada

Thyroid was back ordered at the time of its sale from Pfizer Canada to Erfa Canada in May, and administrative transfers added to the delay in producing Thyroid again. Erfa Canada has been working hard to make Thyroid available in Canada again as soon as possible. The 30 mg size of Thyroid is now expected to be available in October, and the other pill sizes to be available later.

Current hypothyroidism medication options in Canada

A few pharmacies may still have Cytomel or Thyroid although not necessarily in the desired pill sizes. Thyroid patients in Canada can also obtain T3 and desiccated thyroid with a prescription via other methods listed on this page. With the Special Access Programme option below, doctors must fill in a Health Canada form and fax it to Health Canada.

Compounding pharmacies in Canada

Most or all compounding pharmacies can provide synthetic T3 in capsule form. Some (perhaps most) compounding pharmacies can provide desiccated thyroid in capsule form as well. You can do an online search to find compounding pharmacies in your area.

To make finding a compounding pharmacy easier, we've compiled a short list of compounding pharmacies that can provide T3 and desiccated thyroid in capsule form with a doctor's prescription. At all of these pharmacies, you can transfer an existing prescription to them. (Depending on the pharmacy or on how the original prescription was written, it may be necessary for the pharmacy to confirm the transfer with your doctor.) They can also ship prescriptions to you.

If you know of other compounding pharmacies that provide T3 or desiccated thyroid in Canada, feel free to contact us. We may not have time to update this page, but we can pass on the information if people contact us about it.

1. Compounding pharmacies in British Columbia

Finlandia Pharmacy in Vancouver, British Columbia, can provide T3 and desiccated thyroid in capsule form with a prescription from a Canadian-licensed or a US-licensed doctor. They can ship anywhere in Canada or the US. In most cases, the order leaves the pharmacy within three days of receiving approval from the customer's doctor.

2. Compounding pharmacies in Ontario

In Ontario, compounding pharmacies can accept only prescriptions from Ontario-licensed doctors.

Pickering Village Pharmacy in Ajax, Ontario, can ship prescriptions after three full days after the prescription is received.

Glebe Pharmasave Apothecary in Ottawa, Ontario, can ship prescriptions in two business days.

Cross-border shopping for thyroid medications

Residents of Canada can legally buy up to a three-month supply of prescription thyroid medication in the United States and bring it across the border into Canada. However, only a few US states permit pharmacies to fill prescriptions from Canadian-licensed doctors.

Pharmacists from only the following states along the Canada-US border have confirmed that they can fill prescriptions (except for narcotics and restricted substances) from Canadian-licensed doctors. Canadian customers can't use insurance plans to pay for prescription medication in the US, and pharmacists can use their discretion to decide whether or not a prescription is valid. Some restrictions may apply in addition to the ones listed.

• Washington state: prescriptions from Canada must be from doctors licensed in British Columbia
• North Dakota: (no known additional restrictions)
• Vermont: prescribing doctors in Canada must have a DEA number (a number that allows them to prescribe medication in the US); possibly only prescriptions from doctors in Québec can be filled in the US
• Maine: (no known additional restrictions)

Tips when travelling to the US to buy thyroid medication:

• It's a good idea to call US pharmacies in advance to confirm that they have the medication you need in stock and to ask about any additional restrictions.
• Be sure to keep the medication in the original bottle with the prescription information on it until you've crossed the border back into Canada.
• To make the border crossing easier, ask your doctor for two prescriptions so that you can bring one back with you along with the medication. (This tip came from a doctor.) If you don't have two prescriptions, a photocopy of the original one may help.
• If a customs officer won't allow the medication into Canada, ask to speak to the supervisor. Two Canada Customs information officers have confirmed with us that bringing prescription thyroid prescriptions from the US into Canada is legal in all provinces in the above situation.

Online pharmacies in Canada

Some online pharmacies in Canada aren't licensed to ship to Canadian addresses. Others are, and some of these carry Cytomel and desiccated thyroid. Online pharmacies probably have the same supply situation as other pharmacies in Canada.

If you know of any online pharmacies in Canada that still have some Cytomel or Thyroid, please contact us so that we can list them here.

Health Canada's Special Access Programme

Health Canada's Special Access Programme allows medications to be imported through doctors in some situations. From the Health Canada website:

The Special Access Programme (SAP) provides access to nonmarketed drugs for practitioners treating patients with serious or life-threatening conditions when conventional therapies have failed, are unsuitable, or [are] unavailable. The SAP authorizes a manufacturer to sell a drug that cannot otherwise be sold or distributed in Canada.

The procedure:

• The patient's doctor fills out an application form for the drug and faxes the form to Health Canada.
• If the request is approved, Health Canada contacts the drug manufacturer and lets the manufacturer know that they won't object to the medication being imported in this situation.
• The manufacturer ships the drug to the doctor or to a hospital pharmacy, and the patient then obtains the prescription.
• The prescribing doctor provides Health Canada with a report on the results of the drug's use.

See the Health Canada links in the column at the right.

A representative at Health Canada informed us about the SAP option. Even if Health Canada approves a drug via the SAP, though, drug manufacturers may decline to ship the requested drug to Canada. Also, it doesn't appear that Health Canada will approve the importation of Thyroid via the SAP. A poster in the thyroid.about.com forum posted this information from Health Canada:

• Thyroid is considered ineligible under the SAP because there is still a distributor in Canada for this drug.
• There is no shortage of the "equivalent" drug in synthetic form, so Health Canada doesn't acknowledge a shortage of Thyroid (desiccated thyroid).

If you ask your doctor to apply to obtain desiccated thyroid via the SAP, ask your doctor to make these points on the application form:

• Thyroid (Erfa or Pfizer brand) is not currently available in Canada. The bottom line is that Thyroid is not in stock in pharmacies. It qualifies under the Health Canada website statement: "The SAP authorizes a manufacturer to sell a drug that cannot otherwise be sold or distributed in Canada." (Emphasis added.]
• Synthetic T4 is not the equivalent of Thyroid. Synthetic T4 contains T4 only, while Thyroid contains the thyroid hormones T4, T3, and (probably; unmeasured) T2 and T1. Most people on Thyroid were previously on synthetic medications for hypothyroidism, and they still had symptoms of hypothyroidism until they switched to Thyroid.

If you have any experience with the SAP program, please contact us with the information so that we can update this page if necessary.

Updates about medications in Canada for hypothyroidism

Alt.support.thyroid will be updating this page when we receive new information about the availability of T3 or desiccated thyroid in Canada. This page has the date of the most recent update at the top and the bottom of the page.

More information about medications for hypothyroidism

See the following pages at this site:

• Hypothyroidism Medication
• Hypothyroidism Medication Comparison
• T3 References
• Desiccated Thyroid References