Your Patients Need Lisdexamfetamine — Here's How to Help Them Get It

You've written the prescription. Your patient's ADHD or binge eating disorder is well-managed on Lisdexamfetamine. And then they call your office: "My pharmacy says they're out. I've tried three others. No one has it."

This scenario has become routine during the Lisdexamfetamine (Vyvanse) shortage that began in late 2022 and continues into 2026. As a prescriber, you're in a unique position to help patients navigate the shortage more effectively. This guide provides concrete steps your practice can take.

Current Availability: What You Need to Know

As of early 2026, here's the supply situation:

• Generic Lisdexamfetamine capsules remain in shortage per ASHP, with variable availability by manufacturer, strength, and region
• Brand Vyvanse (Takeda) is generally available but costs $300-$400/month without insurance
• Chewable tablets (both brand and generic) tend to be more consistently available than capsules
• Lower strengths (10-30 mg) are typically easier to find than higher strengths (50-70 mg)
• The DEA raised production quotas by ~24% in late 2025, with additional increases for 2026, but manufacturing ramp-up is gradual

Why Your Patients Can't Find It

Understanding the barriers helps you offer better guidance:

Chain Pharmacy Allocation Limits

Large pharmacy chains (CVS, Walgreens, Rite Aid) allocate controlled substances to individual locations based on historical dispensing data. If a location hasn't historically filled many Lisdexamfetamine prescriptions, its allocation may be low — regardless of current demand. This creates artificial scarcity at the pharmacy level even when the manufacturer has supply.

Schedule II Prescribing Restrictions

Patients cannot transfer Schedule II prescriptions between pharmacies in most states. If a patient's prescription is sent to a pharmacy that doesn't have stock, they may need a new prescription sent to a different pharmacy — adding delays and frustration.

Strength-Specific Shortages

The shortage doesn't affect all strengths equally. A pharmacy might have 20 mg capsules in stock but be completely out of 50 mg and 70 mg. Patients often don't know they can ask about this, and pharmacies may not proactively offer alternatives.

Patient Awareness Gaps

Many patients only know to check their usual pharmacy — often a single chain location. They may not be aware of independent pharmacy options, availability tools, or the chewable tablet formulation.

What Providers Can Do: 5 Actionable Steps

Step 1: Check Availability Before Sending the Prescription

Rather than sending the prescription to the patient's default pharmacy and hoping for the best, take 60 seconds to check availability first. Medfinder provides real-time pharmacy stock data that your staff can use to identify pharmacies with Lisdexamfetamine in stock before you e-prescribe.

This simple step can save your patient hours of phone calls and prevent the need for prescription rewrites.

Step 2: Prescribe Flexibly

Build shortage awareness into your prescribing approach:

• Consider lower-strength combinations: If 60 mg capsules are unavailable, prescribe two 30 mg capsules daily. Document the rationale in the chart.
• Offer the chewable tablet option: Write for chewable tablets (available in 10-60 mg) when capsules can't be found. Same active ingredient, same efficacy.
• Include "may substitute" notation: When appropriate, indicate that the pharmacy may dispense any available generic manufacturer.

Step 3: Educate Patients on Pharmacy Options

During the appointment or via patient handouts, let patients know:

• Independent pharmacies often have better controlled substance access than chains
• They can use Medfinder to search for pharmacies with stock
• They should call ahead to confirm availability before visiting
• Mid-month refills may have better success than beginning-of-month

Step 4: Have an Alternative Plan Ready

Don't wait until the patient can't find their medication to discuss alternatives. Proactively talk through backup options:

• Adderall XR (mixed amphetamine salts ER) — same drug class, approximate dose equivalency available
• Dextroamphetamine ER (Dexedrine Spansule) — same active metabolite as Lisdexamfetamine
• Concerta (Methylphenidate ER) — different stimulant class, may require dose titration
• Atomoxetine (Strattera) — non-stimulant, not subject to controlled substance shortages

Having this conversation before a crisis means the patient is prepared and you can switch quickly if needed. For detailed alternative comparisons, see our alternatives guide.

Step 5: Streamline Prior Authorization for Switches

When patients need to switch to an alternative that requires prior authorization, have your team prepared:

• Reference the ASHP shortage listing as clinical justification
• Document the patient's inability to fill their current prescription
• Use shortage-specific PA language that payers recognize
• Many payers have expedited processes for shortage-related medication changes

Alternative Medications: Quick Reference

Workflow Tips for Your Practice

Designate a Shortage Point Person

Assign one staff member (MA, nurse, or pharmacy liaison) to stay current on stimulant availability. They can check Medfinder daily, maintain a list of pharmacies with confirmed stock, and serve as the first point of contact when patients report difficulty filling prescriptions.

Create a Patient Handout

Develop a one-page handout for patients that includes:

• An explanation of the current shortage
• Tips for finding their medication (independent pharmacies, Medfinder, calling ahead)
• Instructions on what to do if they can't find it (call your office, don't skip doses, etc.)
• Links to relevant resources like our finding guide

Build in Follow-Up

For patients affected by the shortage, consider shorter follow-up intervals (phone or telehealth) to monitor for treatment gaps and adjust plans quickly.

Final Thoughts

The Lisdexamfetamine shortage has turned medication management into a logistics challenge for both patients and providers. But with proactive prescribing, patient education, and the right tools, you can minimize disruptions to your patients' care.

Explore Medfinder for Providers to integrate pharmacy availability into your prescribing workflow. For more on the shortage timeline and regulatory context, see our provider shortage briefing. And for cost-related guidance, check our provider's guide to helping patients save money on Lisdexamfetamine.