Your patients need your help navigating this shortage

If you prescribe amphetamine/dextroamphetamine IR (generic Adderall) for ADHD or narcolepsy, you've likely heard from frustrated patients who cannot fill their prescriptions. The shortage — now stretching into its fourth year — continues to create access barriers that directly impact treatment outcomes.

As a prescriber, you're uniquely positioned to help. This guide offers five concrete steps you can take, along with workflow tips to minimize the burden on your practice.

For background on the shortage itself, see our companion article: Amphetamine/dextroamphetamine IR shortage: What providers need to know in 2026.

Current availability snapshot

As of early 2026, amphetamine/dextroamphetamine IR remains intermittently available. Key points:

• Higher-dose tablets (20 mg, 30 mg) continue to be the hardest to source
• Lower-dose tablets (5 mg, 7.5 mg, 10 mg) are often more available
• Independent pharmacies tend to have better access than large chains during shortages
• Supply varies significantly by region — what's available in one ZIP code may be absent 10 miles away
• The DEA's 25% increase in d-amphetamine production quotas (October 2025) is beginning to improve supply, but the effect is gradual

Why patients can't find their medication

Understanding the barriers helps you guide patients more effectively:

Distributor allocation limits

Drug distributors (McKesson, Cardinal Health, AmerisourceBergen) place allocation limits on Schedule II controlled substances. Pharmacies can only order up to their allotted amount each period, regardless of actual patient demand. This is the single biggest barrier at the pharmacy level.

Pharmacy ordering patterns

Large chain pharmacies use centralized ordering systems that may not prioritize controlled substance restocking. Independent pharmacies often have more flexibility to work with multiple distributors and can sometimes special-order specific medications.

Patient timing

Many patients wait until they're completely out of medication before trying to fill, leaving no buffer time to search. Others try to fill at the end of the month when demand peaks.

What providers can do: 5 practical steps

Step 1: Direct patients to Medfinder

Medfinder for Providers helps patients check which pharmacies near them currently have amphetamine/dextroamphetamine IR in stock. Share this tool proactively — ideally at the time of prescribing, not after the patient has already spent hours calling around.

Consider adding the Medfinder link to your after-visit summary or patient handout for ADHD medications.

Step 2: Be flexible with dosing

When a specific strength is unavailable, dose flexibility can solve the problem:

• If 20 mg tablets are out, prescribe 2 × 10 mg tablets with appropriate instructions
• If 30 mg is unavailable, consider 20 mg + 10 mg combinations
• Document the clinical rationale for the dose adjustment in your note

This simple step can dramatically increase the likelihood of a successful fill.

Step 3: Have a switching protocol ready

When amphetamine/dextroamphetamine IR is truly unavailable in a patient's area, having a pre-planned switching protocol saves time:

• To amphetamine/dextroamphetamine XR: Convert total daily IR dose to equivalent XR dose (same total mg, once daily)
• To lisdexamfetamine (Vyvanse): Approximate conversion: Adderall 20 mg/day ≈ Vyvanse 50 mg/day. Start conservatively and titrate.
• To methylphenidate: No direct dose equivalency. Start at a standard initial dose and titrate. Methylphenidate products are generally less affected by the current shortage.
• To dextroamphetamine (Zenzedi): Total daily Adderall dose × 0.5 to 0.75 = approximate dextroamphetamine daily dose. Adjust based on response.

Step 4: Send prescriptions to multiple pharmacies strategically

While you cannot send the same prescription to multiple pharmacies simultaneously for a Schedule II drug, you can:

• Ask the patient which pharmacy they'd like to try first
• If that pharmacy can't fill, promptly void and resend to an alternative pharmacy
• Have the patient check availability via Medfinder before you send the prescription

Step 5: Communicate proactively about the shortage

Many patients don't understand why their medication is hard to find and may blame the pharmacy or feel singled out. A brief, empathetic explanation from their prescriber goes a long way:

• Validate their frustration
• Explain that this is a national supply issue, not a pharmacy-specific problem
• Outline the steps you're willing to take (dose adjustments, medication switches, etc.)
• Provide resources like Medfinder

Alternative medications to consider

When switching is necessary, here are the most common alternatives ranked by similarity to amphetamine/dextroamphetamine IR:

1. Dextroamphetamine IR (Zenzedi, generic): Same amphetamine class, single-entity. Variable shortage impact.
2. Amphetamine/dextroamphetamine XR (generic Adderall XR): Same drug, extended-release. May have better availability for some strengths.
3. Lisdexamfetamine (generic Vyvanse): Prodrug of dextroamphetamine. Generally easier to find. Once-daily dosing.
4. Methylphenidate IR/ER (Ritalin, Concerta, generic): Different stimulant class. Generally available. Effective first-line alternative.

For a patient-facing comparison, you can share our article: Alternatives to amphetamine/dextroamphetamine IR.

Workflow tips for your practice

Create a shortage protocol

Document a standard operating procedure for your practice that covers:

• Which alternative medications you're comfortable switching to
• Approximate dose conversion guidelines
• Standard patient communication language
• Resources to share with patients (Medfinder, discount card information)

Use templated patient communications

Create a patient-facing handout or portal message that explains the shortage, lists alternatives, and provides links to resources. This reduces repetitive conversations and ensures consistent messaging.

Schedule medication management visits accordingly

Consider scheduling ADHD medication checks a few days before the patient's supply runs out, rather than at the time of refill. This gives the patient time to locate the medication and gives you time to adjust the plan if needed.

Track what's working

Keep a running note (even an informal list) of which pharmacies in your area currently have stock of various stimulant medications. Share this information with your care team so everyone is working from the same playbook.

Final thoughts

The amphetamine/dextroamphetamine IR shortage requires providers to be more proactive and creative than usual in ensuring treatment continuity. The five steps outlined above — directing patients to availability tools, offering dose flexibility, maintaining switching protocols, prescribing strategically, and communicating transparently — can meaningfully improve your patients' experience during a difficult time.

Visit Medfinder for Providers to access tools that can help your practice and your patients navigate medication shortages more effectively.