Global shortage of ADHD medicines, lisdexamfetamine, and guanfacine

The NHS Central Alerting System has issued a National Patient Safety Alert notifying healthcare providers that there are global supply problems with ADHD medicines, lisdexamfetamine (Elvanse), and guanfacine (Intuniv).

The ADHD medicines include Equasym XL, Xaggitin XL, Concerta XL, and Xenidate XL and it is likely that availability of the various strengths will be sporadic at best.

Atomoxetine capsules have also been difficult to obtain in the UK and Ashtons are importing supplies specially.

These supply issues are expected to resolve within the coming 3 months.

In the meantime, to manage and mitigate the potential shortages, prescribers and healthcare staff should follow the following guidance:

• Do not initiate new patients on ADHD medicines affected by this shortage.
• Identify patients that are currently prescribed these medicines.
• Establish how much supply is available for these patients.
• Provide alternative treatment plans where necessary due to the unavailability.
• Order sufficient supply of the alternative medicine to maintain the patient’s treatment.
• Take account that different formulations of methylphenidate have different release profiles, and this can affect symptom management.
• Contact the pharmacist if there are surplus supplies of any of these products so that they can be redistributed to patients who need them.
• New prescriptions will need to be written if changes in treatment are needed because most of the ADHD medicines are controlled drugs (Schedule 2), so the special requirements for prescribing, handling, storing and recording will remain in place.

Full details of the safety alert are available here: https://www.cas.mhra.gov.uk/ViewandAcknowledgment/ViewAlert.aspx?AlertID=103238