Provider Briefing: The Amphetamine/Dextroamphetamine Shortage in 2026

The nationwide shortage of Amphetamine/Dextroamphetamine (mixed amphetamine salts) has been one of the most persistent medication access challenges in recent years. Now entering its fourth year, the shortage continues to affect clinical workflows, patient stability, and prescribing decisions across psychiatry, primary care, pediatrics, and neurology.

This article provides an up-to-date summary for prescribers: what's changed, what hasn't, and what you can do to help your patients navigate ongoing supply constraints.

Shortage Timeline

Understanding how we got here helps contextualize the current situation:

• October 2022: Teva Pharmaceuticals, the largest manufacturer of generic Adderall, reports manufacturing delays. The FDA officially lists amphetamine mixed salts as being in shortage.
• 2023: The shortage deepens as demand continues to outpace supply. Multiple generic manufacturers (Sandoz, Mallinckrodt, Lannett, Sun Pharma) report their own supply constraints. Patients report going weeks or months without medication.
• 2024: Modest improvements in some formulations and regions, but the shortage persists nationally. Congressional pressure mounts on both the FDA and DEA to act.
• October 2025: The DEA raises 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 since the shortage began.
• Early 2026: Supply is improving but not fully resolved. Certain strengths (particularly 20mg and 30mg IR) and certain regions remain intermittently affected. The FDA continues to list the medication as in shortage.

Prescribing Implications

The shortage creates several clinical challenges that prescribers should be aware of:

Treatment Interruptions

Patients who cannot fill their prescriptions face involuntary treatment gaps. For adults managing ADHD in the workplace, and for children during the school year, even a few days without medication can have meaningful functional consequences. Abrupt discontinuation can also cause rebound symptoms including fatigue, depression, and impaired concentration.

Dose and Formulation Substitutions

Many patients have been forced to switch between strengths, formulations (IR vs. XR), or even medication classes due to availability issues. While clinically manageable, these switches require careful monitoring — particularly when patients are stabilized on a specific regimen.

Increased Administrative Burden

Providers report spending more time fielding patient calls about pharmacy availability, writing new prescriptions for alternative pharmacies, and completing prior authorizations for substitute medications. This administrative load affects practice efficiency and provider well-being.

Telehealth Prescribing Considerations

The post-pandemic expansion of telehealth ADHD prescribing has contributed to increased overall demand. While telehealth improves access to diagnosis and treatment, prescribers should be mindful of DEA regulations around Schedule II telehealth prescribing, which have evolved since the pandemic-era flexibilities.

Current Availability Picture

As of early 2026, availability varies significantly by:

• Formulation: XR capsules have generally been easier to find than IR tablets
• Strength: Lower strengths (5mg, 10mg) are more consistently available; 20mg and 30mg remain the most constrained
• Geography: Urban areas with more pharmacy options tend to have better availability than rural regions
• Pharmacy type: Independent pharmacies often have more sourcing flexibility than large chains

The DEA's 2025 quota increase and the 2026 production targets suggest continued improvement, but full resolution of the shortage is not expected until manufacturing capacity catches up with the higher quotas.

Cost and Access for Patients

Cost remains a barrier for some patients, particularly those without insurance or with high-deductible plans:

• Generic IR with coupon: $25–$80/month
• Generic XR with coupon: $40–$100/month
• Brand Adderall XR: $300–$450/month without insurance
• With insurance: Typically $5–$50/month for generic

Discount card programs (GoodRx, SingleCare, RxSaver) can significantly reduce out-of-pocket costs for uninsured or underinsured patients. The Teva Cares Foundation (tevacares.org) provides eligible patients with Teva medications at no cost.

For a comprehensive cost guide to share with patients: How to Save Money on Amphetamine/Dextroamphetamine in 2026.

Tools and Resources for Providers

Several resources can help streamline patient access during the shortage:

Medfinder for Providers

Medfinder offers a provider-facing tool that helps you and your staff direct patients to pharmacies with real-time Amphetamine/Dextroamphetamine availability. Rather than sending patients on a wild goose chase, you can check which pharmacies near them currently have stock.

Alternative Medication Reference

When switching patients to an alternative, the most common options include:

• Lisdexamfetamine (Vyvanse): Same amphetamine class; prodrug formulation; generic available since 2023
• Methylphenidate (Ritalin, Concerta, Focalin): Different stimulant class; may be tried if amphetamine supply is unreliable
• Dextroamphetamine (Dexedrine): Pure d-amphetamine; different shortage dynamics
• Atomoxetine (Strattera): Non-stimulant; not subject to DEA quotas; suitable for patients with substance use history
• Guanfacine ER (Intuniv) / Clonidine ER (Kapvay): Non-stimulant alpha-2 agonists; often used adjunctively in pediatric populations

For detailed patient-facing information on alternatives: Alternatives to Amphetamine/Dextroamphetamine.

FDA and DEA Resources

• FDA Drug Shortage Database: fda.gov/drugs/drug-safety-and-availability/drug-shortages — Official tracking of shortage status
• DEA Production Quotas: Published annually in the Federal Register

Looking Ahead

The trajectory is positive but not yet resolved. Key factors to watch in 2026:

• Manufacturing ramp-up: It takes 6-12 months for increased DEA quotas to translate into pharmacy-level supply improvements
• New market entrants: Additional generic manufacturers may help diversify supply
• Telehealth policy: Evolving DEA regulations on Schedule II telehealth prescribing may affect prescribing patterns and demand
• Generic Vyvanse adoption: As generic Lisdexamfetamine becomes more widely available and affordable, it may absorb some demand pressure from mixed amphetamine salts

Final Thoughts

The Amphetamine/Dextroamphetamine shortage has tested the patience of patients and providers alike. While there are signs of improvement, the reality is that this medication remains difficult to find for many patients in early 2026.

As prescribers, the most impactful things you can do are: stay informed about current availability, proactively discuss backup plans with patients, use tools like Medfinder to streamline the pharmacy search, and advocate for policy changes that prevent future shortages of critical medications.

For a practical step-by-step guide on helping patients access their medication, see: How to Help Your Patients Find Amphetamine/Dextroamphetamine in Stock.