A shortage of diabetes drug Ozempic that is used off-label for weight loss is expected in Canada, manufacturer Novo Nordisk says. The injectable drug Ozempic is shown in Houston, Saturday, July 1, 2023.

Image Credit: THE CANADIAN PRESS/AP-David J. Phillip

A shortage of diabetes drug Ozempic that is used off-label for weight loss is expected in Canada, manufacturer Novo Nordisk and Health Canada said on Friday.

"We are experiencing a temporary supply disruption with the Ozempic 1 mg (injection) pen due to the combination of overall global supply constraints coupled with increased demand," said Novo Nordisk spokesperson Kate Hanna in an emailed statement.

Canada is one of "many countries" experiencing a shortage and the company is working with Health Canada to mitigate the impact, Hanna added.

On its website, the federal regulator said "intermittent shortages" are expected from late August to early October.

The lower-dose Ozempic injection pens of 0.25 mg and 0.5 mg remain available and "may be an option for some patients" as an alterative, Health Canada's web page said.

But swapping in multiple lower doses to replace the 1 mg dose is not likely to address the need, said Barry Power, acting chief pharmacist officer for the Canadian Pharmacists Association.

People with diabetes usually start taking Ozempic at a 0.25 mg or 0.5 mg dose before moving up to 1 mg, which is the maintenance dose, he said.

"Because they are starting doses, the inventory would be a lot lower in general because most people are only on those for a short period of time," said Power, who is also a practising pharmacist in Ottawa.

"So it may be a stopgap for a few people, but I think most people, if they run into a situation where they're unable to get the prescription refilled, they will have to work with their health-care professional to sort out an alternative option for them.”

If patients aren't due for a refill until October or later, they may not be affected by the shortage at all, Power said.

For those who do need refills, pharmacists will likely "only fill a one-month supply at any given time over the next little while until the supply is replenished at the global level,” he said.

"It will be important to avoid further shortages," Health Canada's web page said.

Health Canada and Novo Nordisk are "closely monitoring" the supply of Rybelsus, which is the pill form of semaglutide, the active ingredient in Ozempic, it said.

"Patients are encouraged to consult with a health-care practitioner on available options," Health Canada said.

Ozempic and Rybelsus are currently approved by Health Canada for the treatment of Type 2 diabetes.

Endocrinologists have previously told The Canadian Press that semaglutide, prescribed at higher doses, is also an effective treatment for obesity and that they have prescribed it off-label for that purpose.

But some doctors and ethics experts have criticized Novo Nordisk for aggressively marketing both Ozempic and Rybelsus in Canada in recent months, citing concerns that people will seek prescriptions for cosmetic weight loss.

When asked if Novo Nordisk would encourage doctors to stop prescribing Ozempic off-label for weight loss, Hanna said the company "does not promote, suggest, or encourage off-label use of our medicines and is committed to fully complying with all applicable Canadian laws and regulations in the promotion of our products."

"While we respect every health-care provider’s clinical expertise and their right to prescribe treatment based on their own medical judgment, we ask that health-care professionals prescribe semaglutide medicines consistent with their Health Canada-approved indications," she said.

Another semaglutide drug manufactured by Novo Nordisk, Wegovy, has been approved by Health Canada for the treatment of obesity, but it is not yet available in this country.

This report by The Canadian Press was first published Aug. 18, 2023.

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