Canadian Addison Society

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Bulletin Board

Florinef Shortage Update

At the time of writing, Paladin Labs continue to say they do have inventory of Florinef in limited quantities and are shipping allocated quantities on a regular basis.
Regardless we continue to hear of situations across Canada where patients have been unable to have their Florinef prescriptions filled at their usual pharmacy.
We also hear from patients who have had their prescription filled without issue. The writer had such an experience and received a prescription refill in late July, without any indication of a supply issue.
The Health Canada Drug Shortage Report states that Paladin does have "Limited Inventory. Stock available on allocation".

The following link will take you to the website of The Canadian Society of Endocrinology and Metabolism where a message on this topic may be found:

We suggest that you consider asking your pharmacy to call other distributors as clearly some of them have Florinef inventory. Alternatively try pharmacies of other chains, or independent pharmacies.

Solu-Cortef Shortage

We have been alerted by ISMP Canada of an anticipated shortage of Solu-Cortef Act-O-Vials as carried in your emergency injection kit. We have been able to confirm this with Pfizer Canada.
Pfizer advises that a very temporary shortfall may occur in Canada between mid July to mid September depending on existing inventory at distributors and retail pharmacies. Pfizer also advises they hope the product will actually be replenished prior to the mid September timing.
The item of interest to most of us is the 100 mg 2mL Act-O-Vial, DIN# 00030600. If your emergency Act-O-Vials of Solu-Cortef are about to expire you may consider checking with your pharmacy. If your prescription refill may be delayed during this period, hold on to your expired Act-O-Vials until the fresh prescription refill is available.
Pfizer has assured us they will keep us informed as this situation unfolds over the next couple of months. Watch this Bulletin Board for updates.

Brochures & Holder Program

We are pleased to introduce our complimentary Brochures & Holder Program, an important element of our ongoing Awareness Campaign. If you are an AI patient and feel your Doctor(s) may be interested in contributing a little bit of counter space for our Brochures, please take this info sheet to your next appointment.

If you are a Healthcare provider and have a little bit of counter space for us in the patient area of your facility, please email to place an order. There is absolutely no charge of any sort, including refills of brochures. You may view the Brochure on our website by following this link:

Brochures & Holder ProgramSmall countertop footprint
12 cm W x 8.25 cm D
4-3/4" W x 3-1/4" D

Exciting EMS news to report…

We are extremely pleased to share the latest EMS news from Newfoundland & Labrador as of Sept 25, 2018. Following are the intros and links to media reports both print and video, all of which announce and/or discuss the implementation of the new potentially lifesaving EMS protocol for suspected adrenal crisis. We are very grateful to all that helped to make this new protocol a reality.

NTV Evening Newshour Early Edition - Tue, September 18, 2018

LIFE-SAVING MEDICATION TO BE ADMINISTERED BY PARAMEDICS: Paramedics in the province that now able to administer a shot that could save lives.
["Dr. Brian Metcalfe"]

NTV Evening Newshour - Tue, September 18, 2018

THE CARTER FILE: A milestone in our health care system today; paramedics will now be able to administer a life-saving drug.
["Dr. Brian Metcalfe"; "Dr. Carole Joyce"; "Paula Courage"]


The video you are about to see is titled “ICE COLD MOM” and was originally a segment on the popular TV series UNTOLD STORIES OF THE ER. The woman brought into ER and played by an actress is depicting the experience of Shannon Meister, a longtime member of our South/Central Ontario Support Group.
The events that unfold are not necessarily unique regarding the fact that many ER Physicians may have never been faced with what is eventually diagnosed as Addison’s disease (Adrenal Insufficiency). All the symptoms exhibited in this scenario are not necessarily typical of an Addisonian / Adrenal Crisis.

Enjoy the Video!

Spoiler Alert...
The following information will divulge the outcome, but please continue to watch the video to see the process that was followed and how a diagnosis was eventually made.
In an ideal world, early testing of electrolytes may help to reduce the time to diagnose and eliminate unnecessary testing. Low sodium and low cortisol levels are indicators for diagnosis.
As you will see, the good news is that the Doctor did eventually and correctly diagnose Addison’s Disease. Many with Addison’s disease or other forms of Adrenal Insufficiency go for years and endure many ER visits before diagnosis.
Note: Recent guidelines from the Endocrine Society highlight the importance of early electrolyte testing (Sodium) and cosyntropin testing (Cortisol) and support the immediate administration of injectable hydrocortisone and Normal Saline for suspected adrenal crisis. (AACC, 2016)

We are grateful to the Executive Producers, Mark Harmon and Bob Niemack for authorizing use of this segment and highlighting these main points. Injectable hydrocortisone is the right medication to give and it should be given immediately for suspected adrenal crisis!

“The Last Remaining Light”

We are pleased to participate in the global introduction of a short film “The Last Remaining Light”. A link to the film is located at the bottom of this article. The film was produced and directed by Martin Wallgren and co-produced by Addisonian and Team Addison bicyclist Martin Norrman (Martin Norrman also founded the non-profit Swedish Addison’s Association

Following is a short intro to the film:
This is the most brilliant, touching and phenomenal movie for Addison's ever, letting the world know more about primary Addison's (it applies greatly to all forms of AI) along with breathtaking cinematography and narration. It is the story of the illness, fight and triumphs of co-producer and actor Martin Norrman, in coordination with producer and director Martin Wallgren. This movie was made with the goal of raising awareness of AI diseases, and we can't thank Martin and his team enough for their years of hard work and dedication to this important project, and for this awesome film.
While some people diagnosed with primary Addison's might not feel they can resume the level of activity Martin does in this amazing film, they will definitely see their own story in his.

The more we can raise awareness of Addison's and other forms of AI, the more we will increase our diseases' funding, research, treatment options and maybe one day find a cure. This will be the best 15 minutes you will ever have with Addison’s. You can view this film in many languages by clicking the “CC” button at the top.

Addison's Disease (Adrenal Insufficiency)

The number of people with Addison's Disease (Adrenal Insufficiency) varies with surveys in different countries depending on how these surveys are done, but in the United States, between 6 and 11 out of every 100,000 people will be diagnosed with this disease. The statistics are probably the same in Canada.

With this low prevalence of the disease, you may not have met anyone else who has this problem and it can be supportive to discuss your experience with others who have a similar problem.

We hope to help educate not only the medical society but also the public to aspects of the disease.

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M9A 2S1

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