Your Patients Are Struggling to Find Their ADHD Medication — Here's How You Can Help

If you prescribe Amphetamine/Dextroamphetamine XR (generic Adderall XR), you've almost certainly heard from patients who can't get their prescriptions filled. The shortage that began in late 2022 continues into 2026, and while supply is gradually improving, many patients — particularly those on higher strengths — still face regular stock-outs.

As a prescriber, you're uniquely positioned to help. This guide outlines five concrete steps you can take to improve your patients' chances of finding their medication, plus guidance on alternatives and workflow integration.

Current Availability Overview

As of early 2026, the supply picture for Amphetamine/Dextroamphetamine XR varies by strength:

• 5 mg and 10 mg: Generally available at most pharmacies
• 15 mg: Limited; intermittent back orders
• 20 mg: Moderate availability
• 25 mg and 30 mg: Most constrained; multiple generic manufacturers reporting back orders through late February 2026

The DEA's October 2025 quota increase (from 21.2M to 26.5M grams of d-amphetamine) is helping, but manufacturing lead times mean full normalization likely won't occur until mid-to-late 2026.

Why Patients Can't Find It

Understanding the barriers your patients face helps inform your approach:

• Chain pharmacy allocation limits: Large chains (CVS, Walgreens) often have controlled substance ordering caps based on historical dispensing patterns, limiting their ability to stock up during shortages
• Strength-specific shortages: A pharmacy may have 10 mg capsules but be completely out of 30 mg — and patients can't simply take three capsules without a new prescription
• Schedule II transfer restrictions: In most states, Schedule II prescriptions cannot be transferred between pharmacies. Patients need a new prescription sent to a different pharmacy.
• Geographic variation: Availability varies significantly by region, with urban areas sometimes having more competition for limited supply

What Providers Can Do: 5 Steps

Step 1: Recommend Medfinder to Patients

Direct patients to Medfinder, a tool that shows real-time pharmacy stock for hard-to-find medications. Instead of calling pharmacies one by one, patients can check availability by zip code and head directly to a pharmacy that has their medication. You can also use Medfinder from your practice to help identify pharmacies before writing the prescription.

Step 2: Write Flexible Prescriptions

When clinically appropriate, consider prescribing in a way that gives patients more options:

• Prescribe available strengths: If 30 mg is unavailable, consider writing for two 15 mg capsules or a 20 mg + 10 mg combination
• Consider IR as a bridge: The immediate-release formulation (Amphetamine/Dextroamphetamine IR) has been less consistently affected in some markets. A twice-daily IR regimen can maintain coverage while XR supply recovers.
• Use e-prescribing: EPCS makes it faster to send a new prescription to a different pharmacy if the first can't fill it

Step 3: Proactively Discuss Alternatives

Don't wait for patients to come to you in crisis. During routine visits, discuss backup plans:

• Lisdexamfetamine (generic Vyvanse): Long-acting amphetamine prodrug; generic available since 2023; typically $30-$80/month with coupons
• Methylphenidate ER (generic Concerta): Different stimulant class; good option for patients open to trying methylphenidate; $30-$90/month generic
• Mydayis: Same amphetamine salts, triple-bead design for up to 16 hours coverage; brand-only at $300-$400/month
• Dexedrine Spansules: Pure dextroamphetamine ER; $25-$70/month generic

Document the patient's alternative preferences in their chart so you can act quickly if their primary medication becomes unavailable.

Step 4: Help Patients Navigate Cost Barriers

The shortage has created price variability. Help patients access savings:

• Recommend discount cards (SingleCare, GoodRx) that can reduce generic costs to $28-$80/month
• Refer uninsured patients to the Teva Cares Foundation patient assistance program
• Direct patients to NeedyMeds and RxAssist for additional assistance programs
• When switching to alternatives, verify insurance coverage and prior authorization requirements

For a comprehensive cost guide, see our provider guide to saving money on Amphetamine/Dextroamphetamine XR.

Step 5: Establish a Refill Protocol

Create a practice workflow for shortage-affected medications:

• Flag patients on Amphetamine/Dextroamphetamine XR in your EHR
• Send prescriptions 2-3 days before the patient's supply runs out (consistent with state regulations)
• Have a standard response ready when patients call about stock-outs: verify their pharmacy, offer to send to an alternative, and discuss backup options
• Consider brief telehealth check-ins for patients who need prescription adjustments due to the shortage

Alternatives at a Glance

Here's a quick-reference comparison for your prescribing decisions:

• Lisdexamfetamine (Vyvanse): 10-70 mg capsules, ~14 hours duration, generic available, Schedule II
• Methylphenidate ER (Concerta): 18-54 mg tablets, ~12 hours duration, generic available, Schedule II
• Mydayis: 12.5-50 mg capsules, ~16 hours duration, brand only, Schedule II
• Dexedrine Spansules: 5-15 mg capsules, ~8-10 hours duration, generic available, Schedule II
• Xelstrym (dextroamphetamine patch): Transdermal delivery, ~12 hours, brand only, Schedule II

For detailed patient-facing comparisons to share, see: Alternatives to Amphetamine/Dextroamphetamine XR.

Workflow Tips for Your Practice

• Batch shortage communications: Send a monthly update to affected patients via patient portal about current availability trends
• Pre-authorize alternatives: If you anticipate a patient may need to switch, submit prior authorization for an alternative proactively
• Leverage pharmacy relationships: Build relationships with 2-3 independent pharmacies that tend to have better controlled substance stock — share these with patients
• Document everything: Note shortage-related prescription changes in the chart with clinical rationale to support continuity of care and insurance appeals

Final Thoughts

The Amphetamine/Dextroamphetamine XR shortage demands a proactive approach from prescribers. By recommending tools like Medfinder, prescribing flexibly, preparing alternative treatment plans, and streamlining your practice workflow, you can significantly reduce the burden on your patients. The supply situation is improving, but your patients need your support now more than ever.

For the broader shortage context, see our provider shortage briefing for 2026.