Shortage of medicines for ADHD (Attention Deficit Hyperactivity Disorder)

This information has been produced to help patients, carers and their families understand the shortage and how it may impact you.

We are asking you to:

• Check how much medication you have.

• Make sure you order your next supply in plenty of time.

• Only order medicine that you need, to help pharmacies manage supplies.

• Try a few different pharmacies in your local area if you cannot obtain your prescription from your usual pharmacy.

This information leaflet includes information to help you:

• Manage your supply of medicine so that you are less likely to run out.

• Reduce your dose safely if you are unable to get your medicines.

What medicines are affected by the shortage?

Methylphenidate

• Equasym XL® 10, 20 and 30mg capsules
• Xaggitin XL® 18 and 36mg prolonged-release tablets
• Concerta XL® 54mg prolonged-release tablets
• Xenidate XL® 27mg prolonged-release tablets

Lisdexamphetamine

• Elvanse® 20, 30, 40, 50, 60 and 70mg capsules
• Elvanse® Adult 30, 50 and 70mg capsules

Guanfacine

• Intuniv® 1, 2, 3 and 4mg prolonged-release tablets

Atomoxetine

• Atomoxetine 10mg capsules
• Atomoxetine 25mg capsules
• Atomoxetine 40mg capsules
• Atomoxetine 60mg capsules

• Other ADHD products remain available. They may not be suitable for everyone and may not be able to meet the increases in demand. Unfortunately, there may be unavoidable gaps in your treatment.

How long will the shortage last?

The shortage is currently expected to last until December 2023, however there is no definite date for when new supplies will become available, and we continue to monitor the situation carefully.

The supply disruption of these products is caused by a combination of manufacturing issues and an increased global demand.

Your local pharmacy, GP practice, and ADHD services know how important your medication is to you. We are working hard to try to find supplies of these medicines and to minimise the impact on patients and carers.

Who should I contact for advice about my medicines?

If you are trying to get your medicines, contact your community pharmacy first to see if they have supplies. Try a few different pharmacies in your local area if you cannot obtain your prescription from your usual pharmacy.

If you have trouble sourcing supplies of your medication, your community pharmacy, GP practice and/or ADHD service may be limited in how they can help until stock levels return to normal. If you have followed the advice in this information and need more support, your healthcare team can help you manage any changes in symptoms.

Please contact your GP if you usually get your ADHD medication on a repeat prescription. If you get your prescriptions from a service at South West Yorkshire Partnership NHS Foundation Trust such as child and adolescent mental health services (CAMHS), the adult ADHD service, or learning disability services, please contact the relevant service directly.

Please be patient with our staff if you contact us.

What if I’m unable to get my usual medication?

Although this may cause you worry, running out of these medications is not an emergency. If you have no medication left, your community pharmacy, GP practice and/or ADHD service may be limited in how they can help further until stock levels return to normal.

Check your supply of medication and order your next supply in plenty of time.

Before running low on your medications, please read this page and consider how you can best manage your medicine.

What can I do to manage my ADHD during the shortage?

If you are taking methylphenidate or lisdexamfetamine, you could make your supply of medicine last longer by not taking it every day. Think about if there are any days you could manage without medication. For some people this could be at weekends when they are not at work or school. It is safe to take breaks with this medication.

If you take methylphenidate, your prescription may be switched from the brand to generic to reduce the likelihood of supply issues. This change is safe and will not affect your treatment.

You may want to let your family, friends, school, or workplace know about the shortage of medication so that they can provide support in case you have an increase in your ADHD symptoms if you have problems obtaining your prescription.

You may want to think about what helped you to manage your symptoms before you started medication, so that you prepare to manage your symptoms as well as possible in case you have difficulty getting your medicines.

Useful links

These websites have information that might be useful in helping you manage your condition and any changes in symptoms because of medication shortages:

• https://www.mindmate.org.uk/nd/
• https://www.nhs.uk/conditions/attention-deficit-hyperactivity-disorder-adhd
• https://www.youngminds.org.uk/
• https://www.adhdadult.uk/

What should I do if I cannot get my ADHD prescription from the pharmacy?

If your usual pharmacy cannot provide your ADHD medication, firstly contact a few different pharmacies in your local area.

This website can help you find pharmacies in your local area: The NHS website – NHS (www.nhs.uk)

Are there alternative medications available?

Other ADHD products remain available. They may not be suitable for everyone and may not be able to meet the increases in demand. There may be unavoidable gaps in your treatment.

Your healthcare team are always happy to talk to you about your medicines and to explain why getting your medicine may be difficult at the moment. We will also explain what that will mean for your treatment.

Is it safe to stop taking Atomoxetine if I run out?

Yes, it is safe. Atomoxetine does not have any withdrawal effects or symptoms, which means there are no side-effects if you stop taking it. However, if you stop taking this medicine it can cause changes in your ADHD symptoms.

Is it safe to stop taking methylphenidate or lisdexamfetamine if I run out?

Yes, it is safe. These medications can safely be stopped for a few days, for example over weekends, and taking breaks from medication on days when you feel you don’t need it can help your supply last longer. Where possible (for those prescribed some brands of methylphenidate) your prescription may be switched from the brand to generic by a clinician at your GP practice, to reduce the likelihood of supply issues.

Is it safe to stop taking Guanfacine if I run out?

No, Guanfacine must always be stopped slowly by gradually decreasing the dose over a period of time. If you stop taking this medication suddenly it can cause your blood pressure to increase.

GP practices and ADHD services are identifying patients who take Guanfacine and will be in touch soon, to discuss how to adapt your treatment safely.

When will there be an update on the shortage?

We are carefully monitoring the situation and will provide more information as soon as possible. We expect to receive an update on the national shortage at the end of October.

Is this shortage affecting all pharmacies?

This is a national shortage affecting all pharmacies – including hospital pharmacies and community pharmacies.

Pharmacies may use different suppliers or wholesalers to source medicines so availability will depend on whether each pharmacy’s suppliers have stock or not. Where there is a known shortage of a medicine, supply levels can change quickly. This is why some pharmacies may be able to find a medicine while others may not.

Why is my medicine not in stock at the pharmacy?

Medicine supply issues can be caused by lots of things. It could be problems at the manufacturing stage, problems with safety or problems with delivery. Problems can develop quickly and can be shared nationally or can be more of a local issue.

The supply disruption of ADHD medicines is caused by a combination of manufacturing issues and an increased global demand.

Pharmacies in community are working hard to try to get your medicines. Please be patient with them.

Community Pharmacy England have produced a patient factsheet regarding medicines supply: Medicines supply factsheet