Provider Briefing: The Dexmethylphenidate XR Shortage in 2026

The shortage of Dexmethylphenidate XR (Focalin XR) — and ADHD stimulants broadly — continues to be one of the most challenging prescribing environments in recent years. For providers managing patients with ADHD, the supply disruption creates clinical complexity: treatment interruptions, forced medication switches, and increased patient distress.

This briefing covers the current state of the shortage, its impact on prescribing, available alternatives, cost considerations, and practical tools to help your patients maintain access to treatment.

Shortage Timeline

The ADHD stimulant shortage has evolved through several phases:

• October 2022: FDA formally acknowledges a shortage of amphetamine mixed salts (Adderall). The supply disruption quickly spreads across the stimulant class.
• 2023: Dexmethylphenidate XR is added to the ASHP drug shortage list. Multiple manufacturers report back orders across most strengths.
• 2024: The DEA transitions to a semi-annual quota system for non-injectable Schedule II stimulants. During the transition, manufacturers experience delays in receiving quota allocations, exacerbating supply constraints.
• Late 2025: DEA announces increased production quotas for ADHD stimulants including Methylphenidate and Dexmethylphenidate. New generic manufacturers enter the Dexmethylphenidate ER market.
• Early 2026: Supply is improving but remains inconsistent. Par Pharmaceutical has multiple Dexmethylphenidate ER strengths on back order with no estimated release date. Sandoz reports intermittent availability of brand Focalin XR.

Prescribing Implications

The shortage creates several challenges for prescribers:

Treatment Interruptions

Patients frequently report being unable to fill prescriptions, sometimes going days or weeks without medication. For adults with ADHD, this can impact occupational functioning, driving safety, and emotional regulation. For pediatric patients, it disrupts academic performance and behavioral management.

Forced Medication Switching

When a patient's specific medication or dose is unavailable, providers are often asked to prescribe alternatives on short notice. This requires knowledge of cross-class dose equivalencies and an awareness of which medications are more readily available at any given time.

Increased Administrative Burden

Prior authorization requirements, pharmacy callbacks, and the need for more frequent prescription rewrites (since Schedule II medications cannot be refilled or transferred) all add to the administrative load during shortages.

Regulatory Considerations

Schedule II prescriptions cannot be transferred between pharmacies in most states. Providers should be prepared to issue new prescriptions directed to specific pharmacies when patients identify available stock at a different location. E-prescribing of Schedule II controlled substances is now available in all 50 states and can expedite this process.

Current Availability Picture

As of early 2026, the following manufacturers supply Dexmethylphenidate ER capsules:

• Novartis/Sandoz — Brand Focalin XR; intermittent availability, particularly for 5 mg
• Par Pharmaceutical — Generic; most strengths (5-40 mg) on back order, no ETA
• Other ANDA holders — Several additional generic manufacturers have entered or are entering the market, contributing to gradual supply improvement

Availability varies significantly by region, pharmacy, and strength. Real-time tools like Medfinder for Providers can help identify which pharmacies currently have specific strengths in stock.

Cost and Access Considerations

Understanding the cost landscape helps when counseling patients:

• Brand Focalin XR: $250-$490/month (cash price, 30 capsules)
• Generic Dexmethylphenidate ER: $40-$150/month with discount coupons (GoodRx, SingleCare)
• Insurance: Generic is typically Tier 2; brand may require prior authorization or step therapy
• Novartis savings card: For commercially insured patients — patient pays first $10, Novartis covers up to $60/month (not valid for government insurance)
• Patient assistance: Novartis Patient Assistance Foundation provides free medication for eligible uninsured/underinsured patients

For patients struggling with cost, the provider's guide to helping patients save on Dexmethylphenidate XR offers actionable strategies.

Tools and Resources for Providers

Medfinder for Providers

Medfinder offers real-time pharmacy availability data that can be integrated into your prescribing workflow. Instead of asking patients to call dozens of pharmacies, you or your staff can check where Dexmethylphenidate XR is currently in stock and direct prescriptions accordingly.

ASHP Drug Shortage Database

The ASHP shortage database provides manufacturer-level supply updates, including back-order status and estimated release dates when available.

Dose Equivalency Quick Reference

When switching patients to alternative stimulants, the following approximate conversions can serve as starting points (always individualize based on clinical response):

• Dexmethylphenidate XR 10 mg ≈ Methylphenidate ER 20 mg (Concerta, Ritalin LA)
• Dexmethylphenidate XR 10 mg ≈ Amphetamine mixed salts XR 10-15 mg (Adderall XR) — approximate; different mechanism
• Dexmethylphenidate XR 10 mg ≈ Lisdexamfetamine 30 mg (Vyvanse) — approximate; different mechanism

Non-stimulant alternatives (Atomoxetine, Viloxazine, Guanfacine ER, Clonidine ER) have different onset profiles and efficacy characteristics and should be considered on a case-by-case basis.

Looking Ahead

Several developments suggest gradual improvement in 2026:

• Increased DEA quotas should allow manufacturers to produce more
• New generic market entrants add manufacturing capacity
• Regulatory advocacy from medical organizations (AMA, AAP, APA) continues to push for structural solutions to the stimulant shortage

However, the structural issues — quota-constrained supply, concentrated manufacturing, and rising demand — mean that spot shortages may persist for some time. Building flexibility into treatment plans (discussing backup medications with patients proactively) remains a sound clinical strategy.

Final Thoughts

The Dexmethylphenidate XR shortage requires providers to be both clinically adaptable and administratively proactive. Real-time availability tools like Medfinder, familiarity with alternative agents, and proactive patient communication can significantly reduce the clinical impact of supply disruptions.

For practical steps you can take today, see our guide on how to help your patients find Dexmethylphenidate XR in stock.