Drug Shortage Causes & What To Do

If you've been told by your pharmacist that there is an issue filling your prescription, this can be due to temporary local issues. This does not necessarily mean there is a national shortage or drug supply problem. The majority of enquiries we receive from our community on this topic, are resolved at a local level within a couple of days when the correct questions have been asked, so please be reassured there is a solution to help you. 

Please read on for next steps on what to do if you find yourself in this situation, and how we can support you.

Why do drug supply problems happen?

Often it’s about getting the medication out to Pharmacists

In the UK there are only a couple of medication wholesalers and less than 40 warehouses serving the whole country. When your pharmacist says they are unable to order items it’s understandable to assume there is a shortage. Usually, however it is the local depot that has run out – there could still be a supply somewhere else in the supply system. Your pharmacist won’t stockpile items, and will most likely order items frequently instead. Often it’s only when the pharmacy puts in an order that they discover there is a supply problem.

Sometimes there’s a surge in demand

When other medications are in short supply, alternatives are highly sort after. This can lead to knock-on shortages of alternatives.

Occasionally it’s about issues with manufacturing the medication

There are many reasons that manufacturers might stop making a medication, temporarily or otherwise. Ingredients may be in short supply or suddenly too expensive. Legal or licensing problems may also halt production. India and China are the main countries supplying raw pharmaceutical materials.

What to do if you've been told there's an issue supplying your medication

Double-check with the Pharmacy

If your pharmacy says they are currently unable to fulfil the prescription please ask why this is - this will significantly speed up the charity then investigating why there may be an issue.

The pharmacy may be unable to fulfil the prescription due to an issue with the wholesaler having difficulty getting hold of the medication, or a temporary local short supply issue due to a surge in demand. Most commonly we find issues are temporary local issues.

Asking your pharmacist for the exact reason, rather than a general "we can't get hold of it at the moment", allows the ADSHG to give the pharmaceutical companies the information they require to look into why a certain wholesaler is unable to supply a pharmacy at that moment in time. 

We have found that when members ask these further questions to the pharmacist, this then prompts the pharmacist to look further into it and will often resolve it with you directly. 

If you are still unable to get hold of the issue please get in touch with the following information: your pharmacy location, the detailers of the wholesaler your pharmacy has been unable to get the medication from and the type of medication. It is vital we have this information, otherwise we will be unable to look into the issue.

This can be a draining, stressful experience. If this impacts your mental health and well-being, please read our stress article for further emotional support or reach out on our online forum.

Try another Pharmacy

Remember that your green (FP10) prescription is your property. If a pharmacy cannot fulfil your prescription, ask for the prescription back and take it to another pharmacy. Generally, try a bigger pharmacy, but don’t ignore that some smaller or independent pharmacies with knowledgeable pharmacists may have good stocks.

How to manage your Addison’s or adrenal insufficiency during a supply issue

3 months reserve supply of essential steroid medicine

Due to the Sick Day Rules it is necessary to always have 3 months reserve supply of your essential steroid medicine. This is to ensure you have enough to keep you safe through an episode of illness which requires increased dosing, or to cover if there is a shortage of your medicine. During COVID, this has become even more important to prevent an acute adrenal crisis.

The provision of a reserve supply of steroid medication is standard practice for the prevention of an acute adrenal crisis. It is the advice given in the NICE Guidance: Adrenal insufficiency: identification and management, the ADSHG Clinical Advisory Panel, Society for Endocrinology, and the NHS. 

Alternative medication

Hydrocortisone

In the event of being unable to access hydrocortisone tablets, patients with steroid dependency should be able to swap temporarily to prednisolone tablets. Prednisolone has a longer half-life in your body than hydrocortisone, and many people with steroid dependency will be able to stay well just taking one morning dose of Prednisolone.

For more detailed information on cortisol replacement medication, including doses, times of day to take your medication, and which medication is right for you, visit our cortisol replacement page.

Cortisol replacement medication

Fludrocortisone

In the event of a temporary interruption to the fludrocortisone supply, you should immediately start to add extra salt (normal table salt, sodium chloride) to your diet, or some people prefer to take electrolytes. However the recommendation is to eat real table salt, not ‘Lo salt’, as the low salt products contain potassium which will not help your salt (sodium) deficiency.

Signs you need more salt include (but are not limited to): light-headedness, feeling constantly washed-out, or weak, cramps and spasms in the legs, lower back and abdominal pain. Normal dietary advice to avoid too much salt in your diet does not apply to people with primary adrenal insufficiency (Addison's disease), and these important symptoms and feelings should not be ignored. If you continue to feel unwell, increase your hydrocortisone dose immediately and contact a medical professional.

Fludrocortisone

Liquid Hydrocortisone Injection

There are two types of hydrocortisone available for use in adrenal crisis:

• Hydrocortisone sodium phosphate 100mg (1ml liquid ampoule), or
• Hydrocortisone sodium succinate 100mg Powder for Solution for Injection or Infusion 1x2ml - vial with diluent (previously known as Solu-Cortef),

The Department of Health and Social Care (DHSC) has confirmed a shortage of one of these medications: hydrocortisone sodium phosphate. The shortage began at the end of February 2025, and supply is expected to resume in May 2026.

The alternative injection medication, hydrocortisone sodium succinate 100mg powder, will work in exactly the same way in your body, but comes in a different format. Many of you will have used it before and be familiar with it. The alternative is called:

‘Hydrocortisone sodium succinate 100mg powder for solution for injection or infusion 1x2ml - vial with diluent’ (previously known as Solu-Cortef)

We have been working with the DHSC and clinical colleagues in the NHS, alongside fellow patient support groups who are also affected: The Pituitary Foundation (UK), Living with CAH and Alex TLC.

ADSHG members have been speaking about difficulties receiving their hydrocortisone sodium phosphate prescription, so if you'd like to speak with others who understand, please visit the forum to join the conversation

If your injection drugs are reaching their expiry date, please read the medical advice in the News item on our website. We talk you through the alternative injection, the training materials and the further support available if you have any concerns.

Read more: Injection Shortage Alert

Visit our Online Forum

On our forum, we have a dedicated section called "Medication supply and availability issues" where members can report any issues they face about shortages of any of the pharmaceuticals and supplies they need to manage their Addison’s and adrenal insufficiency. Please visit our forum if you have any issues as often this can supply you with an instant solution, advice or reassuring information.

Visit the Online Forum

Please stay in contact and let us know if you need additional advice or if you find medication shortages in your area. We aim to provide educational and supportive resources to help you feel empowered, support your patient self-advocacy, and receive the medical care you need.

Stress of a long-term condition

How to reduce stress and resources to help you.

Online Forum

Speak with others who have Addison's and adrenal insufficiency.

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