Health Canada Designates Dacarbazine for Injection a Tier 3 Critical Shortage

Health Canada has classified dacarbazine for injection as a Tier 3 shortage, its most critical shortage category, with a determination date of September 14, 2026. The only Canadian-marketed dacarbazine injection, DIN 02241445 (600 mg/vial), is manufactured by Pfizer Canada ULC. The designation is primarily relevant to hospital and institutional oncology pharmacy teams, since dacarbazine is administered intravenously in supervised infusion settings rather than dispensed through community pharmacy.

Tier 3 is Health Canada's designation for shortages with "the greatest potential impact on Canada's drug supply and health care system." Dacarbazine is a core component of the ABVD regimen used to treat classical Hodgkin lymphoma and is also used in metastatic melanoma, both frequently curative-intent indications. A case series published in Case Reports in Oncological Medicine describes how oncologists managed advanced-stage Hodgkin lymphoma during a prior international dacarbazine and vinblastine shortage, documenting the regimen substitutions used and the outcomes that followed -- a reminder that shortage-driven regimen changes in curative-intent cancer treatment carry real clinical stakes. Health Canada's public shortage listing states the tier determination but does not specify a cause or an anticipated resolution date.

Practice guidance for pharmacists

• Hospital and cancer-centre pharmacy teams should confirm current dacarbazine inventory and expected incoming shipments with Pfizer Canada or their wholesaler now, rather than waiting for a stockout.
• Escalate the shortage to your institution's pharmacy and therapeutics or drug shortage committee so any regimen-substitution decisions are made jointly with the oncology team -- these decisions belong with treating oncologists, not pharmacy alone, given the curative intent of most dacarbazine-containing regimens.
• Check drugshortagescanada.ca directly for the manufacturer's own shortage report, which may include reason and anticipated end-date fields not shown on Health Canada's Tier 3 summary page.
• Review published experience from prior dacarbazine/vinblastine shortages when regimen substitution is being considered, and document the rationale in the patient's chart.
• Watch for any Health Canada authorization of a foreign-market dacarbazine product as an interim import measure, as has occurred with other recent Tier 3 oncology shortages, and confirm labelling and concentration differences before use if one is authorized.

Dacarbazine joins a growing list of injectable oncology drugs that have faced Tier 3 shortages in Canada in recent years, including cyclophosphamide earlier in 2026. Hospital pharmacy teams already coordinating around other active oncology shortages should fold dacarbazine into the same conservation and monitoring processes.