Regulatory Guidance

 Prescription and Non-prescription Drugs and Substances Information

Naturopathic Doctors in Ontario can recommend supplements and remedies for patients, and also prescribe drugs once they have met the Standard of Practice for Prescribing. There can be confusion when trying to determine if a drug or substance requires a prescription, if it is a natural health product and if it is available in Canada. For example, some drugs can only be acquired through a prescription. Others can be acquired without a prescription but must be dispensed by a pharmacist. Still, other drugs are available for self-selection as are supplements and remedies; however, the same drug or supplement may need a prescription depending on the dosage and/or route of administration.

The following resources can help the ND find the drug and substance related information they are looking for. Please see the bottom of the page for links to all referenced documents and websites.

Prescription Drug List (PDL) and Schedules of the Controlled Drugs and Substances Act (CDSA)

Both the Prescription Drug List and the Schedules that are part of the Controlled Drugs and Substances Act list the drugs/medicinal ingredients that require a prescription. NDs in Ontario do not have access to any drugs on the CDSA schedules. They do have access to some drugs on the PDL; these are listed on Table 3 of the General Regulation made under the Naturopathy Act. If the drug is on Table 3, it requires a prescription and can only be prescribed by an ND in Ontario who has successfully completed the Ontario Prescribing and Therapeutics course and exam.

National Association of Pharmacy Regulatory Authorities (NAPRA)

The NAPRA website enables one to search the schedules for a drug and find out whether a patient must have a prescription to access it. There are four schedules:
  • Schedule I: requires a prescription
  • Schedule II: available from a pharmacist but does not require a prescription. These are the drugs located in the area of the pharmacy "behind the counter", where there is no public access and no opportunity for patient self-selection.
  • Schedule III: does not require a prescription and is available for self-selection from the area of the pharmacy under the direct supervision of the pharmacist.
  • Schedule U: drugs that are unscheduled and that may therefore be purchased from any retail outlet, such as a grocery store.

When searching the NAPRA database and other resources, be aware of the medicinal, generic and brand names that can be used for a drug. For example, a search on the NAPRA database for Tylenol produces no results, while a search for acetaminophen produces four listings for the drug.

Compendium of Pharmaceuticals and Specialties

Table 3 of the General Regulation lists the drugs or "medicinal ingredients" exactly as they are listed on the PDL. To find additional names that can be used for drugs, the CPS is a valuable resource. The CPS can be used to identify the generic and brand names of a drug in addition to the medicinal name used in the PDL and Table 3.

The CPS can be accessed through a subscription service of the Canadian Pharmacists Association on-line by using the CPA's Rx Tx mobile app available for both iOS and Google Play devices.

Health Canada Drug Product Database

It is important to determine whether or not the drug has been approved for use in Canada. The Health Canada Drug Product Database is an up-to-date list of all such human pharmaceuticals and biological drugs.

Licensed Natural Health Product (LNHP) Database 

The Natural and Non-prescription Health Products Directorate maintains the Licensed Natural Health Product Database. The majority of substances found here do not need a prescription. However, there are exceptions when a prescription is required above a certain dosage. For example, products containing Vitamin D are in the LNHP database since a daily dose below 1000 IU does not require a prescription, while Vitamin D above a daily dose of 1000 IU is listed on the PDL.

Ultimately, it is the ND's responsibility to determine whether the profession has legal authority to access a given drug or substance in Canada. Therefore, it is important to use all available resources to make a thorough search for drug-related information.

Additional resources:

 

Prescription Drug List (PDL)

Controlled Drugs and Substances Act (CDSA)

National Association of Pharmacy Regulatory Authorities 

Compendium of Pharmaceuticals and Specialties

Health Canada Drug Product Database

Licensed Natural Health Product (LNHP) Database