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 that there is a solution to help you.
Read on for the 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 fewer 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 sought 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
How to manage your Addison’s or adrenal insufficiency during a supply issue
Maintaining a 3-month reserve supply of essential steroid medicine
To enable you to follow 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.
The provision of a reserve supply of steroid medication is standard practice for the prevention of an acute adrenal crisis.
For further information to share with your GP or prescriber, visit our Prescription Frequency article and/or use our Prescription Frequency letter template to send to your GP.
Prescription frequency letter template
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 medication page.
Fludrocortisone: For those with Addison's disease (primary adrenal insufficiency)
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 that will not help your salt (sodium) deficiency.
Signs that 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.
More information on Fludrocortisone
Emergency hydrocortisone injection
Following the discontinuation of liquid hydrocortisone (hydrocortisone sodium succinate) in May 2026, there is currently just one form of hydrocortisone (powder) available for the emergency injection: ‘Hydrocortisone sodium succinate 100mg powder for solution for injection or infusion 1x2ml - vial with diluent'
The ADSHG are advocating for, and working with the DHSC to facilitate an improved emergency injection process for the future.
You may also be interested in:
- 'Speak' to others who understand (members-only): explore the medication 'topic' on our online community platform.
- It can be stressful managing a long-term condition, with concerns about medication supply and risks of adrenal crisis. We have resources to help support you.
- If you need a refresher on the emergency injection, your kit, re-stocking items, or how you can feel better prepared in case of an emergency, visit our injection page.