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medSask is a medication information service for the public & health care professionals

medSask is a source for reliable information about prescriptions, over-the-counter medications and herbal remedies for Saskatchewan residents. By calling or emailing medSask, your drug-related questions will be answered free of charge by licensed pharmacists. Your question may be answered during your call or a short time after if more detailed information is required. Our services supplement information and advice provided by a doctor or pharmacist, and provide medication support when a doctor or pharmacist isn’t available. medSask is free of charge for anyone in Saskatchewan and all calls are completely confidential. Medication queries can be made 365 days a year by:

-calling 306-966-6378 in Saskatoon or 1-800-665-3784 in Saskatchewan
-emailing [email protected]

medSask was established in 1974 by a pharmacy professor and was first known as Dial Access. It was then termed Saskatchewan Drug Information Services and in March 2013 became medSask. medSask Mission Statement:
Provide accurate evidence-based information about medications and medication therapy to the general public, healthcare providers and other stakeholders to support positive health outcomes in Saskatchewan.

18/08/2026

To improve stability during storage, some vaccines require reconstitution before administration. medSask has recently received reports of administration errors related to preparation.

✅Before administering a vaccine:

- confirm whether reconstitution is required (e.g., Abrysvo®, Arexvy, M-M-R® II Shingrix)

- follow the product-specific preparation instructions

- use the correct diluent and volume

- double-check the final product

❗Dispensing matters too!

If a vaccine is being dispensed to be administered by another provider, consider attaching an auxiliary label noting any reconstitution requirements or advising patients to alert the provider at their appointment. A quick reminder may help prevent vaccine preparation errors.

📰Did you know? News for Shingrix:

Health Canada recently approved a new prefilled syringe presentation of Shingrix that eliminates the need for reconstitution. It’s expected to be available in early 2027. Until then, the currently available Shingrix vaccine still requires combining the antigen and adjuvant before administration.

📖Need a quick reference for vaccines requiring reconstitution?

medSask's Injectable Vaccines with Diluents chart summarizes the correct diluents, storage requirements, and time limits between reconstitution and administration for commonly used vaccines.

Check it out now!https://medsask.usask.ca/sites/medsask/files/2024-04/medSask_InjectableVaccinesDiluents_March29%2C2024.pdf

13/08/2026

🔔Timely alert - shortage!

Diltiazem 120 mg controlled delivery (CD) oral capsule is currently shorting.

While not all brands of diltiazem 120 mg CD capsules have posted shortage reports, inventory has been unstable and may not be available.

We have updated Comparison of Long-Acting (Once Daily) Diltiazem Formulations, which may come in handy during this shortage (or when you have questions about the differences between Cardizem® CD, Tiazac®, and Tiazac® XC).

Check out the document on our Drug Shortages and Discontinuations page or click the link below!

https://medsask.usask.ca/sites/medsask/files/2023-02/comparison-of-long-acting-diltiazem.pdf

30/07/2026

🔔Timely Alert!

Lung conditions and wildfire smoke:

For patients with lung conditions such as asthma or COPD, wildfire smoke can trigger worsening symptoms and lead to increased healthcare utilization, such as emergency room and hospital visits.

Pharmacists can help:

✅Review asthma or COPD action plans so patients know what steps to take in the event of worsening symptoms.

✅Ensure maintenance and reliever medications are up to date.

✅Assess inhaler technique and adherence.

Several organizations such as Asthma Canada, Lung Health Foundation, and Lung Sask provide helpful tips for staying safe in wildfire smoke when living with asthma, COPD or other lung conditions.

💡Tips to stay safe in wildfire smoke (low air quality) when living with lung conditions:

- Limit time outside and avoid physical exertion or exercise outdoors.

- If you must go outside, a well-fitted N95 mask may help reduce exposure to smoke particles

- Keep car/house windows closed; have air conditioners set to “recirculate”.

- Consider a high-efficiency particulate air (HEPA) purifier in your home.

Wildfire smoke can affect anyone, even those who live far away from a wildfire. Children, older adults, pregnant people, outdoor workers, and those with chronic health conditions may be at greater risk.

Check out SCPP’s July 2026 SCOPe newsletter for information on how pharmacists can help provide pharmacy services to those displaced by wildfires.

22/07/2026

West Nile virus (WNV) is mainly spread to humans through the bite of an infected mosquito.

In Saskatchewan (SK), the main carrier is Culex tarsalis. Mosquitoes that can carry WNV are most active from dusk to dawn.

❗Risk is highest in July and August when Culex tarsalis mosquitoes are most abundant and active.

This year in SK, higher-than-usual mosquito numbers have been reported, largely due to wet spring conditions and warm temperatures that favour mosquito breeding.

Higher mosquito numbers may increase exposure to WNV.

⭐Presentation:

- 70-80% of infected individuals will be asymptomatic.

- Symptomatic people may present with fever, headache, body aches, fatigue, nausea/vomiting, rash, and swollen lymph nodes.

These symptoms may develop 2-14 days after infection. After a few weeks or months, most individuals recover completely.

< 1% of infections progress to neuroinvasive disease. Older adults and those with weakened immune systems are at increased risk of meningitis, encephalitis, acute flaccid paralysis, and death. Long-term neurological deficits may occur.

🦟 Insect repellents:

- Use approved repellents like DEET or Icaridin

- DEET has the longest duration of protection.

- ‘Natural’ repellents such as oil of eucalyptus, oil of citronella, and soybean oil may be less effective.

Other measures:

- Wear light-coloured, loose-fitting clothing that covers the skin

- Limit outdoor exposure during dusk and dawn

- Remove standing water around the home.

Mosquito image is a Culex tarsalis, image from the CDC https://www.cdc.gov/mosquitoes/about/culex-mosquitoes.html

14/07/2026

Quick tips: Swimmer’s Ear - Acute Otitis Externa (AOE)

💡Suspect acute otitis externa (AOE) in patients with the following:
- Rapid onset (within 48 hours) of ear pain, itching, or fullness
- Possible hearing loss or discharge
- Presentation is usually unilateral
- Worsening pain occurs with tragus pressure, pinna movement, or chewing

💡Risk Factors of AOE and Prevention Tips

❗Risk factors: water exposure (e.g., swimming, bathing, water sports), ear canal trauma (e.g., from cotton swabs or other objects), removal of ear wax, dermatologic conditions (e.g., eczema), and using earbuds/hearing aids.

✅Prevention tips: Dry ears after water exposure, avoid inserting objects into the ear canal, avoid unnecessary ear wax removal, clean hearing devices regularly, and optimize treatment of underlying dermatologic conditions.

💡Physical examination is required for diagnosis

AOE usually requires prescription ear drops. Otoscopy is needed to assess the ear canal and determine whether the tympanic membrane is intact.

Refer patients to an appropriate healthcare provider (including trained pharmacists in SK, where applicable).

💡Symptom management and what to do while awaiting assessment

- Manage pain with acetaminophen or NSAIDs (as appropriate)
- Keep the ear canal dry
- Advise against ear drops until the integrity of the tympanic membrane can be assessed - OTC ear drops and drying agents (e.g., acetic acid, alcohol-containing products) may be ototoxic if the tympanic membrane is not intact.

09/07/2026

medSask FAQ

❓We have received a prescription for injectable testosterone to be given subcutaneously (SUBQ). The product monograph says intramuscular (IM) only. Can it be administered SUBQ?

💬 Injectable testosterone products are approved for IM administration in Canada. Data is available supporting the use of SUBQ administration. Potential advantages of SUBQ:
- easier to self-administer
- less pain
- no risk of sciatic injury

✅Practice Tips:

- A lower dose may be needed if switching from IM to SUBQ. Some experts recommend an initial dose reduction of 10-15%.

- Injectable testosterone is viscous. Consider using an 18–20G needle to draw up the medication and a 22–23G (IM) or 25–26G (SUBQ) needle for administration.

❗Check out medSask's Testosterone Products in Canada document for more information about other testosterone dosage forms!https://medsask.usask.ca/sites/medsask/files/2023-02/testosterone-v.51.pdf

30/06/2026

I suppose you could call this a medSask FAQ - except its a frequently asked google question!

medSask can answer your complex medication questions! But don't ask us to quickly spell bupropion... which may have taken multiple takes 🙃

Honourable mentions for other medSask pitches for this video:
❓Does AC mean before meals or after meals?

❓How to convert pounds to kilograms?

❓How many mLs are in an oz?

23/06/2026

❓The product monograph for an oral medication says to store it in the original container. Is it ok outside of the original container for 1 to 4 weeks in a dosette or blister pack?

❗It depends!

Some medications should be dispensed in original containers to maintain stability or to ensure safe handling when there is a risk of hazardous exposure.

👉Dabigatran: moisture sensitivity
👉Azilsartan: light and moisture sensitivity
👉Finasteride: exposure risk during pregnancy

Use information provided by the manufacturer, along with your clinical judgment, to help guide your decision on dispensing medications outside of the recommended storage in the product monograph.

🗣️Counselling on pill organizers

Select pill organizers that are light-proof and close tightly to keep moisture out.
Store organizers in a cool and dry area that is out of direct sunlight.

📑Manufacturer Information

Manufacturers may have internal stability data outside of the product monograph, but many lack in-house studies for oral medications stored outside of original containers in blister packs or dosettes (e.g., Florinef ).

Contact the manufacturer directly for additional information or ask medSask.

16/06/2026

✅Quick tips: Maximum Acetaminophen (APAP) Daily Dose in Adults

Some physicians and LTC protocols recommend a maximum acetaminophen dose of 3000 mg per day [in adults], yet the product monograph and package state a maximum of 4000 mg per day. Is there evidence to support the use of a lower maximum dose of acetaminophen [in adults]?

1️⃣The toxic dose of APAP can differ among individuals depending on patient-specific factors

Exercise caution when dosing acetaminophen.
👉Canadian product monograph: The maximum recommended dose of APAP in adults is 4000 mg/day.
👉Other references recommend a maximum of 3000 mg/day, especially when used for more than 7 days.

Special populations
👉People with liver disease/risk factors for hepatotoxicity: use no more than 2000 mg/day.
👉Adults weighing < 55 kg: use pediatric weight-based dosing.

2️⃣Risk factors for acetaminophen-induced hepatotoxicity
Age > 40 years.
Unintentional overdose.
Underlying liver disease (e.g., hepatitis B or C)
Malnutrition (e.g., due to chronic alcohol use, older age, acute illness)
Periods of fasting – intentional or unintentional
Concurrent use of interacting drugs

Patients with symptoms of liver injury (e.g., nausea, vomiting, right upper quadrant pain, jaundice) should seek prompt medical attention.

The medSask team had way too much information on this for a social post, so we also published an article on our website! Check it out for more in depth information and references. Check out the full article on our website: https://medsask.usask.ca/articles/acetaminophen-maximum-dosing-adults

09/06/2026

medSask FAQ from the lines

❓Should individuals with prosthetic joints receive prophylactic antibiotic therapy prior to dental procedures?

📢 For patients with prosthetic joints and/or orthopedic hardware (e.g., pins, plates, screws), routine antibiotic prophylaxis prior to dental procedures is not recommended.

1️⃣ Most prosthetic joint infections are caused by organisms not typically found in the oral cavity.

2️⃣ There is no reliable evidence that dental procedures increase the risk of prosthetic joint or orthopedic hardware infection, or that antibiotic prophylaxis reduces the risk.

3️⃣ Unnecessary antibiotic use exposes patients to potential harms (e.g., adverse effects, antimicrobial resistance) without proven benefit.

❗Tips

Patients should achieve and maintain optimal oral health before and after joint replacement surgery.

Any dental infections should be identified and treated promptly.

❗When is antibiotic prophylaxis prior to dental procedures recommended?

Patients at high risk of infective endocarditis*

Select immunocompromised patients*

High risk dental surgical procedures* (e.g., complex procedures such as difficult third moral extractions, dental implant placement, or major bone grafting)

*Refer to Bugs & Drugs Antimicrobial Prophylaxis in Dentistry (open access) for detailed criteria and procedural considerations.

https://www.bugsanddrugs.org/AD58FC44-99E5-4A03-83BF-3E27A9131B18

NOTE: When antibiotic prophylaxis is indicated for patients, it should be administered pre-operatively.

Address

107 Wiggins Road

S7N 5E5

Opening Hours

Monday	09:00 - 00:00
Tuesday	09:00 - 00:00
Wednesday	09:00 - 00:00
Thursday	09:00 - 00:00
Friday	09:00 - 00:00
Saturday	17:00 - 00:00
Sunday	17:00 - 00:00

Telephone

+18006653784

Website

http://medsask.usask.ca/, http://instagram.com/medSask_

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