The amphetamine mixed salts extended-release (Adderall XR) shortage remains one of the most significant drug supply disruptions affecting psychiatric and primary care practices in the United States. As of early 2026, the shortage continues to impact patient adherence, clinical outcomes, and practice workflows.

This article provides an evidence-based overview of the current situation, including the shortage timeline, prescribing considerations, cost and access landscape, and practical tools to help your patients maintain treatment continuity.

Provider Briefing: Current Status

The FDA and ASHP continue to list amphetamine extended-release oral presentations as being in active shortage. Multiple strengths — particularly the 15 mg, 25 mg, and 30 mg capsules — remain on back order from several generic manufacturers. The shortage affects both brand-name Adderall XR and all authorized generic equivalents (amphetamine salt combo XR).

Key data points for providers:

• The shortage has been continuous since October 2022 — over three years.
• An estimated 41 million amphetamine prescriptions were dispensed in the U.S. in 2023, up from 36 million in 2020.
• The CDC issued a health advisory regarding potential disrupted access to care for patients taking prescription stimulants.
• Patient reports of missed doses, treatment interruptions, and worsening symptoms are widespread.

Shortage Timeline

Understanding the trajectory of this shortage is important for clinical decision-making:

• October 2022: FDA formally announces Adderall shortage following reports from Teva Pharmaceutical Industries of manufacturing delays.
• 2023: Shortage expands to include multiple generic manufacturers. Some strengths become intermittently available while others remain back-ordered for months.
• 2024: Continued supply constraints despite efforts by manufacturers to increase production. Congress holds hearings on stimulant access.
• October 2025: DEA increases the aggregate production quota (APQ) for d-amphetamine from 21.2 million grams to 26.5 million grams — a 25% increase. This is the first significant quota adjustment during the shortage.
• Early 2026: Some improvement in lower-dose availability (5 mg, 10 mg), but higher doses (15 mg, 25 mg, 30 mg) remain constrained. Estimated manufacturer release dates extend to late February 2026 and beyond.

Prescribing Implications

The shortage creates several clinical considerations that prescribers should address proactively:

Treatment Continuity

Abrupt discontinuation of stimulant therapy can lead to rebound symptoms including fatigue, depression, impaired concentration, and increased appetite. When patients cannot fill their prescription, consider:

• Temporarily prescribing an available strength and adjusting the regimen (e.g., two 10 mg capsules instead of one 20 mg)
• Switching to immediate-release Adderall (IR) as a bridge, if available
• Converting to an equivalent dose of an alternative stimulant

Therapeutic Alternatives

When Adderall XR is unavailable, the following alternatives may be considered. Each has different pharmacokinetic properties and insurance coverage profiles:

• Vyvanse (Lisdexamfetamine): Prodrug amphetamine stimulant. Generic available since 2023. Duration up to 14 hours. Lower abuse potential due to prodrug mechanism. Generally well-tolerated and now more cost-effective as a generic ($30–$50/month with coupon).
• Concerta (Methylphenidate ER): Different stimulant class. OROS delivery system providing up to 12 hours of coverage. Long-standing generic availability. Good option when switching drug classes is appropriate.
• Mydayis: Triple-bead mixed amphetamine salts, up to 16 hours of coverage. Approved for ages 13+. Brand only — higher cost ($300–$400/month). May be easier to source due to lower prescribing volume.
• Strattera (Atomoxetine): Non-stimulant SNRI. Not a controlled substance. Takes 4–6 weeks for full effect. Suitable for patients with comorbid anxiety or substance use history.

For a patient-facing version of this information, see Alternatives to Adderall XR.

Availability Picture

Availability varies significantly by region, pharmacy type, and dose strength. Patterns observed in 2025–2026:

• Independent pharmacies often have better access than large chains due to more flexible wholesaler relationships.
• Lower doses (5 mg, 10 mg) are generally more available than higher doses (25 mg, 30 mg).
• Rural and underserved areas face disproportionate supply challenges.
• Brand-name Adderall XR availability varies — some specialty pharmacies maintain supply.

Real-time availability data is accessible through Medfinder for Providers, which allows you to help patients identify pharmacies with current stock.

Cost and Access Considerations

Cost barriers compound the availability problem, particularly for uninsured or underinsured patients:

• Generic amphetamine salt combo XR: Retail price $220–$350/month. With GoodRx or SingleCare coupon: as low as $17–$26/month.
• Brand Adderall XR: $200–$350/month without insurance.
• Insurance: Most plans cover generic Adderall XR as a Tier 2 preferred generic with copays of $5–$30. Brand may require prior authorization.
• Patient assistance: Teva Cares Foundation provides free medications to qualifying uninsured patients. NeedyMeds and RxAssist maintain directories of available programs.

Direct patients who need cost help to our savings guide for Adderall XR.

Tools and Resources for Providers

Several resources can help you support your patients more effectively during the shortage:

• Medfinder for Providers: Real-time pharmacy availability tool. Share with patients or check during appointments to help identify where their medication is in stock.
• ASHP Drug Shortage Resource Center: Up-to-date shortage status, estimated resupply dates, and clinical guidance.
• FDA Drug Shortage Database: Official shortage listings and manufacturer communications.
• CDC Health Advisory: Guidance on managing patients affected by stimulant access disruptions.

Looking Ahead

There are reasons for measured optimism heading into mid-2026:

• The DEA's 25% quota increase from October 2025 should translate into increased production throughout 2026.
• Generic Vyvanse availability continues to expand, providing a viable alternative for many patients.
• Growing congressional attention to drug shortage policy may lead to structural reforms.

However, the fundamental supply-demand imbalance has not been fully resolved. Providers should continue to have contingency plans in place for patients on amphetamine-based stimulants.

Final Thoughts

The Adderall XR shortage is a systemic problem that requires both immediate clinical adaptation and long-term policy change. In the meantime, the most impactful thing providers can do is stay informed, communicate proactively with patients, maintain flexibility in prescribing, and leverage tools like Medfinder for Providers to help patients maintain access to treatment.

For a complementary resource, see our provider's guide to helping patients find Adderall XR in stock.