Your Patients Need Amphetamine XR — Here's How You Can Help

As a provider managing patients with ADHD, you've seen firsthand how the ongoing stimulant medication shortage affects your practice. Patients come in frustrated, anxious, and sometimes without medication for days or weeks. Extended-release amphetamine formulations like Dyanavel XR, Adzenys XR-ODT, and Adzenys ER — all brand-only products — are among the hardest hit.

This guide offers concrete steps you can take to help your patients find Amphetamine XR in stock, maintain treatment continuity, and navigate the current shortage landscape.

Current Availability of Amphetamine XR

As of early 2026, supply of brand-name Amphetamine XR formulations remains inconsistent:

• Dyanavel XR (amphetamine extended-release oral suspension): Intermittent availability. Manufactured solely by Tris Pharma.
• Adzenys XR-ODT (amphetamine extended-release orally disintegrating tablet): Similarly constrained. No generic available.
• Generic Adderall XR (amphetamine/dextroamphetamine mixed salts XR): More widely available due to multiple manufacturers, but still affected by regional shortages.

The DEA increased aggregate production quotas for amphetamine products by up to 25% in late 2025, with 2026 quotas finalized in January. However, manufacturing ramp-up takes time, and demand continues to outpace supply.

Why Patients Can't Find Their Medication

Understanding the barriers helps you guide patients more effectively:

1. Fixed pharmacy allocations: Pharmacies receive controlled substance allocations based on historical ordering. When demand spikes, allocations don't adjust quickly.
2. Chain pharmacy limitations: Large chains (CVS, Walgreens, Rite Aid) deplete their monthly controlled substance supply faster due to high patient volumes.
3. Schedule II transfer restrictions: Patients can't transfer prescriptions to a new pharmacy — they need a new prescription sent to wherever stock is available.
4. Brand-only supply bottleneck: With no generic Dyanavel XR or Adzenys XR-ODT, all supply flows from one manufacturer.
5. Geographic variation: Availability can differ significantly between zip codes, even within the same metro area.

5 Steps Providers Can Take to Help

Step 1: Recommend Medfinder to Your Patients

Medfinder for Providers is a free tool that helps patients find which pharmacies near them currently have Amphetamine XR in stock. Instead of spending hours calling pharmacies, patients can search online and get real-time results.

Consider incorporating Medfinder into your post-visit workflow: mention it during the appointment and include the link in patient after-visit summaries.

Step 2: E-Prescribe to Pharmacies With Confirmed Stock

When a patient identifies a pharmacy with stock (via Medfinder or by calling ahead), send the prescription there directly. Since Schedule II prescriptions can't be transferred, being responsive with new e-prescriptions is critical.

Set up your EHR to make it easy to change the designated pharmacy quickly. Some practices designate a staff member to handle pharmacy change requests during shortage periods.

Step 3: Consider Independent Pharmacies

Recommend that patients check independent, locally owned pharmacies. These pharmacies often:

• Work with multiple distributors, giving them more sourcing flexibility
• Serve fewer patients per location, making their controlled substance supply last longer
• Have pharmacists who will proactively call distributors on behalf of patients

Step 4: Prepare Backup Prescriptions for Alternatives

When writing a prescription for Amphetamine XR, consider discussing a backup plan upfront. If the patient can't fill the primary prescription within a few days, having an agreed-upon alternative ready to prescribe saves time and prevents treatment gaps.

Common alternatives to discuss:

• Adderall XR (generic mixed amphetamine salts XR) — most widely available; $17–$50/month
• Vyvanse (generic lisdexamfetamine) — good prodrug option; $30–$70/month
• Concerta (generic methylphenidate ER) — different class, for patients open to methylphenidate
• Mydayis (triple-bead mixed amphetamine salts) — ultra-long-acting; brand only

For a full comparison, see Alternatives to Amphetamine XR.

Step 5: Help Patients Reduce Cost Barriers

If a patient can find Amphetamine XR but can't afford it, share these resources:

• Tris Pharma Savings Card: Copay as low as $20 for commercially insured patients (coupon.trisadhd.com)
• GoodRx / SingleCare coupons: May reduce cash prices at participating pharmacies
• NeedyMeds.org / RxAssist.org: For patients with financial hardship seeking assistance programs

Switching to generic Adderall XR or generic Vyvanse — when clinically appropriate — can reduce monthly costs from $400+ to under $50. See our provider's guide to helping patients save on Amphetamine XR.

Therapeutic Alternatives: Quick Reference

When considering a switch from Amphetamine XR, keep these key points in mind:

• Dyanavel XR → Adderall XR: Not a 1:1 conversion. Different salt forms and release profiles. Titrate based on response.
• Adzenys XR-ODT → Adderall XR: Similarly requires dose adjustment. Adzenys uses amphetamine base; Adderall XR uses mixed salts.
• Any amphetamine → methylphenidate: Different drug class. No direct equivalence — start low and titrate.
• Any amphetamine → Vyvanse: Prodrug of dextroamphetamine. Conversion tables exist but individual response varies.

Document all shortage-related medication changes thoroughly to support prior authorization appeals and treatment continuity.

Workflow Tips for Your Practice

• Standardize shortage communication: Create a patient handout or template message explaining the shortage and listing resources (Medfinder, savings cards, alternatives).
• Designate a point person: During peak shortage periods, assign a staff member to handle pharmacy stock inquiries and prescription routing.
• Use your EHR favorites: Pre-load common alternative medications and doses in your EHR for quick prescribing.
• Schedule proactive check-ins: For patients on brand-only formulations, schedule a follow-up 2–3 weeks after prescribing to confirm they were able to fill.

Final Thoughts

The Amphetamine XR shortage places an additional burden on already-stretched clinical workflows. But with the right tools and proactive strategies, you can significantly improve your patients' ability to find their medication and maintain ADHD treatment continuity.

Start by sharing Medfinder for Providers with your patients, and familiarize yourself with the alternatives and cost-saving resources outlined above.

For the clinical briefing on the shortage timeline and policy landscape, see our shortage update for providers and prescribers.