Your Patients Need Help Finding Their Medication

The ongoing Dexmethylphenidate XR (Focalin XR) shortage has been a burden not just for patients, but for the providers who prescribe it. Patients call your office frustrated. Pharmacies call requesting alternative prescriptions. Your staff spends time navigating a problem that shouldn't exist — but does.

This guide offers five concrete steps you and your team can take to help patients find Dexmethylphenidate XR, along with workflow tips to minimize the disruption to your practice.

Current Availability

As of early 2026, Dexmethylphenidate XR remains in active shortage. Multiple generic manufacturers have key strengths on back order. Brand Focalin XR from Sandoz/Novartis has intermittent availability. Supply is gradually improving thanks to increased DEA production quotas and new generic market entrants, but availability remains inconsistent across regions and pharmacies.

Why Patients Can't Find It

Understanding the root causes helps when counseling patients and managing expectations:

• DEA quota constraints limit total manufacturing volume for this Schedule II controlled substance
• Manufacturer back orders — Par Pharmaceutical has most strengths unavailable with no estimated release date
• Distribution concentration — large chain pharmacies may receive preferential allocations from distributors
• Demand growth — rising ADHD diagnoses, especially among adults, have outpaced supply increases
• Prescription non-transferability — Schedule II Rx's can't be transferred, so patients must get new prescriptions for each pharmacy they try

What Providers Can Do: 5 Steps

Step 1: Check Availability Before Prescribing

Before sending a prescription, use Medfinder for Providers to check which pharmacies near your patient currently have Dexmethylphenidate XR in stock. This simple step can save your patient hours of phone calls and multiple trips to pharmacies.

Consider making this a standard part of your prescribing workflow for shortage-affected medications: check availability → send Rx to a pharmacy that has stock → confirm with the patient.

Step 2: Be Flexible on Manufacturer and Strength

If a patient's usual strength (e.g., 20 mg) is unavailable, consider whether a combination of available strengths could work. For example, two 10 mg capsules may be substitutable if 20 mg capsules are out of stock. This requires a new prescription specifying the different strength and quantity.

Similarly, different generic manufacturers may have different strengths available. Pharmacists can dispense whichever generic is in stock unless the prescription specifies "brand medically necessary."

Step 3: Have a Backup Plan Ready

Proactively discuss alternative medications with patients before a shortage crisis. Document 1-2 backup agents in the patient's chart so that if Dexmethylphenidate XR becomes unavailable, you can quickly pivot without requiring a full re-evaluation.

Common alternatives include:

• Methylphenidate ER (Concerta, Ritalin LA): Closest pharmacological match. Dexmethylphenidate XR 10 mg ≈ Methylphenidate ER 20 mg.
• Adderall XR (Mixed Amphetamine Salts): Different mechanism; may work for patients who don't respond optimally to methylphenidate-class agents.
• Vyvanse (Lisdexamfetamine): Prodrug with smoother onset; generic now available.
• Atomoxetine (Strattera): Non-stimulant; not subject to DEA quotas or the current shortage. Takes 4-6 weeks for full effect.

For detailed alternative comparisons, see our article on alternatives to Dexmethylphenidate XR.

Step 4: Educate Patients on Self-Advocacy

Empower patients with the tools and knowledge to help themselves:

• Direct them to Medfinder so they can check pharmacy availability independently
• Advise them to begin searching for refills 7-10 days before running out
• Suggest trying independent pharmacies, which may have better access to certain wholesalers
• Remind them that pharmacists can check with distributors and place back orders

You can share these patient-facing resources:

• How to find Dexmethylphenidate XR in stock near you
• How to check if a pharmacy has Dexmethylphenidate XR in stock

Step 5: Address Cost Barriers

Shortage-driven scarcity can push patients toward more expensive options. Help mitigate this by:

• Prescribing generic Dexmethylphenidate ER when possible ($40-$150/month with coupons vs. $250-$490 for brand)
• Informing commercially insured patients about the Novartis Focalin XR savings card (up to $60/month off copay)
• Referring uninsured or underinsured patients to the Novartis Patient Assistance Foundation
• Suggesting discount platforms: GoodRx, SingleCare, RxSaver

See our provider's guide to helping patients save on Dexmethylphenidate XR for more.

Workflow Tips for Your Practice

Designate a Shortage Point Person

Assign one staff member to monitor shortage-affected medications weekly. They can check ASHP updates, Medfinder availability, and manufacturer announcements, then share relevant updates with prescribers.

Use E-Prescribing to Speed Up Changes

When a patient identifies a pharmacy with stock, e-prescribe directly to that location. This is faster and more reliable than paper scripts, and EPCS (Electronic Prescribing for Controlled Substances) is available nationwide.

Batch Shortage Communications

Consider sending periodic patient communications (via portal or email) about the shortage status and what patients can do proactively. This reduces inbound calls and keeps patients informed.

Document Shortage-Related Decisions

Note in the chart when a medication switch was made due to shortage rather than clinical failure. This is important for continuity of care and for insurance appeals if the patient needs to switch back.

Final Thoughts

The Dexmethylphenidate XR shortage adds complexity to ADHD management, but providers who build shortage-resilient workflows — using availability tools like Medfinder, maintaining backup plans, and proactively addressing cost — can meaningfully reduce the impact on their patients.

For the broader clinical picture, see our full provider shortage briefing.