Your Patients Can't Find Aptensio XR — Here's How You Can Help

You've written the prescription. Your patient's ADHD is well-controlled on Aptensio XR. Then they call your office — again — because their pharmacy doesn't have it. The ongoing stimulant shortage has turned medication access into a clinical problem that lands squarely on your desk.

This guide provides actionable steps you can take — and share with your staff — to help patients navigate the Aptensio XR shortage more effectively.

Current Availability

As of early 2026, Aptensio XR availability remains inconsistent nationwide. Key factors affecting supply:

• DEA manufacturing quotas for Schedule II methylphenidate products remain a constraining factor, though quotas have been increased
• Demand for ADHD medications continues to grow, with more patients being diagnosed and treated than ever before
• Supply varies significantly by region, pharmacy type, and specific dosage strength
• Generic methylphenidate ER capsules are generally more available than brand Aptensio XR

For current shortage status, the FDA's Drug Shortage Database and ASHP shortage resources provide regularly updated information.

Why Patients Can't Find It

Understanding the barriers your patients face helps you provide better guidance:

Pharmacy-Level Ordering Limits

Chain pharmacies often have centralized purchasing systems that limit how much of a Schedule II substance any single location can order. Even when the drug is available from wholesalers, a pharmacy may have hit its allocation limit for the month.

Wholesaler Allocation Systems

Drug wholesalers allocate controlled substances based on a pharmacy's historical ordering patterns. A pharmacy that hasn't previously stocked Aptensio XR may not be able to start ordering it easily, even if a patient needs it.

Timing and Demand Patterns

Most patients fill 30-day prescriptions near the beginning of each month, creating demand spikes that can quickly deplete pharmacy stock. By mid-month, supply at individual pharmacies may already be exhausted.

What Providers Can Do: 5 Practical Steps

Step 1: Direct Patients to Medfinder

Medfinder for Providers is a tool that helps patients check real-time medication availability at pharmacies near them. Instead of having your front desk staff call around to pharmacies, you can direct patients to check Medfinder themselves — or check it together during the visit.

Consider adding Medfinder to your after-visit instructions for patients on controlled substances with known availability issues.

Step 2: Recommend Independent Pharmacies

Independent pharmacies often have more flexibility in their ordering relationships with wholesalers. If you know of reliable independent pharmacies in your area, maintain a list your staff can share with patients. These pharmacies may also be more willing to special-order Aptensio XR for a patient.

Step 3: Prescribe with Flexibility in Mind

When clinically appropriate, consider these prescribing strategies:

• Authorize generic substitution — Writing for "methylphenidate ER capsules" rather than brand-only Aptensio XR gives the pharmacy more options to fill
• Have a documented backup plan — Discuss with patients in advance which alternative they'd be comfortable trying if Aptensio XR becomes unavailable. Document this in the chart.
• Consider multiple prescription options — Some providers write a primary prescription for the preferred medication and provide guidance to patients on when to call for an alternative prescription

Step 4: Prepare Prior Authorizations Proactively

If your patient's insurance requires prior authorization for Aptensio XR or its alternatives, submit these authorizations before the patient runs out of medication. Having approvals in place for both the preferred medication and a backup reduces delays when supply issues arise.

Step 5: Educate Patients on Timing and Strategy

Share these practical tips with your patients:

• Fill prescriptions early in the week (Monday/Tuesday) when pharmacy shipments arrive
• Call ahead to verify stock before visiting the pharmacy
• Don't wait until the last day of their supply to attempt a refill
• Try different pharmacies — availability can vary block by block

Therapeutic Alternatives

When switching is necessary, here's a quick reference for Aptensio XR alternatives:

Same Drug Class (Methylphenidate)

• Concerta (methylphenidate OROS): Strengths 18–54 mg. Tablet form, must be swallowed whole. ~12-hour duration. Most widely available methylphenidate ER product.
• Ritalin LA (methylphenidate ER capsules): Strengths 10–40 mg. Can be opened and sprinkled. ~8-hour duration. Most similar to Aptensio XR in delivery mechanism.
• Generic methylphenidate ER: Multiple manufacturers. Generally more available and less expensive than branded products.

Different Drug Class (Amphetamines)

• Adderall XR (mixed amphetamine salts ER): Strengths 5–30 mg. Requires new titration as it's a different stimulant class.
• Vyvanse (lisdexamfetamine): Strengths 10–70 mg. Prodrug with smooth onset. Generic now available.

Non-Stimulant Options

• Strattera (atomoxetine): Not a controlled substance. Good option for patients with substance use history.
• Qelbree (viloxazine ER): Newer non-stimulant, FDA-approved for ADHD in children through adults.
• Intuniv (guanfacine ER) / Kapvay (clonidine ER): Alpha-2 agonists. Often used adjunctively or in patients who can't tolerate stimulants.

For detailed comparison information, see our alternatives guide (a patient-facing version you can share).

Workflow Tips for Your Practice

Consider implementing these workflow changes to reduce the administrative burden of the shortage:

• Create a medication shortage protocol — Document your practice's approach to handling controlled substance shortages, including which alternatives to try first and how to handle patient calls
• Designate a shortage point person — Having one staff member who stays current on shortage status and pharmacy availability can streamline the process
• Use secure messaging — If your patient portal supports it, allow patients to message about availability issues rather than calling, which can be more efficient for both sides
• Batch prior authorizations — When you know a medication is in shortage, proactively submit PAs for alternatives for your affected patients rather than waiting for individual requests
• Partner with pharmacies — Build relationships with 2-3 pharmacies (including independents) that reliably stock ADHD medications, and keep your staff informed about which ones to recommend

Final Thoughts

The Aptensio XR shortage adds complexity to ADHD management that none of us signed up for. But with proactive planning, clear patient communication, and the right tools, you can help your patients maintain treatment continuity.

Direct patients to Medfinder for real-time availability, and visit Medfinder for Providers for tools designed for your practice. For the clinical perspective on the shortage, see our provider shortage update.

For patient-facing resources to share, see our guides on how to find Aptensio XR in stock and how to save money on Aptensio XR.