Methylphenidate ER tablets (Concerta and Teva): Supply issue

Supply status

There remains a New Zealand-wide shortage of extended-release methylphenidate. There is currently no supply of Methylphenidate Teva – ER with the supplier. Further shipments of this brand are planned.

Suppliers and wholesalers are limiting the amount of stock going to pharmacies. As such, your pharmacist may not have any stock. Please be patient.  

We expect some people may not be able to access their medication and alternative treatments will be needed. 

People who take methylphenidate extended-release

You may not be able to get your brand or strength of methylphenidate. 

It is hard when the medicine you are taking is not available – we want you to know that Pharmac is doing everything we can to improve the situation. For example, we have listed an alternative medicine, lisdexamfetamine (Vyvanse), from 1 December 2024. 

You will need to see your prescriber

If you are currently taking an extended-release brand of methylphenidate, and your prescribed strength or brand is not available, you will need to talk to your doctor. Your doctor will talk to you about your options, including whether you should be prescribed a different brand of methylphenidate. 

There are other brands of methylphenidate available, including long-acting, sustained-release, and immediate release options. To access them, your doctor will likely need to get you a new special authority. 

We expect that the supply issues with the Teva and Concerta brands of methylphenidate will last for a while, potentially until the middle of 2025.

Prescribing health care professionals

From the end of August, Pharmac is expecting gaps in both the Teva and Concerta brands of extended-release methylphenidate. This means there will be times when both brands will be unavailable.

Consider writing methylphenidate prescriptions generically. This will enable the pharmacist to substitute whichever brand is available. 

You will need to consider the best alternative for your patient. We anticipate that the GP and nurse practitioner workforce may need to move some people from extended-release methylphenidate to other methylphenidate presentations (with different release characteristics), with clinical advice from psychiatrists or paediatricians, as needed.

We are asking that you do not start people with ADHD on either the Teva or the Concerta brands of extended-release methylphenidate unless it is necessary.

We have received clinical advice, which can be used at your discretion:

• There is information outlining dose equivalence and release profiles of methylphenidate presentations available. 
• For people new to ADHD treatments: please do not start any new patients on extended-release methylphenidate unless absolutely necessary. Instead consider alternative, shorter duration, methylphenidate formulations:
• The 8-hour formulations Ritalin LA or Rubifen SR brands of sustained-release methylphenidate may be used by some patients. 
• Immediate release methylphenidate may also be used by some patients.

Detailed clinical advice (Sept 2024) [PDF, 185 KB]

For people who are currently treated with an extended-release methylphenidate: 

Make an individual case-by-case decision. You may wish to consider the following:

• Can the patient/parent/carer liaise with their usual pharmacy to establish whether they are expecting deliveries of their required strength of methylphenidate?
• Is the patient’s prescribed strength anticipated to have an upcoming shortage? 
• Is a treatment break an option?
• Is an alternative formulation of methylphenidate an appropriate interim measure?  
• Is an alternative formulation appropriate to switch to over a longer period?
• Do they have the appropriate special authority approval? 

Legal requirements for prescribing and Special Authority applications for GPs and nurse practitioners

The regulations outline that, legally, any registered medical practitioner or nurse practitioner may prescribe methylphenidate products for ADHD, when acting on the written recommendation of a registered psychiatrist or paediatrician. 

Restriction on the Supply of Methylphenidate—Approval to Prescribe, Supply and Administer (Approval No.: 2015/AP001) - 2015-go760- New Zealand Gazette(external link)

Medsafe has confirmed that this approval notice, issued under regulation 22 (Misuse of Drugs Regulations), applies broadly to the chemical ‘methylphenidate’– not to a specific presentations or brands of methylphenidate.

This means

• the legal requirements to prescribe a methylphenidate presentation are satisfied regardless of whether the specialist recommendation was written for ‘methylphenidate’ or for a specific presentation of methylphenidate. 
• GPs and nurse practitioners can legally apply for an alternative Special Authority for a methylphenidate presentation if needed, provided that all other relevant eligibility criteria are met.

This relates to the legal situation only. From a clinical perspective, GPs and nurse practitioners may still need specialist advice to change presentations of methylphenidate. 

If you are unsure if your patient has a special authority for the presentation/brand, you can call Sector Operations 0800 855 066

Removing renewal criteria and listing lisdexamfetamine

From 1 December, we have removed the renewal criteria for all ADHD treatments and listed lisdexamfetamine.

Decision to fund lisdexamfetamine for attention deficit hyperactivity disorder (ADHD)

Decision to remove the renewal criteria for stimulant treatments

Thank you

We appreciate your support in helping manage this supply issue. We acknowledge the disruption changing medicines can cause and the additional workload this creates for you and your colleagues.

Advice for pharmacists

If you are unable to source stock of methylphenidate extended-release, you will need to advise affected people to talk to their prescriber about the best alternative for their situation. Please advise them that they may need to pay for an appointment.

People who need to change to an alternative presentation of methylphenidate will need:

• A new prescription
• A new Special Authority – different presentations of methylphenidate have different Special Authority numbers. Check the person has the correct Special Authority for the brand you are dispensing.

The person’s usual GP or nurse prescriber can write this prescription and apply for a Special Authority. The specialist recommendation required only applies to the chemical ‘methylphenidate’, rather than specific presentations.

Because this is a controlled drug with special authorities, when substituting between brands of methylphenidate ER (Concerta and Teva):

• A new prescription is required where a brand is given 
• A new prescription is not required where a prescription is written generically
• A new Special Authority may be needed – check the person has the correct Special Authority for the brand you are dispensing. Concerta and Methylphenidate ER-Teva have different Special Authority numbers.

A5 flier for patients to support your conversations [PDF, 110 KB]

Thank you

We appreciate your support in helping manage this supply issue. We acknowledge the disruption changing medicines can cause and the additional workload this creates for you and your colleagues.

About this supply issue

There is global shortage of ADHD medicines, including methylphenidate extended release. Demand has increased rapidly here and overseas. Demand has increased 140% in Aotearoa over the last two years

Pharmac is expecting gaps in supply of both Concerta and Teva brands of extended-release methylphenidate throughout 2024 and into 2025. 

We’re anticipating that during these supply gaps, some people will not be able to access their brand of extended-release methylphenidate.  

Background

There have been ongoing worldwide shortages of methylphenidate since the COVID-19 pandemic. These shortages have been caused by a global increase in demand, import/export challenges, manufacturing constraints, and quota limits. 

In September 2023, the supplier, Teva, alerted Pharmac to a supply issue for all strengths of Methylphenidate ER - Teva brand extended release methylphenidate. This was due to a global increase in demand. To make sure people could continue to get methylphenidate, we worked with Health New Zealand to issue Special Authorities so people could use the Concerta brand of extended release methylphenidate. 

In March 2024, the supplier, Janssen, alerted Pharmac to a supply issue for all strengths of Concerta brand extended release methylphenidate. We worked with Health NZ again to make changes to Special Authorities so people prescribed Concerta could use the Methylphenidate Teva ER brand of extended release methylphenidate. 

To manage this supply issues we have previously issued relevant Special Authorities so people could use either brand of extended release methylphenidate. The last time this was undertaken was in March 2024. 

There is now anticipated shortages of both brands and we expect some people may not be able to access their medication and alternative treatments will be needed. Because there is not enough, we are not considering further issuing of Special Authorities to manage this supply issue. People will need to talk to their prescriber about an alternative.

Who to contact

If you take methylphenidate, talk with your doctor, nurse, or pharmacist if you have any questions about this supply issue.

If you have questions about the funding of methylphenidate, email enquiry@pharmac.govt.nz

Please include as much information as you can about the product (presentation, brand, pharmacode) and who your wholesaler is.  

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