Administering a Prescribed Substance by Injection


Under the Naturopathy Act, 2007, a naturopath may administer, by injection or inhalation, a prescribed substance.  The prescribed substances are listed in table 2 of the General Regulation, in accordance with the specifications about the route of administration, and any limitations outlined in the table.  

A naturopath can only perform this controlled act if meeting the general requirements outlined on the About Controlled Acts page.

Additional Education and Training


A naturopath may only administer a substance by injection if they have met the Standard of Practice for Prescribing. That requires a member to successfully complete a College- approved course and an examination in Therapeutic Prescribing.  The College’s Naturopathic Doctor Registry includes information about whether a member has met this standard of practice.

Any naturopath mixing, preparing, packaging or labeling two or more substances listed in table 2 must do so in accordance with the standards of practice for compounding.

Injection vs. Intravenous Infusion Therapy


Part II (Controlled Acts) of the General Regulation distinguishes between naturopaths who administer substances by: 1) injection, whether intramuscular (into the patients muscle) or subcutaneous (under the patient’s skin); and 2) intravenous infusion (an IV line).

A naturopath who administers a substance by injection is required only to have met the Standard of Practice for Prescribing. A naturopath who administers a substance by intravenous infusion therapy must also meet the Standard of Practice for IV Infusion Therapy.  The IVIT standard requires a naturopath to successfully complete a College- approved course and an examination in IV Infusion Therapy.  The College’s Naturopathic Doctor Registry includes information about whether a member has met this standard of practice.

A naturopath may only administer by injection the drugs listed on table 2 of the General Regulation.  

Table 2


The following includes information in table 2 from the General Regulation.  Every precaution has been made to provide an accurate reproduction. I n the case of a discrepancy, defer to the regulation.  Explanatory notes describe how the limitation should apply. These notes are for information purposes and do not constitute advice from the College of Naturopaths of Ontario.

Substance
Route of administration  Limitation  Explanatory note 
Acetylcysteine  Intravenous  Must be in combination with other amino acids.  Used only by IV and only with one or more other amino acids. 
Adenosine triphosphate  Intravenous  No limitation specified.   
Alanine
Intravenous  Must be in combination with other amino acids.  Used only by IV and only with one or more other amino acids. 
Arginine  Intravenous  Must be in combination with other amino acids.  Used only by IV and only with one or more other amino acids. 
Aspartic Acid  Intravenous  Must be in combination with other amino acids.  Used only by IV and only with one or more other amino acids. 
Atropine  Intravenous  Administered to a patient by the member in his or her office only in emergency circumstances. In an emergency, administer 0.5-1 mg q3-5 min. Dose must be 0.5 mg or higher but must not exceed 2 mg.  This drug may only be administered in office in an emergency.  The dosage amounts are restricted as identified. 
Biotin  Intravenous  No limitation specified.   
Calcium Chloride  Intravenous  No limitation specified.   
Calcium Gluconate  Intravenous  No limitation specified.   
Calcium Glycerophosphate  Intravenous  No limitation specified.   
Carbohydrates in sodium chloride solution  Intravenous  No limitation specified.   
Chromium  Intravenous  No limitation specified.   
Copper Sulfate  Intravenous  No limitation specified.   
Cupric Chloride  Intravenous  No limitation specified.   
Dextrose Injection  Intravenous  No limitation specified.   
Diphenhydramine Hydrochloride  Intravenous, Intramuscular  Administered to a patient by the member in his or her office only in emergency circumstances with a maximum dose of 100 mg.  This drug may only be administered in office in an emergency.  The dosage amounts are restricted as identified. 
Epinephrine Hydrochloride  Intramuscular  Administered to a patient by the member in his or her office only in emergency circumstances with a maximum dose of 1.5 mg.  This drug may only be administered in office in an emergency.  The dosage amounts are restricted as identified. 
Ferrous Sulphate  Intramuscular  Must be administered by z-track only.  Not for use by IV. May only be administered by z-track. 
Folic Acid  Intravenous, Intramuscular  No limitation specified.   
Glutamine  Intravenous  Must be in combination with other amino acids.  Used only by IV and only with one or more other amino acids. 
Glutamic Acid  Intravenous  Must be in combination with other amino acids.  Used only by IV and only with one or more other amino acids. 
Glycine  Intravenous  Must be in combination with other amino acids.  Used only by IV and only with one or more other amino acids. 
Glutathione  Intravenous, Intramuscular  No limitation specified.   
Histidine  Intravenous  Must be in combination with other amino acids.  Used only by IV and only with one or more other amino acids. 
Hydrochloric Acid  Intravenous  In ratio of 1:1000 or 1:500.  Used only by IV and in the ratios identified. 
Isoleucine  Intravenous  Must be in combination with other amino acids.  Used only by IV and only with one or more other amino acids. 
L-Tryptophan  Intravenous  No limitation specified.   
Lactated Ringer’s Solution  Intravenous  No limitation specified.   
Leucine  Intravenous  Must be in combination with other amino acids.  Used only by IV and only with one or more other amino acids. 
Levocarnitine and its salts  Intravenous  No limitation specified.   
Lysine  Intravenous  Must be in combination with other amino acids.  Used only by IV and only with one or more other amino acids. 
Magnesium Sulfate  Intravenous, Intramuscular  Must never be administered by the member for the treatment of eclampsia or pre-eclampsia.  Prohibited for treatment of eclampsia or pre-eclampsia.
Magnesium Chloride  Intravenous, Intramuscular  Must never be administered by the member for the treatment of eclampsia or pre-eclampsia.  Prohibited for treatment of eclampsia or pre-eclampsia.
Manganese  Intravenous  No limitation specified.
 
Methionine  Intravenous  Must be in combination with other amino acids.  Used only by IV and only with one or more other amino acids. 
Molybdenum  Intravenous  No limitation specified.   
Ornithine  Intravenous  Must be in combination with other amino acids.  Used only by IV and only with one or more other amino acids. 
Phenylalanine  Intravenous  Must be in combination with other amino acids.  Used only by IV and only with one or more other amino acids. 
Potassium Chloride  Intravenous  In dosage form not more than 0.3 mEq/kg/hr.  Must never be administered as a single agent or by intravenous push.  The dosage is limited and may not be administered on its own or by IV push. 
Potassium Phosphate  Intravenous  In dosage form not more than 0.3 mEq/kg/hr. Must never be administered as a single agent or by intravenous push.  The dosage is limited and may not be administered on its own or by IV push. 
Proline  Intravenous  Must be in combination with other amino acids.  Used only by IV and only with one or more other amino acids. 
Ringer’s Solution (sodium, chloride, potassium and calcium)  Intravenous  No limitation specified.   
Saline Solution  Intravenous, Intramuscular  No limitation specified.   
Selenium  Intravenous  No limitation specified.   
Serine Intravenous  Must be in combination with other amino acids.  Used only by IV and only with one or more other amino acids. 
Sodium Bicarbonate  Intravenous  No limitation specified.   
Sodium Iodide  Intravenous  Must be in combination with other minerals.  Used only by IV and only with one or more other minerals. 
Sterile Water  Intravenous, Intramuscular  Must be in combination with other substances  May only be administered with other substances. 
Strontium and its salts  Intravenous  No limitation specified.   
Taurine  Intravenous  No limitation specified.   
Threonine  Intravenous  Must be in combination with other amino acids.  Used only by IV and only with one or more other amino acids. 
Vanadium  Intravenous  Must be in combination with other minerals.  Used only in IV and only with one or more other mineral. 
Viscum Album  Intravenous, Subcutaneous  No limitation specified.   
Vitamin A
Intravenous  Maximum daily dose of 10,000 International Units.
The maximum daily dose is limited to 10,000 IU. 
Vitamin B1
Intravenous  No limitation specified.   
Vitamin B2
Intravenous  No limitation specified.   
Vitamin B3
Intravenous  No limitation specified.   
Vitamin B5 Intravenous  No limitation specified.   
Vitamin B6
Intravenous  No limitation specified.   
Vitamin B12
Intravenous, Intramuscular  No limitation specified.   
Vitamin C
Intravenous  Must administer no more than 15 g per day when patient’s G6PD is deficient.  G6PD test is necessary before administration.  Where a patient’s G6PD is deficient the daily dosage is limited. 
Vitamin D
Intravenous, Intramuscular  No limitation specified.   
Vitamin E
Intravenous  No limitation specified.   
Vitamin K1  Intramuscular  No limitation specified.   
Zinc Chloride  Intravenous No limitation specified.   
Zinc Sulphate  Intravenous  No limitation specified.   


For reference, see the General Regulation in the Resources section of the College’s website.