The pharmacist checks the shelf, then the screen, then looks up and says sorry. Your medicine isn’t in.
If that’s happened to you, you’re not the only one who has found it hard. Advice for patients from the Department of Health and Social Care and NHS England opens with: “We know how difficult and stressful medicines supply issues can be for patients and carers.”
This piece covers what official sources in the UK and the US say about supply problems, and what they suggest doing. Both start in much the same place: with your pharmacist.
Why medicines run short
Sometimes it’s local and short-lived. The US Food and Drug Administration (FDA) says local supply issues are “usually temporary and often involve distribution issues”, which resolve when the pharmacy is able to reorder.
Sometimes it’s bigger. The FDA says manufacturing quality issues are the most common reason for drug shortages, and that other shortages can come from sudden or unexpected increases in demand.
Either way, it isn’t something you did wrong, and it isn’t something you can fix by trying harder.
There are people working on it behind the scenes. The advice for patients in England says medicine suppliers are legally required to report any medicine shortages to the government in advance, and that the government monitors supply and works across the supply chain to reduce the impact on patients. It adds that doctors and pharmacists can use an online tool to see whether specific advice has been issued for your medicine. In the US, the FDA keeps a public list of drugs in shortage, and patients can report a potential new shortage to it.
What official advice says
Talk to your pharmacist, early. The advice for patients in England says to talk to your pharmacist “in the first instance”, and that early is better.
Try other pharmacies. The FDA says that if you can’t find your medicine at your local pharmacy, it may be a temporary, local supply issue, and suggests checking other pharmacies.
Ask whether there’s an alternative. The FDA also suggests asking your healthcare provider or pharmacist whether there’s an alternative. Any change like that is a decision to make with your prescriber, not on your own.
Ask what it means for you. If you have questions about a shortage and how it might affect you, the England advice is to speak to your pharmacist or doctor.
Order ahead, but not extra. The same advice suggests ordering your medicine in advance, while you still have some left, so your pharmacist has time to get what you need. It also asks people to avoid stockpiling or ordering more than they need. If you add your next prescription date to Trace, it shows on Today as it gets closer, which can make ordering early a little easier to remember.
Keep a note of what you’ve tried. Which pharmacies you called, what they said and when they expect more in. It saves explaining everything from the start each time, and it’s useful if you end up talking to your prescriber.
If what you collect looks different
MedlinePlus notes that some methylphenidate products may not be able to be substituted for another, and suggests asking your pharmacist if you have questions about the type you’ve been prescribed.
The NHS says different brands of slow release methylphenidate release the medicine into your body in different ways. If you do need to change brands, it says to check the instructions that come with your medicine carefully.
So if the box, the tablets or the name on the label look different from usual, it’s worth reading the leaflet in the new pack, and asking your pharmacist about anything that’s unclear.
A shortage is a supply problem, not a you problem.
If there’s a gap
If you miss a dose, the leaflet in your pack says what to do. If it doesn’t cover your situation, or you’re going without for longer, speak to your pharmacist or prescriber.
Logging Couldn’t get my meds in Trace keeps a record of the gap, with dates, so you don’t have to piece them together later. It’s useful context for your prescriber, and for you.
Sources
- Department of Health and Social Care and NHS England (published by the NHS Specialist Pharmacy Service): Medicines shortages leaflets and posters
- US Food and Drug Administration (FDA): Frequently Asked Questions about Drug Shortages
- MedlinePlus (US National Library of Medicine): Methylphenidate
- NHS: Common questions about methylphenidate for adults
General information, not medical advice. Talk to your prescriber or doctor about your own treatment. How we write
Spot a mistake? Write to us at hello@trace-adhd.com