February 2012
OxyNEO and OxyContin
Effective March 1, 2012, OxyContin will no longer be available in Canada. A new oxycodone formulation, OxyNEO, will be available as an alternate treatment option.
The Alberta Expert Committee on Drug Evaluation and Therapeutics has concluded OxyNEO drug products are interchangeable with OxyContin and both require a valid Triplicate Prescription in Alberta.
Pharmacists may choose to dispense OxyNEO for a prescription written for OxyContin without obtaining a new Triplicate Prescription. However, there may be clinical circumstances where the pharmacist will require a new Triplicate Prescription for OxyNEO.
While OxyNEO has been promoted as being more tamper resistant than OxyContin, changes to drug formulations cannot fully address the issue of misuse and abuse. Establishing firm boundaries and regularly reviewing pain management strategies helps ensure the most appropriate treatment for each patient. For advice and additional resources, check out the Canadian Guideline for Safe and Effective Use of Opioids for Chronic Non-Cancer Pain at http://nationalpaincentre.mcmaster.ca/opioid/
NOTE:
To order extra triplicate prescription pads please contact the College of Physician & Surgeons at (780) 423-4764 or toll free 1-800-320-8624
July 2011
Tapentadol added to the TPP Medication List – Effective August 1, 2011
Tapentadol (trade name Nucynta®) is an opioid analgesic used to treat moderate and chronic nociceptive and neuropathic pain.
Approved by Health Canada in December 2010, tapentadol has been available for use in Canada since March 2011 and is now included on the Triplicate Prescription Program (TPP) Medication List. Due to its potential for psychological and physical dependence, Health Canada has included tapentadol as a Schedule 1 drug under the Controlled Substances Act. This should help prevent the potential for trafficking and abuse while still making it available for legitimate medical reasons.
October 2010
Ketamine added to Triplicate Prescription Medication List - effective November 1, 2010
Typically used in veterinary medicine, ketamine is also used to a limited degree in human medicine. A recent increase in the use of ketamine for ambulatory patients (chronic non-cancer pain and palliative care) and its value as a street drug prompted the TPP Steering Committee and the Physician Prescribing Practices Advisory Committee to support inclusion of ketamine in the TPP Medication List. On this advice, College Council approved the addition at the September 2010 meeting.
July 2010
An improved online presentation of the TPP Medication List incorporating minor updates was implemented on the CPSA website on June 30, 2010. The medication list displays all included drugs by the generic names of ingredients. Example trade names are provided for reference. A new cross-reference list of example trade names has been added.
Some key changes:
• Improved description of buprenorphine prescribing requirements presented under ‘Prescriber Notes’
• Addition of Butrans® sample trade name under buprenorphine
• Note that Concerta® is an exception to methylphenidate products included in TPP
• Addition of Novo-Methylphenidate ER-C® sample trade name under methylphenidate
May 2010
- All methylphenidate products require a TPP prescription unless evidence confirms low potential for abuse or misuse.
- In 2007, Concerta® was removed as a TPP methylphenidate product. Evidence to date still supports this exclusion.
- Note: A pharmacist who receives a script for Concerta® written on a regular prescription pad and determines it is appropriate to substitute a generic product must consult with the physician. If the pharmacist and physician agree, the physician will provide a TPP prescription for the generic product.
- Introduction of new generic product, Novo-methylphenidate ER C®, has raised questions from pharmacists about TPP requirements.
- Note: This product requires a triplicate prescription.
- TPP requirements for all long-acting stimulants, methylphenidate and others, are currently under review.
- Physicians and pharmacists will be notified if there are any further changes to the TPP requirements.