Your Patients Can't Find Their Medication — Here's How You Can Help

If you prescribe Dextroamphetamine, you've likely seen the impact of the ongoing amphetamine shortage firsthand. Patients calling in distress because no pharmacy has their medication. Requests for early refills, dose changes, or alternative medications. Treatment gaps that undermine months of carefully titrated therapy.

The shortage — now entering its fourth year — isn't something you can fix at the systemic level. But there are concrete steps you can take within your practice to help patients maintain treatment continuity. This guide outlines a practical workflow for navigating the Dextroamphetamine shortage in 2026.

Current Availability Overview

As of early 2026, Dextroamphetamine remains on the FDA and ASHP drug shortage lists. The situation has improved modestly since the DEA raised the d-amphetamine Aggregate Production Quota by 25% in October 2025, but supply still hasn't caught up with demand.

Key availability patterns:

• Immediate-release tablets (generic) in 5 mg, 10 mg, and 15 mg strengths are generally more available than higher strengths.
• Extended-release capsules (generic Dexedrine Spansule) in 10 mg and 20 mg have been particularly scarce, with manufacturers estimating restock in Q1-Q2 2026.
• Brand-name Zenzedi may be available when generics aren't, but at significantly higher cost ($200-$400+/month).
• ProCentra oral solution is occasionally overlooked and may be in stock at pharmacies that are out of tablets.

Why Your Patients Can't Find It

Several factors compound to create the patient experience of "no one has it":

1. DEA production quotas cap total manufacturing volume, regardless of patient demand.
2. Chain pharmacy distribution systems allocate limited controlled substance inventory centrally, leaving some locations chronically understocked.
3. Manufacturer back orders create unpredictable gaps — a pharmacy may have stock one week and nothing the next.
4. Patient clustering — many patients fill at the beginning of the month, creating brief surges that deplete local supply.
5. Geographic variation — availability differs dramatically between regions, cities, and even neighborhoods.

What Providers Can Do: 5 Practical Steps

Step 1: Direct Patients to Real-Time Availability Tools

The most impactful thing you can do is help patients search smarter. Medfinder for Providers provides real-time pharmacy inventory data for Dextroamphetamine and other shortage medications.

How to integrate this into your workflow:

• Share the link (medfinder.com/providers) with patients at the point of prescribing
• Include it in your practice's shortage communication templates
• Have front desk staff reference it when patients call about fill issues

Step 2: Prescribe with Flexibility

Small adjustments to how you write prescriptions can significantly improve fill rates:

• Specify "may substitute" for generic: Ensure the prescription allows the pharmacist to dispense any manufacturer's generic.
• Consider alternative strengths: If 20 mg is unavailable, prescribe 2 × 10 mg tablets. If 15 mg is scarce, 3 × 5 mg may work.
• Offer formulation alternatives: If IR tablets are unavailable, ER capsules (or vice versa) may be in stock. Adjust dosing accordingly — ER is typically dosed once daily at a total daily dose similar to divided IR dosing.
• Note flexibility on the prescription: Where state law allows, adding a note like "or nearest available strength" can give pharmacists room to fill.

Step 3: Have a Switch Protocol Ready

When Dextroamphetamine is consistently unavailable for a patient, having a pre-planned switch protocol saves time and reduces treatment gaps:

• First switch option: Lisdexamfetamine (Vyvanse/generic). As a prodrug of dextroamphetamine, it offers the closest pharmacological match. Generic availability has improved since 2023. Typical starting dose: 30 mg once daily.
• Second option: Mixed amphetamine salts (Adderall/generic). Also affected by the shortage but may have regional availability. Dose is approximately equivalent mg-for-mg to dextroamphetamine IR.
• Third option: Methylphenidate products (Ritalin, Concerta, Focalin). Different mechanism; generally better availability. Requires dose titration from baseline — not directly equivalent to amphetamines.
• Non-stimulant option: Atomoxetine (Strattera/generic) for patients with comorbid anxiety, substance use concerns, or who prefer non-controlled medications. Allow 4-6 weeks for full effect.

Step 4: Communicate Proactively

Patients in a shortage are anxious. Proactive communication builds trust and reduces call volume:

• Discuss the shortage openly during appointments — normalize the experience
• Provide written or digital resources patients can reference (shortage updates, pharmacy search tools, alternative medication information)
• Set expectations: "If you can't fill this within 3 days, call us and we'll adjust the prescription"
• Share patient-facing articles from trusted sources, such as Medfinder's 2026 shortage update

Step 5: Document Everything

Shortage-related prescribing changes should be clearly documented:

• Record the clinical rationale for any medication switches
• Note that the change was driven by supply unavailability, not clinical preference
• Document the patient's prior regimen for easy reversion when supply stabilizes
• Track which formulations and strengths have been successfully filled — this data helps with future prescribing

Alternatives at a Glance

Workflow Tips for Your Practice

• Create a shortage template in your EHR for quick documentation of shortage-related changes.
• Batch shortage calls: Designate time blocks for your staff to address fill issues rather than handling them ad hoc throughout the day.
• Build relationships with local pharmacies: A direct line to a pharmacist who can flag availability changes saves time for everyone.
• Keep a running list of which pharmacies in your area currently stock Dextroamphetamine in which strengths. Update weekly.
• Use Medfinder for Providers as your go-to real-time reference for availability checks.

Final Thoughts

The Dextroamphetamine shortage puts extra burden on providers who are already stretched thin. But with flexible prescribing, proactive communication, pre-planned switch protocols, and real-time tools like Medfinder, you can help your patients navigate this difficult period with minimal disruption to their care.

For the broader shortage context, see our companion briefing: Dextroamphetamine shortage: What providers and prescribers need to know in 2026.

For cost-saving strategies to share with patients: How to help patients save money on Dextroamphetamine.