Provider Briefing: The Amphetamine Shortage in 2026

The nationwide shortage of Amphetamine mixed salts — encompassing both immediate-release and extended-release formulations — continues to affect patient care across specialties in 2026. For prescribers managing ADHD and narcolepsy patients, the shortage presents ongoing challenges in treatment continuity, medication access, and clinical decision-making.

This article provides a concise, evidence-based overview of the current shortage landscape, regulatory changes, prescribing considerations, and practical resources to support your patients.

Shortage Timeline: How We Got Here

Understanding the trajectory of the shortage helps inform current clinical decisions:

• October 2022: The FDA officially declared a shortage of Amphetamine mixed salts, triggered primarily by manufacturing delays at Teva Pharmaceuticals — the largest U.S. producer of generic Adderall — combined with surging demand.
• 2023: The shortage expanded to affect nearly all generic manufacturers. ASHP reported shortages across all IR strengths and most XR strengths. Patient reports of pharmacy-hopping and treatment gaps became widespread.
• 2024: The DEA made modest quota adjustments. Additional generic manufacturers attempted to scale production. The shortage persisted but stabilized in some regions.
• October 2025: The DEA raised the aggregate production quota (APQ) for d-amphetamine by 25%, from 21.2 million grams to 26.5 million grams — the first significant increase. This came after sustained pressure from medical organizations, patient advocates, and congressional inquiry.
• Early 2026: Supply is improving but remains inconsistent. FDA and ASHP continue to list Amphetamine mixed salts (IR and XR) as in active shortage. Specific strengths — notably 10mg and 20mg XR — remain particularly affected.

Prescribing Implications

The shortage has several direct implications for clinical practice:

Treatment Interruptions

Many patients experience gaps in medication access lasting days to weeks. For adults with ADHD, treatment interruptions can affect occupational performance, driving safety, and emotional regulation. For pediatric patients, academic and social functioning may be impacted.

Dose and Formulation Flexibility

Clinicians may need to consider prescribing flexibility to maximize the likelihood that patients can fill their prescriptions:

• Strength substitution: If 20mg XR is unavailable, prescribing two 10mg XR capsules may be an option (though it changes the cost equation for patients).
• Formulation switching: Patients on XR formulations who can't find their medication may tolerate a switch to IR tablets taken twice daily. Conversely, alternative XR formulations (Dyanavel XR suspension, Adzenys XR-ODT) may have better availability.
• Cross-class switching: For patients who cannot access any Amphetamine product, switching to Methylphenidate (Concerta, Ritalin LA, Focalin XR) or Lisdexamfetamine (Vyvanse) may be appropriate. Non-stimulant options — Atomoxetine (Strattera) and Viloxazine (Qelbree) — remain readily available.

Prior Authorization Considerations

Switching formulations or medications may trigger new prior authorization requirements from insurers. Consider:

• Documenting the shortage as clinical justification for non-formulary or non-preferred alternatives
• Proactively submitting peer-to-peer reviews when PA denials occur
• Utilizing appeals processes and citing FDA shortage documentation

Current Availability Picture

As of February 2026, availability varies significantly by region, pharmacy type, and specific product:

• Most affected: Generic Adderall XR 10mg and 20mg capsules; generic Adderall IR 20mg and 30mg tablets
• Relatively better supply: Lower-strength IR tablets (5mg, 7.5mg); some XR strengths from secondary manufacturers; Dyanavel XR and Adzenys formulations
• Independent pharmacies often report better stock than national chains, as they may access different distribution channels

Providers can direct patients to Medfinder for Providers to help patients locate pharmacies with current stock. This tool allows real-time availability searches by medication and location.

Cost and Access Considerations

The shortage has exacerbated cost barriers for many patients:

• Generic Adderall IR: $14-$60/month with discount coupons; $200-$300+ at cash price
• Generic Adderall XR: $17-$80/month with coupons; $250-$450+ at cash price
• Brand alternatives: Mydayis ($400+), Vyvanse ($30-$80 generic, $350+ brand)

Patients without insurance or with high deductibles face significant financial burden. Prescription discount programs (GoodRx, SingleCare, RxSaver) can dramatically reduce out-of-pocket costs. The provider's guide to helping patients save on Amphetamine offers detailed cost-reduction strategies.

Patient Assistance Programs

For uninsured or underinsured patients:

• Teva Cares Foundation: Provides qualifying Teva medications at no cost
• Takeda Patient Assistance: Covers brand Mydayis for eligible patients
• NeedyMeds and RxAssist: Comprehensive directories of patient assistance programs

Tools and Resources for Your Practice

Several resources can help streamline medication access for your patients:

• Medfinder for Providers: Real-time pharmacy availability search tool — direct patients here to find Amphetamine in stock near them
• ASHP Drug Shortage Resource Center: Up-to-date shortage data and clinical guidance
• FDA Drug Shortages Database: Official shortage declarations and manufacturer updates
• State pharmacy boards: Some states have issued guidance on controlled substance dispensing during shortages

Looking Ahead

Several factors suggest gradual improvement through 2026:

• The 25% DEA quota increase from October 2025 is beginning to translate into increased production
• Additional generic manufacturers have received FDA approvals and are scaling production
• Generic lisdexamfetamine (Vyvanse) provides an alternative supply pathway for Amphetamine-responsive patients
• Congressional oversight continues to pressure the DEA to align quotas with clinical demand

However, structural challenges remain. The DEA's quota system inherently limits supply elasticity, and any manufacturer disruption can quickly create localized shortages even when aggregate supply is adequate.

Final Thoughts

The Amphetamine shortage requires prescribers to be both clinically flexible and administratively proactive. Maintaining open communication with patients about availability challenges, exploring alternative medications and formulations, and leveraging tools like Medfinder can help minimize treatment disruptions.

For patient-facing resources you can share, see our articles on finding Amphetamine in stock, Amphetamine alternatives, and saving money on Amphetamine.