We have been made aware that desmopressin 10 microgram/dose nasal spray is out of stock, with an anticipated re-supply date of early September 2025.

There are alternative preparations of desmopressin medication that are widely available, including:

• Desmopressin 100 and 200 microgram tablets
• Desmopressin sublingual tablets
• DDAVP Melt oral lyophilisates (60, 120 and 240 microgram)

The switch from the nasal spray to an oral formulation should be overseen by your endocrinology team. Contact your endocrine team before you run out of supply to ensure that an appropriate alternative (including appropriate dose) is recommended to your GP for prescribing.

The Pituitary Foundation very much understand the concern that this supply issue is causing for our community. We are monitoring this and will be updating our website with any further news that we receive.

What is desmopressin?

Desmopressin is a medication used for the treatment of AVP deficiency. You can read more about what desmopressin is, and how it is used, on our AVP deficiency treatment page.

We’ve been told that from February 2025 to May 2026, there will be a shortage of hydrocortisone sodium phosphate injection.

If you are renewing supplies for your emergency injection kit during this time, you will need to ask for a prescription of hydrocortisone sodium succinate 100 mg powder for solution for injection/infusion, which will be available for patients during the shortage. 

How to order the alternative form

If you need to order a new emergency kit then you should ask your GP to issue a prescription for the alternative form of injectable hydrocortisone. For NHS prescriptions it is necessary to give the generic name which is: 

• Hydrocortisone 100 mg Powder for Solution for Injection or Infusion 1x2 ml – vial with diluent (previously known as Solu-Cortef), by Pfizer
• Those outside the UK (Ireland, Europe and Americas) may also be able to obtain the Act-o-Vial preparation, containing hydrocortisone sodium succinate and water in a chambered ampoule

How to use Hydrocortisone 100 mg Powder for Solution for Injection or Infusion

This form of hydrocortisone is a powder so needs to be mixed with the sterile water solution prior to use. 

The video below shows how to make up this injection type, but we would recommend asking your GP or endocrine nurse for support with this. 

If you have any concerns or more questions about what the drug shortage might mean for you then please contact our nurse helpline. 

Below you can find an overview of:

• What your emergency hydrocortisone injection kit should contain
• Where you can get needles and accessories from
• How to dispose of used needles
• General tips for injection

Each emergency kit should contain:

• An intramuscular hydrocortisone injection
  • premixed hydrocortisone sodium phosphate 100 mg/1 ml (1 vial), or
  • hydrocortisone sodium succinate 100 mg powder and 1 ml water for injection (from a 5 ml or 10 ml vial)
• Two blue needles
• Two 2 ml syringes
• Written instructions in an easy-to-understand format (for example, with diagrams or pictures) on how to prepare and give emergency intramuscular hydrocortisone and how to safely dispose of needles and syringes
• Steroid emergency cards
• Glucose gel (only for babies, children and young people under 16)
• One orange needle and a 1 ml syringe (only for babies under 1 year)

The newly-released NICE guidelines (NG 243) give instructions on what the emergency kits should contain.

Sizes and colours of needles

• 21 g x 1.5 inches 0.8 mm x 40 mm (green) for drawing up the solution
• 23 g x 1 inches 0.6 mm x 25 mm (blue) for administering the injection

Ensure you have enough needles for each injection, plus a spare

Where can you get your needles and accessories from?

It is your endocrine unit’s responsibility, working together with primary care, to ensure you have all the items described by NICE in the emergency pack.

Disposal of used needles

Sharps disposal boxes and clippers: There are different schemes and arrangements in place for the safe disposal of your sharps disposal box once it is full. Schemes vary from nation to nation and even down to the locality, and your local NHS healthcare provider should have information about local disposal methods.

General tips for injections

• Check the expiry date of the hydrocortisone solution
• Wash your hands before preparing your injection
• Always use a new, sterile needle and where possible use a separate needle to draw up solution prior to changing needle for administration
• Check for air bubbles
• Choose injection site
• Take your time
• Watch this video showing you how to inject

Find our hydrocortisone injection boxes here!