STI Medication Order Form

PLEASE NOTE:

There is a national shortage of Bicillin® L-A (1,200,00 IU/2mL), the preferred treatment for syphilis. 

Review current guidance

  • Health Canada has permitted the use of Lentocilin S 1200 (1,200,000/4mL) another benzathine penicillin G-LA medication during the shortage.
  • Prioritize the use of benzathine penicillin G-LA for:
    • Pregnant individuals; and
    • Non-pregnant individuals who may not reliably adhere to treatment and follow-up.
  • Oral doxycycline should be preferentially used for the treatment of syphilis in non-pregnant individuals in whom adherence to treatment and follow-up is expected.

The medications supplied by TBDHU are to be used ONLY for the treatment of sexually transmitted infections. 

This form is for health care providers to order publicly funded STI medication from the Thunder Bay District Health Unit. Be sure to click "Submit" when finished.

  • Medication orders are filled Monday to Friday.
  • Your clinic will be notified via email once the order is ready for pick-up.
  • District orders will be delivered to your local TBDHU branch office for pick-up.
  • If your request is urgent please call 807-625-5976.
  • Expired STI medication can be returned to TBDHU.

FOR TREATMENT OPTIONS REFER TO: Sexually transmitted and blood-borne infections: Guides for health professionals (Public Health Agency of Canada)

For consultation call a Public Health Nurse at (807) 625-8347

bottle
1 BOTTLE MAXIMUM PER ORDER
1 box maximum per order
Diluent for ceftriaxone
For pregnant individuals and non-pregnant individuals who may not reliably adhere to treatment and follow-up. A complete dose of 2.4 mu/8mL requires 2 syringes, each containing 1.2 mu/4 mL of Lentocilin® Additional supplies are required to administer Lentocilin. TBDHU will not provide these supplies. Providers will need to source their own. - 5 mL syringes - 18 G x1 ½” needles - filtered blunt needles
Note: Gentamicin is not kept in stock at TBDHU and must be ordered by special request for patients with cephalosporin allergy ONLY.
*This field must be completed if ordering Gentamicin* 1. Name of MD/NP ordering 2. Client file# (Do NOT include client Name or DOB) 3. Rationale for ordering