A practical guide for providers to help patients find Auvelity XR in stock. Actionable steps, alternative options, and workflow tips to streamline medication access.
Your patients are coming to you frustrated. They have a prescription for Auvelity XR (dextromethorphan/bupropion extended-release), but their pharmacy says they don't carry it or can't get it. As a prescriber, you can play a pivotal role in helping them navigate this challenge. This guide offers actionable steps to streamline the process.
Auvelity XR is not on the FDA drug shortage list as of early 2026. Axsome Therapeutics continues to manufacture and distribute the medication. The availability challenges are primarily at the pharmacy level — a function of stocking decisions, wholesaler allocation, and the economics of carrying a high-cost brand-name medication.
This is an important distinction to communicate to patients: their medication exists in the supply chain. It's a matter of finding the right pharmacy.
The three major wholesalers (McKesson, Cardinal Health, AmerisourceBergen) use allocation systems that may limit order quantities for pharmacies without established purchasing history for a given drug. A pharmacy trying to order Auvelity XR for the first time may face delays or quantity limits.
Prescribing of Auvelity XR is concentrated among psychiatrists and providers treating patients with difficult-to-manage depression. This creates geographic pockets of high demand — particularly in metropolitan areas with dense psychiatry practices — while pharmacies in other areas may never receive a prescription and therefore never stock it.
With a wholesale cost approaching $900-$1,300 per month of therapy, Auvelity XR represents a significant inventory investment for pharmacies. Many pharmacy managers are reluctant to stock a medication that may sit on the shelf, particularly if reimbursement is uncertain or if prior authorization delays mean prescriptions go unfilled.
The absence of a generic alternative means pharmacies cannot stock a lower-cost equivalent. This limits options for both the pharmacy and the patient, and makes the manufacturer copay card program especially important for maintaining access.
The Medfinder provider portal allows your staff to search for pharmacies with Auvelity XR in stock on behalf of patients. This is often faster and more efficient than having patients call multiple pharmacies themselves. Consider integrating this into your prescribing workflow for any patient starting Auvelity XR.
Coach patients to contact their pharmacy at least 7-10 days before their refill is due. This gives the pharmacy time to order Auvelity XR from their wholesaler if it's not in stock. Waiting until the last minute often results in treatment gaps.
Independent pharmacies often have more flexibility in their ordering and stocking decisions than chain pharmacies. They may work with different wholesalers and are typically more willing to special-order medications for their patients. Maintaining a list of reliable independent pharmacies that stock Auvelity XR can be a valuable practice resource.
When clinically appropriate, discuss with patients the possibility of dose flexibility. The standard 45 mg/105 mg strength is the most widely stocked. If a pharmacy has the medication in stock at the appropriate strength, having the prescription ready to send immediately can prevent the stock from being allocated to another patient.
Cost barriers are closely linked to access barriers. Patients who can't afford their copay may abandon prescriptions even when the pharmacy has stock. Make sure every Auvelity XR patient is aware of:
If a patient cannot access Auvelity XR despite best efforts, the following alternatives may warrant discussion:
Document any alternative trials thoroughly — this strengthens future PA appeals should the patient return to Auvelity XR.
Given the recurring nature of access challenges with newer brand medications, consider implementing these workflow optimizations:
Assign a medical assistant or patient navigator to handle medication access issues — including prior authorizations, savings card enrollment, and pharmacy stock verification. This reduces prescriber burden and improves patient satisfaction.
Before sending a new Auvelity XR prescription, use the Medfinder provider portal or call a known pharmacy to confirm stock. This prevents the frustrating cycle of prescription → denial → callback.
Maintain a running list of pharmacies that reliably stock Auvelity XR, including both local options and mail-order pharmacies. Update this list periodically as stocking patterns change.
For patients you anticipate starting on Auvelity XR, submit the prior authorization proactively — before the first prescription, if possible. Include complete documentation of prior antidepressant trials, clinical rationale, and supporting literature.
Helping patients access Auvelity XR requires a proactive, team-based approach. The medication is available — the challenge is connecting patients with pharmacies that stock it and ensuring cost isn't a barrier to adherence.
Key actions:
Related provider resources:
Share with your patients: Auvelity XR Shortage Update for Patients
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