Managing ADHD medicine changes

Methylphenidate is a tightly controlled medicine in Aotearoa New Zealand, so when supply problems occur, it’s not easy to get extra stock or switch brands quickly.

There are several formulations and strengths available, and they're not easily swapped from one to another because they can work differently for each person. Supply issues are challenging, but your pharmacist and prescriber will do their best to find a safe and effective option for you.

If your medicine is out of stock

Talk to your pharmacist or prescriber. They can work with you to help manage your treatment. For example, they may:

• Find out when your medicine will be back in stock: They may be able to check with suppliers. Sometimes delays are short, so your brand may be available soon.
• Use available strengths to supply your prescribed dose: If another strength of your usual formulation is in stock, they may combine units to provide the same prescribed dose.
• Switch to a different brand or formulation of methylphenidate: This could mean changing from a long-acting to a short-acting form (or vice versa) or switching to a different brand. Read more below on what to expect when switching to a different brand or formulation of methylphenidate.
• Consider other stimulants: They may suggest alternatives like dexamfetamine or lisdexamfetamine if appropriate.
  
  

If you're given only a partial amount, until stock arrives

If the pharmacy doesn’t have enough of your medicine, they can give you part of your prescription if some is available. The rest will be given to you when they get more stock, as long as it’s within the legal time frame allowed for your prescription.

• The remaining medicine must be collected from the same pharmacy once it’s ready.
• The pharmacy can’t transfer the remaining medicine to a different pharmacy. This is because pharmacy computer systems don’t allow repeat supplies of any medicine to be given from different pharmacies.
  
  

If your repeat prescription is affected

Your healthcare provider can write a prescription for methylphenidate for up to 3 months’ supply. However, the pharmacy can only give you up to 1 month’s supply at a time. This is called a repeat supply. Sometimes your healthcare provider might limit how much you get and how often, based on your situation.

• After you get your first supply of methylphenidate from a pharmacy, all remaining repeat supplies must be picked up from the same pharmacy.
• This is because pharmacy computer systems don’t allow repeat supplies of any medicine to be given from different pharmacies.
• If you need to switch to a different pharmacy, you’ll need a new prescription. Your prescriber can help you with this.

For many people, switching brands or formulations of methylphenidate is straightforward, but some may notice differences and need extra support during the transition. Here are a few things to expect.

Differences in how the medicine is released

• Different brands or formulations of methylphenidate may release the medicine into your body at different speeds, start working sooner or later, or last for different lengths of time. Read more about methylphenidate formulations and brands.
• You might notice changes in how well your symptoms are controlled, or changes in side effects such as appetite, sleep, or mood.
• Your prescriber may adjust your dose, the time of day you take the medicine, or how often you take it to help achieve the best effect.
• Tip: Keep a daily record of how you feel to discuss at your next appointment.
  
  

Need for a new prescription

• If your brand, strength or formulation changes, your prescriber may need to write a new prescription.
• This is because methylphenidate is a tightly controlled medicine, and pharmacists must supply exactly what's written on the prescription.
• There may be a short delay while a new prescription is arranged.
• Let your prescriber know as early as possible if your medicine is running low so they can help avoid gaps in treatment.
  
  

Monitoring and adjustment period

• You may need more check-ups after switching to make sure the new medicine is working well and side effects are managed.
• A short adjustment period during the first few days or weeks is common.
• Watch for changes in how you feel, such as differences in symptom control, side effects, or energy levels.
• Be sure to let your prescriber know if you notice any new or worsening side effects, changes in how well the medicine is working, or any concerns about how it makes you feel. Adjustments can often be made to improve how well the medicine works for you. If symptoms are severe, ongoing, or worrying, contact your healthcare provider straight away.
  
  

Special Authority changes

• There are two Special Authorities for methylphenidate, depending on the brand. One approval is for brands that are usually tried first and are lower cost such as Ritalin (immediate release), Rubifen (immediate release), Rubifen SR, Methylphenidate Sandoz XR and Methylphenidate ER – Teva.
• A separate approval is needed for other brands, such as Concerta and Ritalin LA, that cost more or are generally used if the first options haven’t worked well or aren't suitable. 
• Switching to a different brand within the same Special Authority category does not require a new application. However, changing to a brand in the other category does require a new Special Authority application.

For more detailed information, read about how methylphenidate is prescribed and dispensed in New Zealand.

Adjusting to your new methylphenidate

• Take your medicine as advised: Always follow the advice of your healthcare provider and the instructions that come with your new medicine. Make sure you know how to take it. Different brands of methylphenidate tablets and capsules may have different instructions.
• Keep track of how you feel: Keep a daily record of your symptoms, mood, appetite, and sleep because your symptoms and side effects can change from day to day or throughout the day. This record can help you notice patterns or triggers and makes it easier to talk about with your healthcare provider.
• Be patient during the change: Different brands may be absorbed slightly differently or have different inactive ingredients, so it might take a few days or weeks to adjust.
• Contact your healthcare provider if you notice any new or worsening side effects, or if your symptoms don't seem controlled with the new medicine. Don’t stop or change your doses on your own. Check with your healthcare provider first.
  
  

Getting support in daily life

Managing changes to your methylphenidate medicine can affect different areas of your life, including work, study, and relationships. Talking with your family, close friends, or support networks can make the change easier.

• If you’re studying, inform your tutors or support team about any problems you may be experiencing with medicine changes so they can offer flexibility and additional support if needed.
• At work, consider discussing the change with your manager or support person to help set clear expectations.
• If necessary, ask your prescriber for a supporting letter to provide documentation for any adjustments you may require.
• Consider reaching out to support groups or organizations such as ADHD NZ(external link) where you can connect with others who understand what you’re going through and find helpful resources.
  
  

Supporting your child if their medicine has changed

Changes in medicine can also affect your child’s school and social life. To support them during this time:

• Let your child’s teachers or school support team know about the medicine change so they can provide flexibility or additional support if needed.
• Talk to your child about the change, encouraging them to share how they feel.
• If your child is struggling, discuss possible adjustments with your child's prescriber. You can also request a letter from them if the school or other activities require documentation.