Health Canada, as of December 1, 2018, is making changes to the dispensing of all Medically Important Antimicrobials (MIAs). From that date onward, products containing antibiotics will require a prescription from a veterinarian, and can only be dispensed by a veterinarian, or licensed pharmacist. Health Canada is making these changes to aid in protecting human health by reducing the factors to the nationwide incidents of drug resistant organisms.

How does this affect horse owners and animal welfare?  Horse owners may have been in the habit of obtaining products containing antibiotics at feed stores or tack shops, rather than through their veterinarian.  They may also have imported products containing antibiotics for their own use from the US, or from online pharmacies in the past.  These options will no longer be available.  Those without a veterinarian, with whom they have a valid client-patient-relationship, will not be able to access products that contain antibiotics without a prescription.  Horse owners in remote areas may have greater difficulty obtaining products containing antibiotics.



Fact Sheet: Changes to Use of Medically Important Antimicrobials

As of December 1, 2018, all Medically Important Antimicrobials (MIAs) will require a prescription from a veterinarian, and can only be dispensed by a veterinarian, licensed pharmacist. Health Canada is making these changes in an effort protect human health by decreasing the opportunity for antibiotic resistant organisms to emerge.  The list of drugs is based on the Antimicrobial categorization determined by Health Canada in relation to their importance to Human Medicine.


What are MIAs?

Some MIAs include: (star beside antimicrobials commonly used in horses) 

  • Apramycin
  • Bacitracin * (BNP ointment for eyes, topical medications)
  • Erythromycin
  • Lincomycin
  • Neomycin *
  • Penicillin G *(common penicillin)
  • Spectinomycin
  • Streptomycin/ Dihydrostreptomycin
  • Sulphonamides * (commonly used oral medication)
  • Tetracycline/Chlortetracycline/oxytetracycline *
  • Tilmicosin
  • Tiamulin
  • Virginiamycin
  • (or their salts or derivatives)


How do you prepare for these changes?

  1. Develop a valid client-patient relationship (VCPR) with your veterinarian.  Confirm that you have a VCPR before December 1st, 2018.
  2. Share this information with other horse owners.
  3. Consider developing a farm plan with your veterinarian.
  4. If you live in a remote area, talk with your veterinarian about how you will access antimicrobials in an emergency.  Conversations with local pharmacies may be helpful to determine what medications they carry.


What is a VCPR?

Veterinary client-patient relationship is the relationship you establish with your veterinarian and the terms to which it operates under. A strong VCPR is most important in areas where access to veterinary care is limited due to distance and remote access. By establishing the terms with the veterinarian, you are prepared in the event that a prescription is needed in a timely fashion. The terms of VCPR are based on the veterinarian’s knowledge of the animals and the people who care for them.


What Determines a Legitimate Veterinarian-Client-Patient-Relationship (VCPR)?

A legitimate VCPR is considered to exist only if medical records of the practice contain sufficient evidence of relevant and timely interaction between the veterinarian, animal owner and animal patients.

These interactions may include, but are not limited to:

  • Farm or home visits
  • Clinic appointments
  • Consultations
  • Direct animal examinations (individual or herd/flock)
  • Laboratory reports
  • Production record reviews, etc.

The VCPR is supported by documented evidence that the veterinarian has undertaken the steps necessary to establish medical needs and consequently prescribes and subsequently dispenses pharmaceuticals.

The VCPR is not a signed contractual agreement but rather a working connection and interaction between veterinarian, client and specific animal patient or group of animals. The VCPR is not in and of itself an entitlement to prescribe and subsequently dispense pharmaceuticals.

For more information on VCPR visit


Visit Health Canada for more information on the changes.



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