Staying #Up2Date 🚨

1: Pharmacists + Physios? 🤝

Could your next partner in primary care be a physiotherapist? New Nova Scotia research explored whether pharmacists and physiotherapists could team up to manage acute muscle and joint injuries, combining pharmacists’ expertise in pain medications with physios’ expertise in assessment and rehab. Regulatory and advocacy groups largely supported the idea, but flagged funding, unclear scopes and regulatory silos as hurdles. With nearly 11 million Canadians affected by musculoskeletal injuries each year, researchers say the partnership could help patients get the right care, from the right professional, sooner.

💬 Pharmacists + physios: good idea or logistical nightmare? Weigh in on r/RxBriefly →

2: A New Rival for Pantoprazole? 🔥

Pantoprazole may have some competition. In a new randomized trial, researchers compared the potassium-competitive acid blocker tegoprazan with pantoprazole for erosive esophagitis. The primary 4-week healing difference wasn’t statistically significant, but tegoprazan worked much faster on symptoms: 84.4% of patients had at least a 50% improvement during the first week versus 31.3% with pantoprazole. In an exploratory subgroup with more severe disease, healing was 100% versus 68.8%. The results are early, but they offer an interesting glimpse at another way to tackle acid suppression.

3: Medication Mix-Ups Are Climbing 💊

Taking the wrong pill or accidentally doubling a dose may be more common than we think. A recent analysis of US poison-centre data identified 115,071 medication errors outside healthcare settings that resulted in hospital admission between 2000 and 2024. The hospitalization rate linked to these errors rose nearly 197% over that period, with adults over 69 at highest risk. Cardiovascular drugs were involved most often, and common mistakes included taking the wrong dose, the wrong medication or accidentally taking a medication twice.

Shelf Watch 🏥

Drug Shortages ⚠️

Rivaroxaban 

• Company: Apotex

• Drug Class: direct oral anticoagulant (DOAC) 

• DIN: 02470500

• Strength affected: 15 mg

• Shortage Status: Actual Shortage 

• Reason for Shortage: Disruption of the manufacture of the drug

• Start Date: 2026-09-29

• Estimated End Date: 2026-10-30

Moxifloxacin 

• Company: Pharmascience Inc

• Drug Class: fluoroquinolone 

• DIN: 02432218

• Strength affected: 0.5% 

• Shortage Status: Actual Shortage 

• Reason for Shortage: Disruption of the manufacture of the drug

• Start Date: 2026-10-04

• Estimated End Date: 2026-12-07

Newly Approved Drugs ✨

Hernexeos (Zongertinib): A targeted oral tyrosine kinase inhibitor (TKI) used to treat certain patients with HER2-mutated non-small cell lung cancer (NSCLC).  

• NOC Date: 2026-09-24

• Submission type: New Drug Submission (NDS)

• Submission class: New Active Substance (NAS)

• Manufacturer: Boehringer Ingelheim

• Product type: Prescription Pharmaceutical 

• DIN: 02571730

• Dosage Form: 60 mg tablet 

• Indication: For adults with unresectable or metastatic NSCLC that carry HER2 (ERBB2) tyrosine kinase domain activating mutations and have previously received systemic therapy. 

More NRT options are moving behind the counter. Now what?

A patient walks into the pharmacy looking for help quitting smoking. Maybe they’ve tried the patch but still had cravings. Maybe gum wasn’t for them. Or maybe they’re asking about one of the newer nicotine products they’ve heard about.

There are more nicotine replacement therapy (NRT) options to choose from than there used to be, and some of the newer ones are sitting behind the pharmacy counter.

Under Health Canada’s rules for nicotine replacement therapies, established NRT formats on its self-selection list can continue to be sold on open shelves. Newer or emerging formats that aren’t on that list, including nicotine pouches and rapid-disintegration nicotine tablets, must be kept where customers can’t access them without assistance and sold by a pharmacist or someone working under their supervision.

Health Canada introduced the restrictions over concerns about inappropriate access and use by young people. But putting these products behind the counter also means pharmacists are more likely to be part of the conversation when an adult who smokes wants to try one.

So, what do you ask?

A good place to start is with what they’ve already tried. CAMH notes that patches provide nicotine slowly and steadily to help manage withdrawal, while faster-acting options such as gum, lozenges, inhalers and sprays can help with breakthrough cravings. The two approaches can also be combined.

So a previous attempt with NRT doesn’t necessarily mean NRT itself is off the table. Were cravings still breaking through? Was gum unpleasant or difficult to use consistently? Did side effects, inconvenience or simply not liking the format make it difficult to stick with? Understanding what didn’t work can help narrow down what might work better next time.

What about nicotine pouches?

Authorized oral nicotine pouches add another format to consider. Placed between the gum and cheek, they deliver nicotine through the oral mucosa without tobacco.

For someone who hasn’t found patches, gum or lozenges to be a good fit, pouches offer another format to discuss. They don’t require chewing or application to the skin, which may matter for patients whose previous NRT experience was limited by the format itself. And because they’re kept behind the counter, pharmacists have an opportunity to talk through whether they fit the patient’s needs and previous quit experience.

The growing number of NRT options doesn’t necessarily make the decision simpler. But it does give pharmacists more ways to help patients find an approach they can stick with.

Hot Off The Press 🗞️

1:🤰Health Canada has recalled hCG One Step Pregnancy Tests because they may detect low levels of hCG below the stated assay sensitivity, potentially resulting in false-positive results in non-pregnant people. The package insert is being updated to reflect that low hCG levels can occur at or after onset of perimenopause. Hopefully, this keeps “One Step” from turning into several unnecessary ones.

2: 🇨🇦 Americans who order cheaper prescriptions from Canadian pharmacies could soon face a major roadblock. New US import rules taking effect Oct. 22 will require mailed medications to go through a more formal customs process, and the Canadian International Pharmacy Association warns it could effectively stop many personal prescription shipments from Canada. The stakes are significant: an estimated 2.3 million Americans have purchased prescriptions from outside the U.S. to save money, with some Canadian prices reportedly 50% to 80% lower.

3: 🤧 Flu season may be getting an unusually early start. Influenza cases are already cropping up weeks earlier than expected, with unusually high positivity in parts of the Northern Hemisphere. So far, H1N1 is dominating US cases, accounting for 96% of subtyped positives in one recent week, and researchers are watching an emerging mutation called G155E that might be less easily recognized by existing antibodies. In Canada, influenza test positivity has also been increasing in recent weeks, although activity remains at very low levels nationally. Scientists caution it’s still early, and an early start doesn’t necessarily mean a more severe season.

Prescribing or dispensing topical retinoids for acne? The routine matters, too.

Retinoids are often an important part of a treatment plan for patients with acne. Still, the prescription is only one piece of the routine. When skin feels dry, tight or uncomfortable, the questions tend to follow: What should they cleanse with? Should they moisturize? What else can support the routine?

A published Canadian study examined a ceramide-containing Hydrating Cream-to-Foam Cleanser and Facial Moisturizing Lotion used alongside topical retinoids. In this 3-minute video abstract, see how the routine was evaluated for treatment-related side effects and tolerability.

RxBriefly Picks 💊

🎃 Bake: the Great Pumpkin, but make it cake. This pumpkin-spiced Bundt stacks two mini cakes into one very impressive-looking pumpkin, complete with orange frosting and a chocolate-dipped ice-cream-cone stem. Surprisingly doable, even if cake decorating isn’t your thing.

✈️ Shop: for your next trip. October Prime Day has travel gear on sale, including Samsonite and Away luggage, Travelpro carry-ons, compression socks, trackers and other actually-useful travel accessories.

🎧 Listen: to this podcast discussing whether pharmacists can help fix Canada’s primary care crunch. Pharmacist and U of T researcher Dr. Mina Tadrous dives into the data behind expanded pharmacy care, including what’s working, what’s still debated and where the profession could go next.

📚 Learn: what happens after the hot flashes fade? This free 30-minute course on genitourinary syndrome of menopause covers how to recognize and screen for GSM, plus evidence-based treatment options and patient-centred counselling strategies.

Relax 🧩

First clue: Cleverness, or the opposite if it follows nit

Give it a go →

Need a rematch? We’ve got you covered. Check out our Crossword Archive to find every puzzle we’ve ever made, all in one place.

Think you crushed it? Challenge your pharmacist friends to beat your time.

Meme Of The Week 😂

Advertise with RXBriefly 📣

Want to reach thousands of Canadian pharmacists every week? Email [email protected] to learn more.

Help Us Get Better 🙏