Adderall, antibiotic shortages likely to continue into 2023, Colorado pharmacist says

Coloradans should prepare for shortages of common antibiotics and psychiatric medications to last into the new year and take steps to find replacements if needed, a pharmacist said.

The U.S. Food and Drug Administration lists 125 medical products with shortages, ranging from an asthma drug to vials of sterile water at certain sizes. The ones that affect the most people are shortages of Adderall, which treats attention deficit hyperactivity disorder, and the antibiotic amoxicillin, said Dr. Kelsey Schwander, a clinical pharmacist at the University of Colorado Anschutz medical campus.

Both drugs have reasonable alternatives, but not all medications in the same class work equally well for all people, Schwander said. Still, it's better to have a planned switch to a different drug or different dosing plan than to run out of medication unexpectedly, she said.

In the case of Adderall and its generic equivalents, some dose sizes remain available, while others are backordered, according to the FDA's website. Some other types of amphetamines don't have a shortage, so doctors may advise their patients to switch if they can't get the drug they typically used.

People who know they will need Adderall or other stimulant drugs on a regular basis would do well to set up automatic refills with their pharmacy, so it can anticipate the need and reach out if there's a supply problem, Schwander said. If you don't have automated refills, it's a good idea to reach out to the pharmacy when you have about four days' worth of medication left, so you have time to check with other pharmacies or to call your doctor if a switch is necessary, she said.

"It's a controlled substance, so it's a little more complicated to switch" than with some drugs, she said. "Doing it the day before, the day of (running out of pills), you're probably not going to walk away with a different medication."

Unlike Adderall, amoxicillin isn't a drug that people typically plan to use for an extended time, making it harder to plan ahead. Still, people can save themselves some driving by calling ahead to their preferred pharmacy, and maybe a few others, Schwander said. If they don't have it in stock, the pharmacist may be able to suggest some alternatives for the prescribing doctor to consider, she said.

Of five companies that produce amoxicillin powder to be mixed into a liquid, only one reported its supply wasn't constrained, according to the FDA. One said it could only serve current customers; two were shipping the drug based on an allocation plan from the FDA; and one said it would have a limited supply through the first quarter of next year.

The early and relatively severe respiratory virus season may be contributing to the amoxicillin shortage, since it's commonly prescribed for secondary bacterial infections that settle in alongside a virus, Schwander said. But many of the shortages have common roots, as the pandemic disrupted manufacturing overseas and drugmakers struggle to hire enough workers. And a shortage of one product can cause increased demand for similar medications, creating shortages of still more drugs, she said.

"Unfortunately, there's no quick fix," she said. "I don't think these drug shortages are going away, and they may get worse."