A Canada-wide shortage of the common antidepressant Wellbutrin XL has pharmacists scrambling for alternatives and is creating anxiety for patients with mental illness.
Pharmacist Chris Chiew, general manager of London Drug’s pharmacy division in Western Canada, said the shortage of Wellbutrin XL and its generic counterpart bupropion has been occurring for about one month.
“The manufacturers for both the generic and brand name kept on giving us dates when it would be back in stock and it seemed like we’d have enough to last through the shortage, which we thought would be resolved about this time,” Chiew said on Monday.
“But the manufacturer has given us another date and it’s going to be pushed again. So we are starting to run out right now.”
All London Drugs pharmacies have been instructed to find out who is taking the medication and to call those patients to discuss how much medication they have left. The pharmacists will then work with the patient and their physician on what the alternatives are and the next best step, said Chiew.
“We’re trying to be proactive to let patients know ahead of time,” he said.
The drug shortage has upset people, said Alfred Hoo, pharmacist at Pharmasave on Hillside Avenue.
“Some patients have phoned three or four different pharmacies and nobody has any. Your normal reaction would be: ‘Why?’ ” Hoo said.
According to the Ministry of Health, roughly 66,600 British Columbians filled prescriptions for Wellbutrin XL from July 1, 2017, to June 30, 2018.
Drug manufacturers are required by law to report anticipated or actual drug shortages to the national drug shortages website. The Health Ministry also includes drug shortage information and has daily updates on its shortages list.
Pharmacists are being advised to adapt patients’ prescriptions from the once-a-day version of Wellbutrin to the twice daily formula, the ministry said in an email.
But the short-acting Wellbutrin doesn’t behave the same way as the extended release, said Lisa Holtner, pharmacy technician at Oak Bay Pharmasave. “Some customers don’t want to change. They’re concerned about how it will affect them.” The pharmacy is only giving patients one month of medication at a time, she said.
“We’re trying to keep everybody on track and we’re keeping an eye on it every single day to see if we can change things for them,” said Holtner.
Bausch Health, the company that manufactures Wellbutrin, reported its shortage on Sept. 6. Its latest report from Nov. 15 says the shortage has been resolved.
Bausch Health has begun shipping Wellbutrin and pharmacies in B.C. will receive it shortly, depending on delivery schedules, the company said in an email.
Spokeswoman Lainie Keller would not disclose the reason for the shortage.
“From time to time, all pharmaceutical manufacturers are faced with drug-shortage situations. We do understand this is challenging for patients and health care practitioners to manage, and we’re glad the situation is being resolved,” said Keller.
Still, there is no release date for the drug.
“Sometimes these things filter in really slowly,” said Holtner. “They might just release one bottle at a time to the pharmacies.”
Chiew said he believed it will be another couple of weeks before Wellbutrin XL is on the market again. “For some patients, that might be OK. For other patients, it might not be,” said Chiew. “It really depends.”
But the Wellbutrin shortage is only part of a much larger problem. There have been shortages of prescription drugs, over-the-counter medications and other health products, said an Oak Bay pharmacist, who requested anonymity. “The shortages are just everywhere and no one really knows why. We weren’t able to get drugs for epilepsy. There were antibiotics we weren’t able to get. It’s not just this drug, it’s everything,” she said.
The drug shortages seem to have become a lot worse over the last couple of years, said Chiew.
This year, Health Canada warned of an EpiPen shortage. The medication is used for the emergency treatment of life-threatening allergic reactions. The shortage is over and EpiPens are available in local pharmacies.