Following sign-off by the Dorset Formulary Working Group, Mental Health Working Group, GP Alliance and Integrated Medicines Optimisation Committee (IMOC) it has been agreed that:
Patients prescribed methylphenidate MR tablets can be switched to Xaggitin XL or Affenid XL tablets.
Using a slow and co-ordinated approach, GP teams are asked to work with community pharmacy and secondary care, to return to the branded prescribing of Methylphenidate modified release tablets.
Xaggitin XL and Affenid XL are now the first line branded formulary choice of Methylphenidate modified release tablets.
Concerta brand of methylphenidate has now been made non-formulary in Dorset.
Best practice guidance states to prescribe methylphenidate MR products by brand where possible.
The previous long standing manufacturing supply shortages associated with branded preparations of Methylphenidate MR tablets have now been resolved. It is anticipated that stocks will be normalised from January 26.
The proposed prescribing changes will reduce the cost of ADHD medications to the system, increasing capacity to treat patients and provide wider access.
- Please ensure a gentle transition to branded products, to reduce the risk of disruption to supply chains.
- Notify community pharmacy colleges of the intention to revert to branded prescribing of Methylphenidate MR tablets.
- Work with community pharmacy colleagues to ensure sufficient stock of the branded products is available to support the switching programme and minimise disruption to patients, GP and community pharmacy teams.
- Identify people prescribed generic methylphenidate MR tablets or Concerta branded MR tablets using the SystmOne search provided, (excluding any patient noted by specialist teams to require Concerta XL because of failure on all other formulary brands of MR methylphenidate tablet.)
- Use the patient text messages and letters within SystmOne to notify people of a change to their methylphenidate MR prescription.
- SystmOne search: Dorset SystmOne GPs> PQS Finance 25/26> F14 Methylphenidate
- Template patient letter – in SystmOne communications annexe
- Template patient text message – Template patient letter – in SystmOne communications annexe
"Dorset Specialist Clinicians have asked GP teams to the review prescribing of Modified Release (MR/XL) methylphenidate tablets and convert them to the Xaggitin XL or Affenid XL branded Methylphenidate modified release tablets. Your prescription has been updated. Your medicine may look slightly different, but these products are clinically interchangeable and help the NHS budget treat more patients. If you would like to discuss this change further, please contact NHS Dorset on customer.careteam@nhsdorset.nhs.uk"
