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Help and advice on medicines shortages

Sometimes in the NHS we experience medicines shortages.  This could be for a number of different reasons.  Find more information below about what medicines we are experiencing shortages of in Greater Manchester, and advice on what to do if this affects you.


General frequently asked questions

There are different medicines shortages affecting the NHS. This page gives advice for people living in Greater Manchester.

The different medicines shortages include medicines used to treat menopause symptoms, help to manage diabetes, help to manage Attention Deficit Hyperactivity Disorder (ADHD) symptoms and those used to manage infections.

There are several reasons for medicines shortages. These include problems getting the ingredients needed to make the medicine, shortages in packaging such as injection devices and because demand has increased.

Your GP practice and pharmacy have no control over medicines shortages. The NHS is currently working with the companies who make medicines to try and get better supplies for the UK.

You will need to speak to the person who prescribes your medication.

If your GP practice normally prescribes your medicine, they will look at how well your medicine is working, if you still need it and what alternatives there are to plan with you what to do.

If it is urgent that you get a replacement, your GP will try to make sure you get this as soon as possible, but for certain people, it is safe to miss a few days of medicine.

Your GP will not be able to find you an alternative if they do not normally prescribe your medicine. If someone other than your GP prescribes your medicine, you will need to speak to them to get an alternative.

Medicines shortages can last from several weeks to many months and each medicine is different. Your local pharmacy or practice pharmacist, GP practice or another professional who prescribes your medicine will be able to tell you how long the medicine shortage is likely to last. However, sometimes shortages last longer than first thought, so any information may change.


Medicines used to treat diabetes

The NHS is currently facing a supply issue with medicines used by people living with type 2 diabetes. This information has been put together by GPs, pharmacists, and other health professionals to help answer any questions you may have.

Anyone affected should follow the advice of a health and care professional.

The NHS is experiencing a shortage of medicine called ‘glucagon-like peptide receptor agonists’ or GLP-1s used for managing blood glucose levels in people with diabetes. The drug names often end in ’tide’.

There are different GLP-1s for type 2 diabetes. The names of these include:

  • Dulaglutide (with the brand name Trulicity) – once weekly injection
  • Exenatide (with the brand name Byetta or Bydureon) – twice daily injection (Byetta) OR once weekly injection (Bydureon)
  • Liraglutide (with the brand name Victoza) – once daily injection
  • Lixisenatide (with the brand name Lyxumia) – once daily injection
  • Semaglutide (with the brand name Ozempic or Rybelsus) – once weekly injection (Ozempic) OR once daily tablet (Rybelsus)

 

There are several reasons including increased demand and an increase in private prescriptions.

We think that the shortage will last until at least April 2024 meaning everyone taking this medicine will be affected eventually.

Yes, you should where possible contact your GP when you have a month or less of your medicine left.

What if I have already run out?

If you have already run out of your GLP-1 and can’t get anymore, it is important to contact your GP practice as soon as possible. For some people, a doctor or nurse may decide with you, that this medicine can be safely stopped, and you don’t need an alternative.

For other people, an alternative will be needed, and a healthcare professional will agree with you what this should be. You should only change the medicine you take after you have spoken to a healthcare professional.

Will my GP practice contact me first?

GPs and other healthcare professionals may contact you first to discuss the medicines you are taking. There may also be changes you want to suggest, worries that are bothering you or questions that you want answered.

If your GP practice has not contacted you and you feel you need to talk to a healthcare professional, please call them or use one of the online booking request systems, available via your practice website, to ask for an appointment to review your medication.

Please note your GP practice may call you from an ‘unknown number’, please answer and check for voicemails. Your practice may text you as well. You should check that your contact details are up-to-date.

Yes, if the medicine is in date and has been stored correctly, you should continue to take it as normal.

No, you should only change the dose of your medicines or how often you take it, if your doctor, nurse or other healthcare professional tells you to do this.

 

  • Your healthcare professional will have looked at how well the medicine was working for you and decided that it does not help you as expected so has stopped prescribing this.
  • The medicine shortage means that your medication is not currently available, and it is safe to not take any medicine now, or an alternative may have been prescribed.

No, the NHS has asked doctors and nurses not to do this where possible as all products are affected by shortages.  It also means other people already prescribed the drug or dose will find it harder to get their supplies.

 

If you have run out, please do not attempt to get more from other areas as all areas across the UK are affected.

You should also avoid buying medicine privately or without a prescription. Buying medication without a prescription is not legal, even if you have previously had a prescription for the same medication.

There is also a risk that the medication may not be what it says it is. There is no guarantee that there will be a continued supply privately.

Yes, there is a shortage of all GLP-1s whatever they are used for. You should speak to the person prescribing your medicine to find out what you should do.

GLP-1s lower your blood sugar levels and reduce your appetite meaning you get better control of your diabetes and can lose weight.

If your blood sugar goes up, this could mean you are more likely to have problems caused by your diabetes. Please contact your GP practice or other prescriber to discuss this.

If you have lost weight, there is a chance that weight will be regained after stopping GLP-1 medicine. If you’re concerned about weight gain, please talk to your healthcare team to discuss alternatives.

Ask your doctor or nurse about free diabetes education courses. People who go on these courses often feel more confident about managing their diabetes, making healthier food choices, and looking after themselves.

Contact NHS 111 if you think you have high blood sugar and have one or more of the following symptoms:

  • you’re feeling sick, being sick or have stomach pain,
  • you’re breathing more quickly than usual or your heart is beating faster than usual
  • you feel drowsy or are struggling to stay awake (you should ask someone to stay with you),
  • your breath has a fruity smell (like pear drop sweets),
  • you feel confused or have difficulty concentrating,
  • you have a high level of ketones in your blood or pee (if you have previously been advised to test for this).

You are likely to need a review, even if you have already had one. This is so that a plan can be made for if, or when, you run out of medicine. Healthcare professionals, like GPs, pharmacists, specialist nurses and dieticians, are working together to review people’s needs.

Your GP practice will only ask you to come in for a review if they need to monitor your progress and discuss something with you. You might be asked to come in for a review before you run out of your GLP-1 so that they can discuss what you would like to do when you do run out of medicine.

 

Keep giving your child their GLP-1s as normal and try to obtain your next supply as normal. If you have run out of your child’s medicine and can’t get anymore, contact the team that usually looks after your child’s diabetes care, and they will agree with you what the best option for your child is.

Children taking this medication are usually looked after by a specialist hospital doctor, known as a consultant, and their team. Together, they help manage a child’s diabetes and agree all treatments with parents / guardians.

Although these medicines can help people manage their type 2 diabetes; it’s important to have a healthy diet, exercise, quit smoking, and cut back on the alcohol you drink. Together, these actions can help lower your blood sugar levels and support you to live well with diabetes.

Most adults living in Greater Manchester can access their own diabetes data on their GP record by registering for the Greater Manchester Diabetes My Way service. Or, contact england.diabetesmyway@nhs.net for more information.

It’s free to use and provides additional advice, support, resources and e-learning packages.

If you have any concerns, you can speak to your GP practice, pharmacy or the person who normally looks after your diabetes care.

 


Medicines prescribed for ADHD

The NHS is currently facing a national shortage of medication prescribed to help manage ADHD symptoms. This information has been put together by pharmacists, GPs and other health professionals to help answer any questions you may have.

Anyone affected should follow the advice of a healthcare professional.

This is a national supply problem. All services, including children’s and adults’, are affected as well as community and hospital pharmacies.

The medicines affected are:

  • Methylphenidate prolonged-release capsules and tablets
  • Lisdexamfetamine capsules
  • Guanfacine prolonged-release tablets

There are also on-going shortages of the Atomoxetine capsules and liquid.

The supply disruption of these medicines is due to some manufacturing issues and increased global demand.

Some medicines are expected to be unavailable until at least April 2024.

However, the situation is constantly changing therefore please check current stock availability with your local pharmacy.

If one pharmacy is unable to obtain the medicine you usually take, please try a different pharmacy.

You can find pharmacies in your local area on the NHS website.

Pharmacies may use different suppliers and wholesalers to source medicines so availability will depend on their stock levels. Please try visiting or calling independent pharmacies as well as the larger pharmacy chains, as their suppliers will differ.

Where there is a known shortage of a medicine, supply levels can change quickly. This is why pharmacies in one area may be able to find a medicine and others may not.

Alternatively, it may be preferable to leave the prescription with a pharmacy that could check wholesaler stock levels daily and place an order. If the medicine remains unavailable, then an alternative medicine may need to be prescribed. Consult your GP practice or ADHD service as soon as possible if you cannot get your prescription from the pharmacy.

Please do not buy medicines from the internet or from abroad as these may be out of date, diluted or fake and could be dangerous to your  health. Buying medication without a prescription is not legal, even if you have previously had a prescription for the same medication.

Other ADHD products remain available. They may not be suitable for everyone and may not be able to meet the increases in demand.

We know how important getting your medicines is. Your doctor or pharmacist will be happy to talk to you about your medicines and to explain why getting your medicine may be difficult now.

You may be offered the choice between taking a treatment break or changing your medication to one that is not currently affected by the supply shortage.

The change in medication may mean you are taking medication more often through the day, or that they are tablets instead of capsules.

Your specialist team will liaise closely with your GP and work together to minimise disruption. There may be temporary changes to how and where you collect your prescription/ medication.

Once the supply shortage has been resolved your medication will be changed back to the medicine you were previously prescribed, as appropriate.

Please be aware that there may still be delays at pharmacies in obtaining the newly prescribed medication.

Please consult your GP practice or ADHD service for guidance if you think you are running out of medication and cannot obtain a supply.

National treatment guidelines recommend having regular treatment breaks from ADHD medications. It is not unusual to stop taking medication over the weekend or during school holidays.

Therefore, it is unlikely any harm should come from stopping the medication, but this should be done in a planned way.

If you are prescribed Guanfacine (Intuniv) please contact your ADHD service and this medication must be stopped slowly as it can cause your blood pressure to increase if stopped suddenly.

Consult your GP or ADHD service as soon as possible if you cannot get your prescription from the pharmacy.

These websites have information that might be useful in helping you manage your condition and any changes in symptoms because of the medication shortage:

If you have any concerns, you can speak to your GP practice, pharmacy or the specialist ADHD service you attend.

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