Shortage of medicines for ADHD
There is a national supply shortage of the medication prescribed to help manage ADHD symptoms.
This information has been produced to help patients, carers and their families understand the shortage and how it may impact you.
We are asking patients 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 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.
There are a number of local and national charities and support groups who may be able to provide support during this time:
https://www.adhdfoundation.org.uk/services-for-adults/
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 unlikely to result in harm. 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 the advice in this leaflet 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.
We appreciate this must be a very worrying time and a disruption to taking medication has potential to affect how you manage in day-to-day situations. Here are a few suggestions to help:
Think pre- medication: It may be helpful to reflect on coping strategies that you used prior to taking medication. It is likely that you have continued to build on these alongside taking medication. The “How To ADHD” series on YouTube offers lots of helpful tips on managing specific symptoms of ADHD.
Exercise: Many people find exercise helps with ADHD symptoms and for managing low mood and anxiety. Start gradually if needs be, for example a walk a day.
Consider discussing with your employer/ educator: If you are working/studying, it may be helpful to discuss the current situation with your manager/ educator, if you feel comfortable doing so. You may be able to discuss making reasonable adjustments to help with any particular areas of difficulty during this time. Here’s some helpful advice on discussing reasonable adjustments with your employer.
Self-care: Try to prioritise looking after yourself including eating well, focusing on sleep and taking time for hobbies that you know make you feel good.
Self-compassion: Everyday tasks may feel harder without medication. It may be helpful to talk to friends and family to explain that you may struggle in certain areas currently and see if anyone is able to offer extra support during this time. You can use information such as that on the NHS website to help explain to others.
Peer support: The West Yorkshire ADHD support group offer opportunities to access peer support from other people with ADHD. You can find more information on their website.
Seek further support when needed: If you are struggling with your mental health, seek support from your GP who can provide support and signpost you to the most appropriate support.
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/
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: Find a pharmacy – 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.
Is it safe to stop taking Atomoxetine if I run out?
Yes, it is safe. Atomoxetine does not have a recognised withdrawal syndrome, 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?
It is generally safe to stop these medications without gradually reducing the dose. Many people routinely stop 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.
People on higher doses may experience some tiredness or low mood when stopping their medication suddenly and taking a lower dose for a few days before stopping may help prevent this.
Suddenly stopping doses of 50mg of lisdexamfetamine (Elvanse) or less are unlikely to result in any issues. If you are on a high dose of lisdexamfetamine then we ask that you discuss stopping this with your pharmacist.
Where possible (for those prescribed some brands of methylphenidate) your prescription may be switched from your usual brand to an alternative form by a clinician at your GP practice, to reduce the likelihood of supply issues. Please discuss this with your pharmacist.
Is it safe to stop taking guanfacine if I run out?
No, Guanfacine must always be stopped slowly by gradually decreasing the dose. If you stop taking this medication suddenly it may 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.
Your community pharmacy team are working hard to try to get your medicines. Please be patient with them if they are having difficulty getting the medicines for you.
Community Pharmacy England have produced a patient factsheet regarding medicines supply: Medicines Supply Factsheet
Visit our ADHD service web page for more information about our service.