When your medication isn't available, what are your options?

If you've been trying to fill a prescription for amphetamine/dextroamphetamine IR (generic Adderall) and keep running into empty shelves, you're not alone. The ongoing shortage has left millions of patients scrambling for their ADHD and narcolepsy medication.

But going without treatment isn't the answer. There are several effective alternatives that your doctor can prescribe — and some of them may actually be easier to find right now.

In this guide, we'll explain what amphetamine/dextroamphetamine IR is, how it works, and walk you through the most common alternatives so you can have an informed conversation with your prescriber.

What is amphetamine/dextroamphetamine IR?

Amphetamine/dextroamphetamine IR is a central nervous system (CNS) stimulant sold under the brand name Adderall. It's FDA-approved for treating ADHD in children (age 3+) and adults, as well as narcolepsy.

The IR (immediate-release) formulation comes in tablet form and is typically taken 2 to 3 times daily. It starts working within 30 to 60 minutes and lasts about 4 to 6 hours per dose.

It's classified as a DEA Schedule II controlled substance, which means strict rules govern how it's manufactured, prescribed, and dispensed.

How does amphetamine/dextroamphetamine IR work?

Amphetamine/dextroamphetamine works by increasing levels of two key brain chemicals: dopamine and norepinephrine. It does this by blocking their reuptake (so they stay active longer) and promoting their release from nerve cells.

The result is improved focus, attention, and impulse control — the core symptoms of ADHD. For narcolepsy, it helps reduce excessive daytime sleepiness.

Understanding the mechanism matters because it helps explain why some alternatives work similarly and others take a different approach. For a deeper dive, see our article on how amphetamine/dextroamphetamine IR works.

Alternative 1: Methylphenidate IR (Ritalin)

Methylphenidate is the other major stimulant used for ADHD. Brand names include Ritalin, Methylin, and Focalin (dexmethylphenidate).

Like amphetamine/dextroamphetamine, methylphenidate increases dopamine and norepinephrine in the brain — but it does so through a slightly different mechanism. It primarily blocks reuptake rather than promoting release.

• How it compares: Similar effectiveness for ADHD. Some patients respond better to amphetamine-based medications, others to methylphenidate. It's generally considered a first-line alternative.
• Duration: IR formulation lasts 3 to 4 hours; taken 2 to 3 times daily.
• Availability: Methylphenidate is also a Schedule II controlled substance, but it has generally been less affected by the current shortage than amphetamine products.
• Cost: Generic methylphenidate IR is affordable — typically $15 to $30 for a 30-day supply with a discount coupon.

Alternative 2: Lisdexamfetamine (Vyvanse)

Lisdexamfetamine (Vyvanse) is a prodrug of dextroamphetamine, meaning it's inactive until your body converts it into the active drug. This gives it a smoother onset and longer duration of action.

• How it compares: Very similar to amphetamine/dextroamphetamine in terms of effectiveness, since it converts to the same active ingredient. Smoother effect with less "peak and crash" than IR formulations.
• Duration: Up to 14 hours — once-daily dosing.
• Availability: Generic lisdexamfetamine became available in 2023, improving both availability and cost. It has generally been easier to find than generic Adderall IR during the shortage.
• Cost: Generic Vyvanse runs approximately $30 to $80 for a 30-day supply with coupons.

Alternative 3: Dextroamphetamine (Dexedrine, Zenzedi)

Dextroamphetamine is a single-entity amphetamine — one of the two active components in Adderall. It's available as both IR tablets (Zenzedi) and extended-release capsules (Dexedrine Spansules).

• How it compares: Very similar mechanism and effectiveness. Some patients find pure dextroamphetamine produces fewer side effects (like anxiety or jitteriness) compared to the mixed amphetamine salts in Adderall.
• Duration: IR form lasts 4 to 6 hours; Spansules last 8 to 10 hours.
• Availability: Dextroamphetamine is also affected by the stimulant shortage, but availability varies by region. It's worth checking.
• Cost: Generic dextroamphetamine IR typically costs $15 to $45 for a 30-day supply with coupons.

Alternative 4: Amphetamine/Dextroamphetamine XR (Adderall XR)

If the IR formulation is unavailable, the extended-release (XR) version may be an option. It contains the same active ingredients but uses a bead-delivery system for longer action.

• How it compares: Same drug, different release profile. XR is designed to last 10 to 12 hours with a single morning dose.
• Duration: 10 to 12 hours — eliminates the need for midday dosing.
• Availability: XR has experienced its own supply issues, but some strengths may be available when IR is not.
• Cost: Generic Adderall XR costs approximately $25 to $60 for a 30-day supply with coupons.

What about non-stimulant alternatives?

If stimulants aren't an option for you (due to side effects, substance use history, or other reasons), there are non-stimulant ADHD medications:

• Atomoxetine (Strattera): An SNRI that works on norepinephrine. Takes 4 to 6 weeks for full effect.
• Guanfacine ER (Intuniv): An alpha-2 adrenergic agonist. Often used in children or as an add-on to stimulants.
• Viloxazine ER (Qelbree): A newer non-stimulant option approved for ADHD in children, adolescents, and adults.

Non-stimulants are generally less effective than stimulants for ADHD but are not controlled substances, which means they're easier to prescribe and fill.

Final thoughts

Being unable to fill your amphetamine/dextroamphetamine IR prescription is stressful, but you have options. Talk to your doctor about which alternative makes the most sense for your situation.

Before switching medications, it's also worth trying to locate your current prescription using Medfinder — we help patients find amphetamine/dextroamphetamine IR in stock near them.

And if cost is a concern with any of these medications, check out our guide on saving money on amphetamine/dextroamphetamine IR.