Provider Briefing: Adzenys XR-ODT in 2026

The ongoing stimulant shortage continues to create challenges for providers who prescribe Adzenys XR-ODT (amphetamine extended-release orally disintegrating tablet). As a single-source brand-name medication, Adzenys XR-ODT has been disproportionately affected by supply constraints since 2022.

This article provides a comprehensive overview for physicians, nurse practitioners, psychiatrists, and other prescribers managing ADHD patients who rely on this medication. We'll cover the current availability picture, prescribing implications, cost and access considerations, and practical tools to support your patients.

Shortage Timeline

Understanding the history of the stimulant shortage helps contextualize the current situation:

• October 2022: The FDA formally confirmed shortages of amphetamine mixed salts (generic Adderall), affecting immediate-release and extended-release formulations.
• Late 2022 – 2023: The shortage expanded to affect virtually all amphetamine and methylphenidate products. Brand-name products like Adzenys XR-ODT experienced increased demand as patients sought alternatives to unavailable generics.
• 2023 – 2024: The DEA increased aggregate production quotas for Schedule II stimulants. Some generic manufacturers ramped up production. However, single-source brand products showed slower recovery.
• 2025: Generic amphetamine supply improved modestly. Adzenys XR-ODT continued to face intermittent availability issues due to its single-manufacturer status (Tris Pharma) and lack of generic competition.
• Early 2026: Availability of Adzenys XR-ODT remains inconsistent. While not in continuous shortage, supply gaps are common, particularly for certain strengths and in certain regions.

Prescribing Implications

The shortage has several practical implications for prescribers:

Prescription Validity and Refills

Adzenys XR-ODT is a Schedule II controlled substance. Federal law does not allow refills on Schedule II prescriptions. Each fill requires a new prescription, which adds administrative burden during shortages when patients may need to try multiple pharmacies.

Some states have enacted emergency provisions allowing partial fills or extended prescription validity during declared shortages. Check your state's pharmacy board for current guidance.

Dose Equivalency Considerations

If patients need to switch from Adzenys XR-ODT to another amphetamine product, dose equivalency is important. Adzenys XR-ODT strengths correspond to the following approximate Adderall XR equivalents:

• Adzenys XR-ODT 3.1 mg ≈ Adderall XR 5 mg
• Adzenys XR-ODT 6.3 mg ≈ Adderall XR 10 mg
• Adzenys XR-ODT 9.4 mg ≈ Adderall XR 15 mg
• Adzenys XR-ODT 12.5 mg ≈ Adderall XR 20 mg
• Adzenys XR-ODT 15.7 mg ≈ Adderall XR 25 mg
• Adzenys XR-ODT 18.8 mg ≈ Adderall XR 30 mg

These are approximate equivalencies. Individual patient response may vary, and close follow-up after switching is recommended.

Prior Authorization Challenges

Many insurance plans require prior authorization for Adzenys XR-ODT and may impose step therapy requirements (typically requiring trial and failure of generic amphetamine salts). During shortages, some payers have relaxed these requirements. Document shortage-related access issues to support PA requests.

Current Availability Picture

Adzenys XR-ODT availability in 2026 can be characterized as intermittent and regionally variable. Key factors affecting availability:

• Single manufacturer: Tris Pharma is the sole manufacturer. No authorized generic exists.
• Pharmacy stocking patterns: Most chain pharmacies do not routinely stock Adzenys XR-ODT due to low prescription volume relative to generic Adderall XR and Vyvanse.
• Wholesaler allocation: During supply constraints, wholesalers may allocate limited quantities to pharmacies based on historical ordering patterns, further disadvantaging pharmacies that don't regularly dispense the product.

Independent and specialty pharmacies may have better success sourcing the medication through alternative distribution channels.

Cost and Access Considerations

Cost remains a significant barrier for many patients:

• Cash price: $300 to $450 per month (30-day supply)
• With commercial insurance: Copays of $30 to $100 after prior authorization approval
• Manufacturer copay card: Tris Pharma offers copay assistance for eligible commercially insured patients, potentially reducing out-of-pocket costs to approximately $30 per fill
• Patient assistance programs: Uninsured patients may qualify for manufacturer patient assistance or programs through NeedyMeds and RxAssist

For a comprehensive cost breakdown and savings strategies to share with patients, see How to Help Patients Save Money on Adzenys XR: A Provider's Guide.

Tools and Resources for Providers

Several tools can help you and your patients navigate the shortage:

Medfinder for Providers

Medfinder offers real-time pharmacy availability data that can help your staff or patients locate Adzenys XR-ODT in stock. Rather than having patients call pharmacies individually, direct them to Medfinder to check stock in their area before you write the prescription.

FDA Drug Shortage Database

The FDA maintains an updated list of current drug shortages at accessdata.fda.gov. This can help you stay informed about supply status and expected resolution timelines for amphetamine products.

Alternative Medication Reference

When Adzenys XR-ODT is unavailable, consider the following alternatives:

• Adderall XR (generic available): Extended-release capsules; can be opened and sprinkled. Most widely available amphetamine ER product.
• Vyvanse/Lisdexamfetamine (generic available): Prodrug with smoother pharmacokinetic profile. Good option for patients with abuse concerns.
• Dyanavel XR: Amphetamine extended-release oral suspension by Tris Pharma. Good for patients needing non-solid dosage forms.
• Mydayis: Triple-bead mixed amphetamine salts for up to 16 hours of coverage. Brand-name only.

For detailed comparisons, see Alternatives to Adzenys XR.

Looking Ahead

Several developments may improve the Adzenys XR supply situation in the coming months and years:

• DEA quota increases: The DEA has progressively increased manufacturing quotas for Schedule II stimulants since 2023. Additional increases could help stabilize supply.
• Potential generic entry: While no generic Adzenys XR-ODT has been approved, the pharmaceutical pipeline may eventually produce one, which would increase supply and lower costs.
• Market dynamics: As generic Vyvanse becomes more established, some prescribing patterns may shift, potentially reducing demand pressure on amphetamine salt formulations.

Final Thoughts

The Adzenys XR-ODT shortage requires a proactive approach from prescribers. Key recommendations:

1. Communicate early: Discuss potential supply issues with patients before they run out.
2. Have backup plans: Know the dose equivalencies for alternative amphetamine products.
3. Leverage tools: Direct patients to Medfinder for real-time availability checking.
4. Document everything: Shortage-related documentation supports prior authorization requests and insurance appeals.
5. Stay informed: Monitor the FDA shortage database and manufacturer communications for supply updates.

For a practical workflow guide on helping your patients find this medication, see How to Help Your Patients Find Adzenys XR in Stock.