ADHD medicines supply disruption update

Please download the latest information on the attention deficit hyperactivity disorder (ADHD) medicines supply shortage, including updates to the clinical information and re-supply dates. Please share this information with your teams. This is an update to the information that was circulated on Tuesday.

Considering the Medicine Supply Notification (MSN): lisdexamfetamine (Elvanse®) capsules (13 February 2024) and guanfacine (Intuniv®) (28 March 2024), ADHD service providers and specialists should:

• not initiate new patients on guanfacine modified release (MR) tablets until the shortage has resolved;
• proactively identify any patients on guanfacine 2mg and 3mg MR tablets;
• contact patients or carers to establish how much supply they have left, ensuring they are aware of the risks of abrupt withdrawal;
• Continue to defer initiating new patients on Elvanse® capsules; There are intermittent supply problems until quarter two of 2024. Initiating new patients will prolong this problem.
• Offer rapid response to primary care teams seeking urgent advice or opinion for the management of patients. This includes those known to be at a higher risk of adverse impact because of these shortages. For example, those with complex presentations including co-morbid autism, mental health or substance misuse needs;
• Be aware dexamfetamine tablets remain available, and if switching patients to this treatment, ensure that they are not intolerant to any of the excipients and are counselled on the appropriate dose

Some key points regarding the shortage:

• even with the dates stated, it may take time for supplies to reach the front line.
• the stock situation remains fluid so please do speak to patients to understand their current supply.
• the national advice is not to start new patients on any affected products until the supply situation resolves.
• non-pharmacological advice and coping strategies can be suggested to patients who are impacted by the supply disruption, the specialist services will have expertise in this area.

We appreciate that the supply disruption will cause anxiety for patients and their families, a reminder that NHS Kent and Medway has set up a non-clinical helpline for patients who would like more information on the supply disruption (01634 335095 option 3 then option 3, ADHD Medicine Shortages). This may help you to support the messaging for patients.

A gentle reminder that community pharmacies will only be able to dispense what is written on the prescription, therefore new prescriptions will be needed for changes to the drug, dose or strength. This is a legal requirement, please bear this in mind. A phone call to local pharmacies to understand stock levels prior to prescribing is recommended.