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You're standing at the pharmacy counter and hear the words "Your medication is currently out of stock" — and suddenly you're wondering how your treatment is supposed to continue. The good news: in the vast majority of cases, there is a way forward. This guide shows you the concrete chain of steps when a medication is out of stock — and what you'd better not do on your own.
Set up your medication plan in brite — with active ingredient, dosage and pack size. That way, if there's a shortage, you'll quickly find the right alternative. Free of charge.
A supply shortage (Lieferengpass) means a particular preparation is temporarily unavailable or only available in limited quantities. That's different from a true supply crisis (Versorgungsengpass), where an active ingredient becomes scarce overall — which is far less common. In most cases only one specific product from one manufacturer is missing, while the same active ingredient remains available from other companies or in other pack sizes.
The causes are varied: production problems, supply chains that depend on just a few countries, quality defects in a single batch, a sudden surge in demand (for example during cold and flu season) or economic reasons. For you as a patient, the cause is usually secondary — what matters is that there is almost always a workable substitute. That's exactly what this guide is about.
The Federal Institute for Drugs and Medical Devices (BfArM, Germany's national medicines regulator) maintains a public shortage register in which reported shortages can be looked up. In everyday life you don't need to search it yourself — your pharmacy knows the current situation and the available alternatives precisely.
When a medication is out of stock, the pharmacy and the practice work through a fixed sequence. You don't have to organise these steps yourself — but it helps to understand what happens so you can ask the right questions.
| Step | What happens | Who |
|---|---|---|
| 1. Same-ingredient preparation | Swap for a generic with the same active ingredient and the same strength (Aut-idem) | Pharmacy |
| 2. Different pack / form | Different pack size or, for example, a tablet instead of a capsule | Pharmacy |
| 3. Import / individual import | Sourcing an identical preparation approved abroad | Pharmacy |
| 4. Prescription change / alternative ingredient | Switch to a different, therapeutically suitable active ingredient | Practice |
In practice the matter is usually resolved after step 1: the pharmacy dispenses a generic with the same active ingredient, and you carry on with your treatment as normal. Only if even that isn't possible do the further stages come into play.
The most common and simplest route is the swap for a preparation with the same active ingredient. Almost every active ingredient is offered by several manufacturers. If one company's product is missing, the identical active ingredient is often still available from another company — just under a different name and in different packaging.
The term for this is Aut-idem (Latin for "or the same"). If the Aut-idem box on your prescription is not ticked, the pharmacy is allowed to dispense an equivalent preparation — and during supply shortages there are even relaxed special rules for this. Good to know: a generic contains the same active ingredient in the same amount and works the same way. Any differences are at most in appearance, colour or the excipients (inactive ingredients). You can read more in the guide Generics vs. original.
brite records the active ingredient and dosage — even when the name and appearance change.
If your usual preparation isn't available in the usual pack, it sometimes helps to look at other pack sizes or dosage forms. Perhaps the pack of 100 is sold out but the pack of 50 is available. Or, instead of the usual tablet, there's a same-ingredient capsule, drops or an orodispersible tablet.
Here too the rule applies: the pharmacy checks this within its special rules and coordinates with the practice if needed. What matters is that the active ingredient and strength stay the same. If the strength changes (e.g. two 50 mg instead of one 100 mg), have the new way of taking it explained to you precisely — this is where most everyday misunderstandings occur.
If a preparation isn't available in Germany at all, the pharmacy can, under certain conditions, import an identical product approved abroad. For rare or special medicines this is called an individual import (Einzelimport). This usually takes a little longer — which is why it makes sense to raise a foreseeable shortage early, rather than waiting until the last tablet.
For you, nothing changes about the active ingredient. However, the packaging and the package leaflet may be in another language. In that case, have the way of taking it explained at the pharmacy and ask for a German-language patient information leaflet.
Only when no same-ingredient substitute and no import are possible does the practice come into play. In that case a different, therapeutically suitable active ingredient can be prescribed — for example another blood-pressure medication from the same group. This is a medical decision, because the effect, dosage and possible interactions have to be weighed up again.
Sometimes the pharmacy calls the practice itself and sorts out the prescription change directly — so you don't necessarily have to make an appointment yourself. Feel free to ask at the pharmacy whether they'll handle it for you. When switching active ingredient, you should pay particular attention to your symptoms in the first few days and report any changes to the practice.
Even though the pharmacy and practice organise the swap, there's plenty you can contribute to make everything run smoothly:
The guide Keeping a medication list shows you how to set up a good overview. The e-prescription is also handy, because it often lets you switch more flexibly to available preparations.
With a shortage, the biggest danger isn't the missing preparation but a hasty reaction. There are two things you should definitely avoid:
Equally unhelpful is stockpiling large supplies out of worry. Hoarding makes the shortage worse for everyone else and leads to medications expiring unused. A normal supply for a few weeks, as your prescription provides for anyway, is entirely sufficient. Reorder in good time — but don't stockpile.
So that you don't have to run back and forth between pharmacy and practice during a shortage, pharmacies have extended powers. When a supply shortage has been reported, they may deviate from the prescription without consulting the practice — for instance on pack size, quantity or the specific preparation, as long as the active ingredient and strength match. This saves time and trips.
For you, these special rules mean: in many cases you get a solution directly at the pharmacy, without needing a new prescription. Ask actively if you're unsure whether a swap is possible — the pharmacy knows the current situation and the rules in force.
