Supply of children's chewable medicine dwindling in Quebec, along with liquid Tylenol

Some kids' painkillers in short supply An unprecedented cold and flu season coupled with supply chain issues has led to a shortage of children's Advil and Tylenol.

The Quebec Order of Pharmacists is urging parents to resist the temptation to hoard certain hard-to-find children's medicines should they happen upon a well-stocked store.

Liquid suspensions of acetaminophen and ibuprofen for children remain in short supply in many pharmacies across the province and in the rest of the country, after several months.

On Tuesday, a Quebec manufacturer of generic and store-brand drugs, Laboratoire Riva, also reported a shortage of its chewable acetaminophen tablets.

But the order's president Bertrand Bolduc said stockpiling is not the answer and can even pose a risk to children who find it in the home.

"We don't advise to stockpile because acetaminophen is one of the most dangerous products for intoxication of kids, especially because it's flavoured," Bolduc said, adding that every year there are pediatric emergency room visits for suspected cases of poisoning.

He suggests parents ask their pharmacist for an alternative to the formats or concentrations they're used to giving their kids when they're in pain or have a fever, whether they're acetaminophen products known by the trade name Tylenol, or ibuprofen, contained in Advil products.

In addition, parents can turn to generic or house brands instead, although Bolduc conceded that stock of those products is also diminishing.

But there are solutions.

"Sometimes we're going to use a very similar product like pediatric oral drops that are used for newborns and that we can use for a little bit older kids," Bolduc said. "And if we have a teenager or someone who's able to swallow, we can use chewable tablets, possibly adult tablets they can cut and take with food, like peanut butter," he suggested.

In a pinch, it's also possible for pharmacists to compound the product, which means preparing it themselves by mixing the active ingredient with liquid suspension material.

"They can order the ingredients, and it's very easy to do. Every pharmacist has the ability to do that," he explained.

The shortages are being blamed in part on global supply chain issues, but drug manufacturers are doing what they can "to catch up," according to Justin Bates, the CEO of the Ontario Pharmacists Association.

"The raw materials, sourcing, and putting all this together has caused challenges with respect to keeping and maintaining the supply of these products," Bates said. "And on top of that, we have unprecedented demand due to both cold and flu as well as fever and pain that we haven't normally seen at this time of year."

Bolduc agreed that the situation is highly unusual.

"Usually, when we have a drug shortage, we have a manufacturing plant that has a problem, there's been a flood, a fire," he said, "but this time it's likely due to unavoidable poor planning brought on by the pandemic."