MisterPharmacist

MisterPharmacist Your Toronto Pharmacist. Helping you make friends with your medicines!

09/04/2026

This inhaler trick makes perfect sense… until you realize it doesn’t actually work.

For years, people have been told to drop their inhaler canister into water.

If it sinks, there’s medication left.

If it floats, it’s empty.

Easy enough.

Except your inhaler wasn’t designed to be a pool toy.

Different inhalers use different canisters, propellants, weights, and designs. That means how high or low a canister floats does NOT reliably tell you how many usable doses remain.

And some manufacturers specifically tell you not to put the canister in water.

So how ARE you supposed to know when your inhaler is running out?

First, check for a dose counter.

If your inhaler has one, use it. That little number is much more useful than anything a glass of water is going to tell you.

No dose counter?

Check how many doses your inhaler contains when new.

Then keep track of your puffs.

If your inhaler contains 200 doses and you take 4 puffs every day, you have roughly 50 days of medication.

For rescue inhalers, it gets trickier because you may use 2 puffs today and none for the next week.

That’s why I recommend keeping track of your use and having a replacement available before you think you’re completely out.

And here’s something many people don’t realize:

Don’t judge your inhaler by whether it still sprays.

Something coming out of the mouthpiece does NOT necessarily mean you’re still receiving the expected medication dose.

So yes, I dropped a bunch of inhaler canisters into water.

But I did it to make one point:

Your asthma medication is too important to measure by whether it sinks or swims.

Use the dose counter. Track your doses. And if you’re not sure, bring the inhaler to your pharmacist.

Follow Alex Mihaila, R.Ph., MBA | Medication Safety Pharmacist for medication advice that makes sense outside the pharmacy too.

Like kids in a candy store i guess:)
09/01/2026

Like kids in a candy store i guess:)

08/28/2026

Quick PSA to physicians: your pharmacist is not just the person who fills the prescription after the decision has already been made. 👀

We’re in the trenches with medications every single day.

We see what patients are actually taking versus what’s sitting on their medication list. We hear about the side effects they forgot to mention at their appointment. We catch interactions, duplicate therapies, dosing concerns, adherence issues, insurance barriers, and the classic, “Oh, I stopped taking that months ago.”

And we also know what’s actually happening with medication access in real time.

We know which drugs are on shortage.
We know which strengths are impossible to get.
We know when a medication has technically been prescribed, but the patient has called five pharmacies and still can’t find it.
We often know which alternatives are available, which formulations are easier to source, and what barriers the patient is going to hit before they ever leave the pharmacy counter.

That kind of information matters.

Because the “best” medication on paper is not always the best medication for the patient if they can’t actually get it.

Pharmacists live at the intersection of clinical knowledge and real-world medication access.

We’re constantly counseling patients, reviewing medication profiles, troubleshooting treatment problems, navigating shortages, dealing with coverage issues, and seeing how medication plans actually play out outside of the exam room.

That doesn’t replace the physician’s expertise.

It complements it.

The best patient care happens when we stop treating healthcare like a collection of separate professions and actually use the expertise sitting right beside us.

So if you’re a physician with a pharmacist available to collaborate with, use them.

Ask what they’re seeing.
Ask what’s on shortage.
Ask what patients are struggling to access.
Ask what medication-related problems keep coming up in the real world.

Because sometimes that “in-the-trenches” knowledge is exactly what turns a good treatment plan into one the patient can actually follow.

Some food for thought from Alex Alex Mihaila, R.Ph., MBA | Medication Safety Pharmacist    Do you have a pharmacist!:))?
08/27/2026

Some food for thought from Alex Alex Mihaila, R.Ph., MBA | Medication Safety Pharmacist Do you have a pharmacist!:))?

04/25/2026

Unpopular opinion: just because it’s sold online doesn’t mean it’s safe.

Over 350,000 supplements just got recalled.
Not because the ingredients were bad…
But because the packaging could literally put a child at risk of serious injury or dð.

Let that sink in.

These weren’t random, sketchy products.
They were prenatal vitamins. Bariatric supplements. Even a “kids” coffee alternative.
Sold in real stores. Sold online.

And still… something as basic as safe packaging was missed.

Here’s the problem no one wants to say out loud:
You’re being asked to trust products you’ve never seen, from brands you don’t actually know, sourced from places you can’t verify.

And when it comes to supplements?
That’s a risk.

Because supplements aren’t just “wellness.”
They’re potent.
They affect your body.
And in some cases—like iron—too much can be disastrous .

So before you click “add to cart” because of a cute brand, good marketing, or a viral recommendation… ask:

→ Do I know where this comes from?
→ Do I trust how this is made?
→ Would I feel safe giving this to my family?

Because convenience should never come before safety.

Save this as your reminder: not everything sold online deserves your trust.

04/21/2026

Most people think minoxidil was created for hair loss.

It wasn’t.

It was originally used to treat severe high blood pressure…
until patients started growing hair as a side effect.

And not just a little—enough that researchers couldn’t ignore it.

So they didn’t.

They turned the side effect into the product.

Now it’s one of the most widely used treatments for hair loss.

This is one of my favorite reminders that in medicine,
what you don’t expect can end up changing everything.

What’s another drug you’ve always wondered about? 👇

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