Update on ADHD medication shortage in the UK

We are providing an important update on the ongoing ADHD medication shortages affecting the UK. This situation impacts several medications commonly used to treat Attention Deficit Hyperactivity Disorder (ADHD), leading to significant disruptions for patients. We acknowledge the challenges this shortage presents and are committed to providing support to our clinicians and patients. 

These notifications have superseded the earlier NatPSA and provide detailed updates on the supply situation. Prescribing advice is available from the following key resources listed in the NatPSA:

• NICE guideline [NG87]. Attention deficit hyperactivity disorder: diagnosis and management
• MHRA (2022). Methylphenidate long-acting (modified-release) preparations: caution if switching between products due to differences in formulations

Medications affected and alternatives

• Methylphenidate modified-release tablet brands are in limited supply and intermittent regional supply disruptions are expected to continue until normal resupply resumes. Brands in stock include:
  • Affenid XL 27mg prolonged release tablets
  • Concerta XL 18mg prolonged-release tablets
  • Concerta XL 27mg prolonged-release tablets
  • Concerta XL 36mg prolonged-release tablets
  • Concerta XL 54mg prolonged-release tablets
  • Delmosart 36mg prolonged-release tablets
  • Delmosart 54mg prolonged-release tablets
  • Matoride XL 18mg Prolonged-release Tablets
  • Matoride XL 36mg Prolonged-release Tablets
  • Matoride XL 54mg Prolonged-release Tablets
  • Xaggitin XL 27mg prolonged-release tablets
  • Xaggitin XL 36mg prolonged-release tablets
  • Xaggitin XL 54mg prolonged-release tablets
  • Xenidate XL 36mg prolonged-release tablets
  • Xenidate XL 54mg prolonged-release tablets

Methylphenidate (Equasym XL) modified-release capsules remain available but cannot support increased demand.

Prescribing and switching between modified-release methylphenidate contains a summary of the pharmacokinetic profiles for methylphenidate brands currently licensed in the UK. This can be used to support product selection.

Lisdexamfetamine (Elvanse, Elvanse Adult) capsules remain available and can support increased demand.

Prescribe Elvanse, Elvanse Adult capsules generically until normal methylphenidate prolonged-release tablet supply resumes.

Supply issues affecting atomoxetine capsules, guanfacine (Intuniv) modified-release tablets and methylphenidate (Equasym XL) modified release capsules have been resolved. Restrictions placed on new patient initiations for guanfacine, and atomoxetine have been lifted and service providers should resume prescribing for new and deferred patients.

The disruption is due to a combination of manufacturing issues and increased global demand This may have an impact upon several of the young people in your care.

Actions

Information for families

• Please do not share your medication with anyone else.
• If your needs are very complex, for example you have mental health problems, or your ADHD symptoms causes you severe difficulty, you can discuss this with your GP, and they may recommend a specialist consultant review. 
• Anyone who is currently waiting to be started on ADHD medication affected by shortage will not receive a prescription until stocks are available. 
• A non-clinical helpline is available for patients who would like more information on the supply disruption (01634 335095 option 3 then option 3, ADHD Medicine Shortages).

Information leaflet 8.2024 V3.docx [docx] 19KB

Advise for Prescribers

Specialist teams should:

• Consider pausing new patient initiations on all methylphenidate prolonged-release tablet brands until normal supply resumes.
• As lisdexamfetamine capsules remain available, consider appropriateness of prescribing as a first line alternative in adults, if a treatment is required before normal supply of methylphenidate prolonged-release tablets resume.
• Prescribe Elvanse Adult capsules generically.
• Please email CAMHS Pharmacy CAMHSPharmacy@nelft.nhs.uk for case/patient specific guidance; information on most recent clinical updates which will be shared via email cascade.
• For children and young people consider offering other clinically appropriate and available options (pharmacological and non-pharmacological) in line with NICE guidance to avoid undue delays in initiating treatment, and
• Offer rapid response to primary care teams seeking urgent advice/opinion for the management of patients with ADHD, narcolepsy and idiopathic hypersomnia. This includes those known to be at a higher risk of adverse impact due to these supply disruptions, e.g. those with complex presentations including co-morbid autism, mental health or substance misuse needs.

For patients currently prescribed methylphenidate prolonged-release tablets, clinicians should:

• Consider prescribing alternative clinically equivalent available brands of methylphenidate prolonged-release tablets ensuring that the patient is not intolerant to any of the excipients.
• Review the patient post switch and reassure them that any changes to their prescription will be short-term and for the duration of the supply issue only, and they have the option to switch back to their original brand once the supply issue is resolved.
• Ensure methylphenidate prolonged-release tablets are prescribed on a separate prescription (FP10) or an electronic prescription which should not be sent to a nominated pharmacy unless the medicine is confirmed to be in stock at that pharmacy (see Supporting Information); and
• If the above options are not considered appropriate, advice should be sought from specialists on other clinically appropriate options (pharmacological and non-pharmacological) in line with NICE guidance to avoid potentially disruptive breaks in treatment if methylphenidate is unavailable

Advice to primary care services

• Practices are advised to identify patients who are currently on ADHD medications and add alert to clinical record of supply issues. A patient information leaflet and ‘easy to read leaflet’ are available to support conversations with patients.
• Provide 28 days or maximum 30 days (for controlled drug) prescriptions for stable and repeat prescriptions of ADHD medicines. Do not issue more than 30-day supply as this may exacerbate supply shortages.
• GPs are advised to contact the appropriate specialist service at the earliest opportunity if there are on-going issues in obtaining medication for advice on dose adjustments OR if patient is identified as ‘high risk/ high needs’- Contacts are provided at the end of this memo.
• Liaise with local and nominated pharmacies for patients with electronic prescriptions to ensure pharmacies are pre-emptively keeping adequate stocks and are informed where a dose/ formulation has changed.

If you have any worries or concerns, please contact your GP surgery or specialist team for help/ advice.

London CAMHS

Kent and Medway CYPMHS

Essex (SET CAMHS) 

(Last updated 18 March 2025)