Methylphenidate ER tablets (Concerta and Teva): Supply issue

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 are working to list an alternative medicine, lisdexamfetamine (Vyvanse), from 1 December 2024. 

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.  

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

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.

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

We are currently consulting on removing the renewal criteria for stimulant medicines from 1 December 2024. 

Proposal to remove the renewal criteria for stimulant treatments

We have also consulted on funding lisdexamfetamine (Vyvanse) from 1 December 2024.

Proposal to fund lisdexamfetamine for Attention Deficit Hyperactivity Disorder (ADHD)

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.

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.

Substituting between brands of methylphenidate ER (Concerta and Teva):

• A new prescription is not required
• A new Special Authority is required – 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.