Provider Briefing: The Procentra Shortage in 2026

If your pediatric patients are having trouble filling Procentra (Dextroamphetamine Sulfate oral solution, 5 mg/5 mL) prescriptions, the problem isn't isolated. The amphetamine shortage that began in October 2022 continues to affect availability of nearly all Dextroamphetamine formulations — and the oral solution, as a niche product with limited manufacturers, has been disproportionately impacted.

This briefing covers the current state of the shortage, prescribing considerations, alternative therapies, and tools you can use to help your patients navigate the access challenge.

Shortage Timeline

Understanding the arc of this shortage helps contextualize the current landscape:

• October 2022: The FDA first acknowledges a shortage of amphetamine mixed salts (Adderall). Multiple manufacturers report supply disruptions. ASHP adds amphetamine products to its active shortage list.
• 2023: The shortage expands beyond mixed salts to include Dextroamphetamine formulations. Oral solution availability becomes especially inconsistent as limited manufacturers struggle with production constraints and DEA quota limitations.
• 2024: Supply improves slightly for some tablet formulations but remains critical for extended-release capsules and oral solutions. Congressional hearings on the shortage draw national attention.
• October 2025: The DEA raises the aggregate production quota (APQ) for d-amphetamine from 21.2 million grams to 26.5 million grams — a 25% increase. This is the first significant quota adjustment since the shortage began.
• Early 2026: ASHP continues to list amphetamine extended-release and oral presentations as in active shortage. Multiple manufacturers report back orders on specific strengths. Procentra and generic Dextroamphetamine oral solution remain difficult to source in many markets.

Prescribing Implications

The shortage creates several clinical challenges for prescribers treating pediatric ADHD and narcolepsy patients:

Patient Population Considerations

Procentra is FDA-approved for ADHD in children ages 3-16 and for narcolepsy. The oral solution is clinically necessary for:

• Children ages 3-5 who cannot swallow tablets or capsules
• Patients with dysphagia or swallowing difficulties
• Patients who require precise, titratable dosing in small increments
• Patients with feeding tube access who require liquid medications

For these patients, switching to a tablet formulation is not straightforward and may not be clinically appropriate.

Dose Conversion Considerations

If converting a patient from Procentra oral solution to another Dextroamphetamine formulation:

• Procentra contains 5 mg Dextroamphetamine Sulfate per 5 mL
• Zenzedi tablets: 1:1 mg-for-mg conversion (same salt, same release profile)
• Adderall (mixed amphetamine salts): Contains approximately 75% d-amphetamine and 25% l-amphetamine; not a direct 1:1 equivalence to pure Dextroamphetamine
• Vyvanse (Lisdexamfetamine): Prodrug with different pharmacokinetics; standard conversion: 30 mg Lisdexamfetamine ≈ 10 mg Dextroamphetamine (approximate)
• Methylphenidate: Different drug class; no direct conversion — titrate from a starting dose

Regulatory Reminders

As a Schedule II controlled substance, Procentra prescriptions:

• Cannot be called in to pharmacies in most states (requires written or electronic prescription)
• Cannot be refilled — a new prescription is required each time
• Are subject to state-specific quantity limits and early fill restrictions
• Require separate prescriptions for each formulation change (pharmacists cannot substitute between brands or salt forms without a new Rx)

Current Availability Picture

As of March 2026:

• Brand Procentra (Independence Pharmaceuticals): Intermittent availability. Some pharmacies report stock while others are completely out. Regional variation is significant.
• Generic Dextroamphetamine oral solution: Limited manufacturers with multiple strength/NDC back orders.
• Dextroamphetamine tablets (generic/Zenzedi): More widely available than the oral solution, though not immune to spot shortages.
• Adderall/generic mixed salts: Availability improving but still inconsistent for some strengths.

Cost and Access Considerations

When recommending alternatives, cost is a factor for many families:

• Brand Procentra: $200-$612 per 473 mL bottle (cash price)
• Generic Dextroamphetamine oral solution: ~$75+ with coupon (cash price)
• Generic Dextroamphetamine tablets: Starting around $44 with GoodRx coupon
• Manufacturer coupon: Independence Pharmaceuticals offers a copay card reducing out-of-pocket cost to $10 (max savings $100/fill)

Many commercial insurance plans cover generic Dextroamphetamine as Tier 2. Brand Procentra often requires prior authorization and may be classified as Tier 3 (non-preferred).

For patients facing cost barriers, refer them to our patient savings guide for Procentra or to resources like NeedyMeds.org and RxAssist.org for patient assistance program information.

Tools and Resources for Your Practice

Several resources can help you and your patients navigate the shortage:

• Medfinder for Providers: Real-time pharmacy stock checking for Procentra and other shortage-affected medications. Recommend this tool to patients and care coordinators.
• ASHP Drug Shortage Resource Center: Updated shortage status with manufacturer-specific information and estimated resupply dates.
• FDA Drug Shortage Database: Official shortage listings with current status and expected resolution timelines.
• Independence Pharmaceuticals: Manufacturer website (procentrahcp.com) with prescribing information and patient coupon resources.

Workflow Tip

Consider adding a shortage check to your prescribing workflow for all amphetamine products. Before writing a Procentra prescription, your staff can verify availability at the patient's preferred pharmacy using Medfinder to avoid the cycle of write-reject-rewrite that wastes clinical time and delays patient care.

Looking Ahead

The 25% DEA quota increase from October 2025 is a meaningful step, but its full impact on pharmacy shelves may not be felt until mid-to-late 2026. Given continued growth in ADHD diagnosis rates and the structural challenges facing oral solution production, intermittent shortages are likely to persist for the foreseeable future.

Proactive communication with patients and families — setting expectations about potential access challenges and having an alternative plan ready — is the most effective clinical approach during this period.

For provider-focused guidance on helping patients find their medications, see our companion article: How to help your patients find Procentra in stock.

Final Thoughts

The Procentra shortage is now in its fourth year and shows no signs of fully resolving in the near term. For providers who prescribe this medication — particularly pediatricians and child psychiatrists — familiarity with alternative formulations, conversion considerations, and availability tools is essential for maintaining continuity of care for your patients.

Encourage patients and families to use Medfinder to locate pharmacies with stock, and stay informed through ASHP and FDA shortage databases for the latest manufacturer updates.