Helping Your Patients Find Evekeo in Stock

As a prescriber, you already know the stimulant shortage is impacting your patients. But for those on Evekeo (amphetamine sulfate), the challenge is even greater. Evekeo's niche 1:1 racemic amphetamine formulation, limited manufacturer base, and small market share make it one of the hardest stimulants to source in 2026.

Your patients are frustrated, and many are spending hours calling pharmacies only to hear "we don't have it" over and over. This guide gives you practical steps to help — from verifying stock before prescribing to developing contingency plans.

Current Availability Landscape

As of early 2026, Evekeo availability remains inconsistent across the country. Key factors driving the shortage include:

• Single primary manufacturer: Azurity Pharmaceuticals is the main source of both Evekeo tablets and Evekeo ODT
• DEA quota constraints: Schedule II manufacturing quotas limit how much amphetamine sulfate can be produced annually
• Low pharmacy stocking rates: Many chain pharmacies don't carry Evekeo as a standard inventory item due to low prescription volume
• Wholesaler allocation: During shortage periods, wholesalers may allocate limited supply based on a pharmacy's historical ordering patterns

The result: even when Evekeo is technically in production, getting it to the right pharmacy at the right time remains a challenge.

Why Patients Can't Find Evekeo

Understanding the patient experience helps frame your approach:

1. Chain pharmacies say "not in stock": Most large chains don't regularly carry Evekeo and can't easily order it during shortages
2. Transfer restrictions: Schedule II prescriptions can't be transferred between pharmacies in most states, requiring a new prescription each time
3. Dose-specific shortages: A pharmacy may have Evekeo 5 mg but not 10 mg, or tablets but not ODT
4. Insurance barriers: Even when found, prior authorization requirements or non-preferred status can delay filling
5. Cost shock: Patients who find Evekeo but face $350-$600 cash prices may not be able to afford it

What Providers Can Do: 5 Actionable Steps

Step 1: Verify Stock Before Sending the Prescription

The single most impactful thing you can do is confirm that a pharmacy has Evekeo in stock before e-prescribing. This prevents the demoralizing cycle of patients going to a pharmacy only to be turned away.

Use Medfinder for Providers to check real-time availability at pharmacies near your patient. Staff can do this in seconds during the appointment or as part of prescription processing.

Step 2: Build a Pharmacy Network

Identify 3-5 pharmacies in your area that have been able to source Evekeo reliably. This typically includes:

• Independent pharmacies with multiple wholesaler relationships
• Specialty pharmacies focused on psychiatry or pediatrics
• Hospital outpatient pharmacies that may have separate supply chains

Maintain a list in your EHR or office reference and update it monthly. Share this list with patients proactively.

Step 3: Prescribe Flexibly When Appropriate

When clinically appropriate, prescribing flexibility can increase the odds of a successful fill:

• Consider both formulations: If Evekeo tablets are unavailable, Evekeo ODT may be in stock (available in 5 mg, 10 mg, 15 mg, and 20 mg)
• Discuss dose adjustments: If a patient's specific strength is unavailable, you may be able to prescribe an available strength with adjusted quantity
• 90-day supplies: When a pharmacy does have stock, a 90-day prescription (where regulations and insurance allow) reduces the frequency of the sourcing challenge

Step 4: Have a Documented Backup Plan

For every patient on Evekeo, document a contingency plan in the chart:

• Preferred alternative medication (e.g., generic mixed amphetamine salts, lisdexamfetamine)
• Conversion dose — note that Evekeo's 1:1 ratio is not directly equivalent mg-for-mg to Adderall's 3:1 ratio
• Patient's agreement to the backup plan
• Trigger point — at what point (e.g., 1 week without medication) to activate the switch

Having this documented means a covering provider can act quickly if you're unavailable when a patient can't fill their prescription.

Step 5: Address Cost Barriers Proactively

Even when Evekeo is found, cost can prevent patients from filling. At each visit, briefly address:

• Whether the patient's insurance covers Evekeo (many plans require prior authorization or don't cover it)
• Manufacturer savings programs through Azurity Pharmaceuticals
• Discount card options (GoodRx, SingleCare) that may reduce cash prices
• Patient assistance programs for uninsured or underinsured patients

Direct patients to our guide on how to save money on Evekeo, or review our provider's guide to helping patients save on Evekeo.

Alternatives to Consider

When Evekeo is genuinely unavailable and treatment continuity is at risk, the following alternatives may be appropriate:

• Adderall / generic mixed amphetamine salts: Closest pharmacological match, though the 3:1 d/l ratio differs from Evekeo's 1:1. May require dose adjustment.
• Dexedrine / generic dextroamphetamine: Pure d-amphetamine. More potent per milligram. Available in IR and ER formulations.
• Vyvanse / generic lisdexamfetamine: Prodrug with smoother onset and lower abuse potential. Once-daily dosing. Generic now available.
• Methylphenidate products: Different mechanism of action. Consider if patient has failed or not tolerated amphetamine-class medications.

For patient-facing information on alternatives, share our guide on alternatives to Evekeo.

Workflow Tips for Your Practice

Implementing a few workflow changes can reduce the burden on both staff and patients:

Pre-Visit Pharmacy Check

Train front desk or nursing staff to check Evekeo availability on Medfinder before the patient's appointment. This way, you can discuss pharmacy options and send the prescription to a confirmed location during the visit.

Refill Tracking

Flag Evekeo patients in your scheduling system. When their refill is approaching (5-7 days before), have staff proactively check stock and notify the patient of where to go.

Patient Communication Template

Create a standard message (via patient portal or letter) that includes:

• Current shortage status
• Steps the patient can take (including the Medfinder link)
• Instructions for contacting the office if they can't fill their prescription
• The documented backup medication plan

Prior Authorization Preparation

Keep a template for Evekeo prior authorizations that includes standard clinical justification language. Having this ready reduces turnaround time when insurance denials occur.

Final Thoughts

The Evekeo shortage places an extra burden on providers who are already managing complex patient panels. But a proactive approach — using Medfinder for Providers, building a reliable pharmacy network, documenting backup plans, and addressing cost barriers — can significantly reduce treatment disruptions for your patients.

For the broader shortage picture, see our clinical briefing on the Evekeo shortage. For drug interaction considerations when switching medications, review our article on Evekeo drug interactions.