Information on the Availability in Canada of Cefixime (Suprax) for the treatment of Gonorrhea

December 2002

On November 22 2002, an MMWR report from the United States revealed that Wyeth-Ayerst is announcing the unilateral discontinuation of cefixime (Suprax) tablets in the US. Wyeth-Ayerst's patent for the medication in the United States expired on November 10, 2002.

Although Wyeth-Ayerst does not market cefixime in Canada, they do supply the medication to Rhone-Poulenc Rorer Canada Inc. who in turn supplies cefixime to Aventis Pharma - the Canadian distributor for the medication. Therefore this discontinuation will affect the Canadian supply of the medication. Health Canada was not informed of the discontinuation by any of the companies involved.

Aventis has been contacted regarding the discontinuation. Initial conversations with Aventis have revealed that they are aware of the discontinuation in the US and are currently seeking access to another supplier, although one has not yet been found. Aventis claims to have enough stock to supply the Canadian market for all of 2003. They feel confident that they will find another supplier and they have no intention of discontinuing the drug in Canada at this time.

Cefixime remains a recommended treatment for gonorrhea in Canada, as indicated in the Canadian STD Guidelines, 1998 Edition. Treatment alternatives such as ceftriaxone and quinolones do exist. However ceftriaxone requires an injection (as opposed to oral cefixime) and in some areas of Canada, gonorrhea has significant levels of resistance to quinolones, limiting their use.

After years of decline, reported gonorrhea rates in Canada have recently increased substantially. Since 1997, reported cases have increased by 53% among men and 33% among women. About half (48.9%) of all reported cases of gonorrhea in Canada in 2001 were among 15-24 year olds. A one time, readily available and well-tolerated treatment such as cefixime, is essential as one of the tools in addressing the increased rates of gonorrhea in Canada to prevent disease transmission and complications of the infection.

The provincial and territorial STD Directors were informed of the cefixime discontinuation through a communication sent from the Division of Sexual Health Promotion and STD Prevention and Control on November 22, 2002. Together with the Therapeutic Products Directorate (TPD) of Health Canada, we will keep you abreast of any further developments in the availability of cefixime in Canada.