Friday Five (March 4, 2022)

This week's Friday Five includes Health Canada updates, Tramadol prescribing & dispensing announcement, and a position statement on virtual patient care

Virtual Patient Care and Ensuring Patient Safety in Pharmacy Practice  

In an effort to establish baseline expectations and parameters relevant to virtual patient care, particularly as it relates to pharmacy practice, Council has recently approved the Position Statement – Virtual Patient Care and Ensuring Patient Safety in Pharmacy Practice. 

All pharmacy professionals are reminded of their obligation to ensure patient safety at all times, and comply with all applicable legislation, standards of practice, practice directions, and the Code of Ethics. 


Tramadol Prescribing and Dispensing Changes Coming March 31, 2022   

On February 22, 2022, CPhM Council approved the addition of all single-entity tramadol products and tramadol preparations (tramadol + 1 active non-narcotic ingredient) to the M3P list, pending the approval of the College of Physicians and Surgeons of Manitoba (CPSM) Council in March. All changes to the M3P list must be jointly approved by CPhM and CPSM Councils. All pharmacy professionals will be advised once this occurs.  

In addition, please be reminded that federal changes to the scheduling of tramadol products will take effect on March 31, 2022. Tramadol will be removed from the Prescription Drug List (PDL) and listed in Schedule I of the Controlled Drugs and Substances Act (CDSA). Tramadol will also be listed in the Schedule of the Narcotic Control Regulations (NCR) and therefore subject to all the regulatory requirements set out in the CDSA and NCR. 

As of March 31, 2022, the following record keeping requirements will apply to all tramadol products:  

  • Pharmacists will be responsible for maintaining, in an auditable manner, all the records required by the NCR regarding their activities with tramadol for a minimum of two years. This includes, but is not limited to the following records:    
  • Purchase records    
  • Records of receipt    
  • Sale/Provision records    
  • Emergency transfer records    
  • Records of returns to licensed dealers    
  • Destruction records    
  • Furthermore, pharmacists must include all tramadol prescriptions dispensed on or after March 31, 2022, in their special narcotic prescription file. This includes part-fills of tramadol that may be dispensed after March 31, 2022, pursuant to a prescription received or partially filled prior to the scheduling change.  
  • Pharmacists must perform inventory counts and reconciliations on a regular basis (at minimum, every THREE months per provincial requirements, after a pharmacy move, and after a change in pharmacy manager or owner) to ensure all controlled substances, including tramadol, are accounted for. If discrepancies are discovered, they must be investigated. Any theft or unexplained loss of any narcotic or controlled drug must be reported to Health Canada and the College of Pharmacists of Manitoba within 10 days of discovery. Additionally, local police must be informed of any theft without delay.   

For additional information, please see the related Controlled Substances Bulletin. 


Health Canada  Updates

Recent Summary Safety Reviews  

Health Canada’s Marketed Health Products Directorate has released two recent summary safety reviews below that pharmacists are encouraged to read. To view all recent summary safety reviews, please see the following link:

  1. Methadone – Assessing the Potential Risk of Hypoglycemia 
  2. Oral, Over-the-counter Diphenhydramine – Containing Products – Assessing the Potential Risk of Serious Side Effects in Children  

Pharmacy professionals are strongly encouraged to subscribe to Health Canada’s MedEffect Canada e-notices here. 

Health Canada Consultation

On February 16, 2022, Health Canada launched consultations on its draft Handbook for healthcare professionals: Biosimilar biologic drugs. 

This handbook has been tailored to meet the information needs of healthcare professionals. It outlines how Health Canada regulates biosimilars, and the scientific basis underlying their authorization. This handbook aims to improve knowledge and understanding of biosimilars among healthcare professionals to help to build confidence in biosimilars as a treatment option for authorized indications.  

The draft handbook was developed by a working group composed of representatives from various relevant healthcare professional associations and relevant subject matter experts from Health Canada.  

This consultation is open for 60 days until Sunday, April 17, 2022. Forward your feedback and comments to All comments will be considered in the finalization of the documents.

2022 Council Elections: Nominations Close March 9 

The deadline to submit nominations for candidates in the 2022 Council Elections is 4:00 p.m., Wednesday 9th March 2022.  Elected Council members serve a two-year term. 

In order to let your name stand, you must follow the nomination process and submit nomination papers and a candidate profile.  

Further information and links to download the Nomination Form and Candidate Profile and Statement can be found at 


Correction: Three Amended Practice Directions for Stakeholder Feedback  

CPhM Council approved the release of the following three amended practice directions for stakeholder feedback below.   

The hyperlinked email address provided for feedback in the previous Friday Five publications and on the website was incorrect.  

Any feedback submitted to the College through the originally provided email link was not received due to the error. Our sincere apologies for this error. We kindly ask you to resubmit any feedback to the correct email address: 

Due to this error, the College will be extending the consultation to March 18, 2022 

Future consultations will continue to be announced in the Friday Five and posted on the CPhM website’s consultation page 

Amended Practice Directions   

Administration of Drugs including Vaccines   

Permanent and Temporary Pharmacy Closure   

Termination of a Patient Relationship   

Thank you for your cooperation and understanding.  


Call for Members – Safety IQ Advisory Committee   

The College is seeking additional volunteers to serve on the Safety IQ (Safety Improvement in Quality) Advisory Committee. Members of the public, pharmacists, pharmacy students, pharmacy interns, and pharmacy technicians are welcome to join. Although Safety IQ is a mandatory continuous quality improvement (CQI) program for community practice, the committee is comprised of pharmacist and pharmacy technician volunteers from both community and non-community-based practices to provide different perspectives on CQI and patient safety.  

The Committee serves as a resource to Council and the Quality Assurance Committee in matters related to Safety IQ. Following implementation of Safety IQ in 2021, the Committee will continue to evaluate the progress and success of the program and make recommendations to Council on program enhancements that will improve pharmacy practice and patient safety. More information about the Committee can be found in the Safety IQ Advisory Committee Terms of Reference 

To express your interest, please review information on Committee Service and submit a Committee Expression of Interest Form to Please include a current copy of your resume and/or curriculum vitae within the email. 

Summer Student Job Opportunity 

The College has an exciting summer job opportunity for a pharmacy student. We are looking for someone who is passionate about patient safety and is keen to contribute to exciting patient safety initiatives at the College. Join our skilled team of pharmacists and help further your career in pharmacy.   

Please read the job posting for more information.   

Submit an application on or before Friday, March 21, 2022 at 4:00 p.m. to Lindsay Henderson,


Notice from St. Boniface Hospital: Electronic Patient Record Order Reconciliation Management Project  

On March 7, 2022, St. Boniface Hospital will be the first facility in Manitoba to start using the integrated Electronic Patient Record (EPR) Order Reconciliation and Prescription Writer functions. Community pharmacists will receive two new reports from St. Boniface Hospital replacing the SBGH Discharge Medication Reconciliation/Prescription Order Form as part of this implementation. 

  1. The Discharge Prescription will have a new format. It lists the medication name, indications (if entered), instructions, quantity, duration and refills for those medications the patient requires a supply of.  
  1. The Discharge Medication Reconciliation Summary report is a reference for the complete list of medications on discharge, medications on admission, and prescriptions provided in standard tables. It is intended for primary care providers and community pharmacists. The Medications on Discharge section contains all the medications that the prescriber intends for the patient to take after their hospital stay. Discontinued home medications may be indicated on the prescription and/or the summary report. If not indicated, the pharmacist can discern which home medications have been discontinued at discharge by comparing the admission and discharge tables.

Upcoming Events & Professional Development Opportunities 

Mini MEDS: An Evening of Evidence  

March 17, 2022  

Register here  

ACS Network Heart Attack Day 2022 

April 29, 2022 

Register here