Provider Briefing: The Dextroamphetamine Shortage in 2026

The amphetamine-class stimulant shortage that began in October 2022 continues to affect clinical practice in 2026. For providers who prescribe Dexedrine (Dextroamphetamine sulfate) for ADHD or narcolepsy, the shortage creates real challenges: patients calling with unfilled prescriptions, treatment interruptions, and difficult conversations about medication switches.

This briefing covers the current state of the shortage, its prescribing implications, and practical tools you can use to support your patients.

Timeline: How We Got Here

Understanding the shortage timeline helps contextualize the current situation:

• October 2022: The FDA officially lists amphetamine mixed salts (Adderall) as in shortage after Teva Pharmaceutical — the largest generic Adderall manufacturer — reports intermittent supply constraints.
• Late 2022–2023: The shortage expands to include Dextroamphetamine products (Dexedrine, Zenzedi, generics). Patient reports of pharmacy stockouts surge. CDC issues a Health Advisory Notice (HAN) in November 2023.
• 2024: The DEA transitions to a semi-annual quota allocation system for non-injectable controlled substances. Delays in distributing new quotas to manufacturers worsen supply gaps. Congressional hearings pressure the DEA to increase Aggregate Production Quotas (APQs).
• 2025: Some improvement in generic amphetamine mixed salts supply. Dextroamphetamine-specific products remain constrained. Generic Lisdexamfetamine (Vyvanse) provides a partial relief valve.
• Early 2026: Supply is better than 2023–2024 but remains inconsistent. The ASHP and FDA continue to list amphetamine products as in shortage. Regional variability is significant.

Prescribing Implications

The shortage creates several clinical considerations:

Treatment Continuity

Patients who have been stable on Dexedrine may face forced gaps in treatment. Abrupt discontinuation of stimulant therapy can lead to fatigue, depression, disrupted executive function, and in some cases, rebound ADHD symptoms that are worse than baseline. For patients with narcolepsy, interruption carries safety risks (e.g., drowsy driving).

Medication Switching

When Dextroamphetamine is unavailable, the most common switches include:

• Adderall (mixed amphetamine salts): 75% Dextroamphetamine / 25% Levoamphetamine. Closest pharmacological match. Available in IR and XR.
• Vyvanse / generic Lisdexamfetamine: Prodrug that converts to Dextroamphetamine. Longer duration (10–14 hours), lower abuse potential. Generic availability since 2023 has improved access.
• Xelstrym (Dextroamphetamine transdermal system): Same active ingredient, novel delivery. FDA-approved for ADHD in patients ≥6 years. May be available when oral formulations are not.
• Methylphenidate-class agents (Concerta, Focalin, Ritalin): Different mechanism of action. Consider for patients who cannot access any amphetamine-class medication.

When switching, approximate dose equivalencies are useful but individual titration is essential. Monitor patients closely during transitions.

Prior Authorization and Insurance Barriers

Switching medications may trigger new prior authorization requirements. Brand-name products (Zenzedi, Xelstrym) frequently require PA. Document the clinical rationale for the switch (shortage-related therapeutic substitution) and consider peer-to-peer review if initial PA is denied.

Current Availability Picture

As of early 2026:

• Generic Dextroamphetamine IR tablets: Intermittently available. Manufacturers include Teva, Mallinckrodt/SpecGx, and Aurobindo. Supply varies regionally.
• Generic Dextroamphetamine ER capsules: More constrained. Fewer manufacturers produce the extended-release formulation.
• Brand Dexedrine Spansule: Manufactured by Amneal Pharmaceuticals. Limited availability.
• Zenzedi (brand IR): Available but at premium pricing ($200–$500+).
• Xelstrym (transdermal patch): Newer product with separate supply chain. May be easier to find.
• ProCentra (oral solution): Niche product. Availability varies.

Cost and Access Considerations

Cost remains a barrier for many patients, especially those who are forced to switch to brand-name products:

• Generic Dextroamphetamine IR: $20–$60 for 30 tablets with discount cards
• Generic Dextroamphetamine ER: $38–$120 for 30 capsules with coupons
• Brand Dexedrine Spansule: $300–$685 without insurance
• Xelstrym: Premium pricing; manufacturer savings card available

Patients without insurance or with high-deductible plans may benefit from discount cards (GoodRx, SingleCare, RxSaver) or patient assistance programs. There is no manufacturer PAP specifically for Dexedrine, but organizations like NeedyMeds, RxAssist, and the PAN Foundation may offer assistance for ADHD medications.

For a patient-facing savings guide you can share: How to save money on Dexedrine.

Tools and Resources for Your Practice

Medfinder for Providers

Medfinder allows providers and patients to check real-time pharmacy stock for Dexedrine and other controlled substances. You can direct patients to search by medication name and zip code to find nearby pharmacies with current availability.

Patient Education Resources

Consider sharing these resources with patients who are struggling to fill prescriptions:

• How to find Dexedrine in stock near you
• Alternatives to Dexedrine
• Dexedrine shortage update for patients

Prescribing Tips During the Shortage

• Write for both IR and ER when clinically appropriate, so patients have options if one formulation is out of stock
• Consider 90-day prescriptions where state law and insurance allow — reduces the frequency of refill-related stockout encounters
• Specify "DAW 0" (or equivalent) to allow any manufacturer's generic, maximizing the chance a pharmacy can fill the order
• Proactively discuss alternatives with patients before they run out, so they have a backup plan

Looking Ahead

The DEA faces ongoing congressional pressure to increase production quotas for stimulant medications. Any quota increases take months to translate into additional supply at the pharmacy level. Meanwhile, the availability of generic Lisdexamfetamine and the Xelstrym patch provide additional prescribing options that weren't available when the shortage began.

The shortage is improving, but slowly. Planning for continued supply variability throughout 2026 is prudent.

Final Thoughts

The Dextroamphetamine shortage is a systems-level problem that lands in your exam room as a patient-level crisis. Proactive communication, familiarity with equivalent alternatives, and tools like Medfinder for Providers can help minimize treatment disruptions.

For a practical workflow guide, see: How to help your patients find Dexedrine in stock.