Forget that prescription: Pharmacists can offer solutions to kids' pain reliever shortage

Doctors in Toronto and possibly in other parts of the country may now be getting more prescription requests for over-the-counter pain medications, thanks to a much-publicized letter from Toronto’s Hospital for Sick Children advising parents their child may need a physician’s requisition for these hard-to-get drugs. But should doctors really be doing this extra work when pharmacists—who are already dealing in-store with patients inquiring about supply shortages of pain, cough and cold medications—can offer a solution? “Don’t bother writing the prescription,” said Kristen Watt, the pharmacist owner at Kristen’s Pharmacy in Southampton, Ont., about a three-hour drive north of Toronto. “I think a lot of things got overlooked in that (Hospital for Sick Children) message.” Read: U.K. pharmacists warn that drug shortages have put patients at risk She highlighted a few important facts physicians and pharmacists may want to share with patients asking about a pain med prescription for a child: A prescription isn’t necessary for over-the-counter pain relievers. “Liquid Tylenol, for one, is an unscheduled medication,” she said. “But because it’s in such short supply, we’re reserving it for patients under two years old and providing it in smaller quantities. We’ve moved it behind the counter for now but we don’t require a prescription for it.” Backordered meds remain on backorder, with or without a prescription. Waving a prescription in front of a pharmacist won’t make unavailable products “magically available,” said Watt. “If we don’t have something in supply, we can’t just produce it because you come in with a prescription.” Pharmacists can provide other solutions. Many patients don’t realize their pharmacist can recommend adult-version alternatives to children’s pain or fever medication—such as crushed, half-tablet dosages—or that they can make compound medications, with dosages customized for children. This is extra work for pharmacists. To make sure they provide the right medication for their young patients, pharmacists will need to consult with their parents and, if appropriate, the child. They may need to do compounding, or repackage available OTC drugs into smaller bottles as part of an effort to stretch supply. Patients need to be aware of the additional work this puts on pharmacists and not begrudge them the fees for these extra services. Please don’t panic-buy. Pain and fever medications for kids aren’t the only items in short supply, said Watt. Cough and cold medications are still hard to come by. With COVID and other viral illnesses continuing to sicken Canadians, demand for these drugs far exceeds supply. “And it doesn’t help that people were hoarding and panic-buying,” said Watt. “We’ve now put a limit of one-per-purchase on all acetaminophen and ibuprofen pediatric products and we hope customers respect that so that there’s enough for everyone." Read: Doctors say lack of communication on epidural shortage 'frustrating' After news of the letter stoked unfounded concerns that prescriptions may now be required for OTC children’s pain medications, the Hospital for Sick Children issued a statement saying the letter was meant only for its patients and their families, and not the general public. “‘Dear Caregiver’ letters are routinely distributed to patients and families,'' the statement said. “The letter was not intended as a recommendation for the general public.'' Jen Belcher, vice president of strategic initiatives and member relations for the Ontario Pharmacists Association, told media outlet CP24 that a prescription “does make it easier in the sense that it provides instructions for dispensing of that product. But ultimately, liquid Tylenol has not changed from an over the counter drug to a prescription-only product.” In a follow-up story by Canadian Press, Belcher added that pharmacists can dispense liquid acetaminophen from stock bottles without a prescription, and that some children may be able to take chewable tablets. Read: Shortages of some baby formula in Quebec due to panic buying, U.S. supply issues

Forget that prescription: Pharmacists can offer solutions to kids' pain reliever shortage

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