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Responding to the removal of natural health products from the National Drug Schedules

March 23, 2022
Pharmacy teams must use professional judgement to assess risks and conduct effective patient assessment.

As of January 2022, the National Association of Pharmacy Regulatory Authorities (NAPRA) removed natural health products (NHPs) that were listed within Schedules I and II from the National Drug Schedules (NDS) with the exception of ephedrine and pseudoephedrine. This removal process was initiated because NHPs were determined to be outside the scope of NAPRA’s NDS. The removal of ephedrine and pseudoephedrine will occur on January 2, 2024. NHPs in the lowest risk categories, Schedule III and Unscheduled, were removed from the NDS in January 2020.

In consideration of the un-scheduling of NHPs including probiotics, herbal remedies, and vitamins and minerals, pharmacy teams must implement measures to ensure ongoing appropriate patient assessment. Many natural health products have potential health risks or may interact negatively with prescribed medications. Patients may be unaware of health risks associated with NHPs and packaging may not effectively outline health warnings. As such, if a pharmacist believes a particular unscheduled natural health product requires additional patient assessment, that product can be kept behind the counter to facilitate patient monitoring.   

Pharmacy teams are encouraged to implement strategies related to NHPs. As of 2024, all products with a Natural Product Number (NPN) or Drug Identification Number-Homeopathic Medicine (DIN-HM) from Health Canada will be considered outside the scope of NAPRA’s NDS. As such, pharmacy teams will have an ongoing responsibility to consider measures related to NHPs to effectively serve, support, and protect the public’s health and well-being.