Provider Briefing: Quillivant XR Shortage in 2026

The Quillivant XR (methylphenidate HCl extended-release oral suspension) shortage continues to present challenges for providers managing ADHD patients in 2026. As the only commercially available long-acting liquid methylphenidate formulation, supply disruptions disproportionately affect pediatric patients and others unable to use solid oral dosage forms.

This briefing provides prescribers with an updated overview of the shortage, its clinical implications, and practical strategies for maintaining continuity of care.

Shortage Timeline

The Quillivant XR shortage has evolved through several phases:

• Late 2022: The broader ADHD stimulant shortage begins with amphetamine salt products (Adderall), causing increased demand for methylphenidate alternatives.
• 2023: Tris Pharma, the sole manufacturer of Quillivant XR, experiences production disruptions. The FDA lists Quillivant XR as "currently in shortage." Some pharmacies report the product as discontinued, though Tris Pharma confirms ongoing production intent.
• 2024: Supply improves modestly but remains inconsistent. The ASHP continues to list methylphenidate extended-release oral presentations on its shortage database. The CDC issues a health advisory (HAN-00510) regarding disrupted access to prescription stimulant medications.
• 2025–2026: The shortage persists. Quillivant XR availability varies significantly by region, wholesaler, and pharmacy. No generic has entered the market despite FDA approval of a generic application.

Prescribing Implications

The shortage creates several clinical challenges for prescribers:

Patient Population Most Affected

Quillivant XR is most commonly prescribed for:

• Children aged 6–12 who cannot swallow tablets or capsules
• Patients requiring precise dose titration (the liquid formulation allows adjustments in 5 mg increments)
• Patients with dysphagia or swallowing disorders
• Patients previously stabilized on Quillivant XR who have not been successfully transitioned to tablet formulations

Key Prescribing Considerations

• Do not substitute milligram-per-milligram when switching between methylphenidate formulations. Different release profiles and bioavailability characteristics require independent dose titration.
• Document the medical necessity for liquid formulation in patient charts. This supports prior authorization requests and appeals for insurance coverage.
• Educate caregivers that some capsule formulations (Ritalin LA, Focalin XR, Aptensio XR) can be opened and sprinkled on soft food — this may offer a viable alternative for patients who cannot swallow capsules whole.
• Monitor patients closely during any medication transition. Changes in formulation can affect onset, duration, and peak effect timing.

Current Availability Picture

As of early 2026:

• Quillivant XR remains on the FDA Drug Shortage Database as "currently in shortage"
• ASHP lists methylphenidate extended-release oral presentations as in shortage (updated December 2025)
• Availability varies significantly — some regions and wholesalers have intermittent stock while others report prolonged unavailability
• No generic Quillivant XR is commercially available, despite FDA approval of a generic application
• Tris Pharma remains the sole manufacturer

Medfinder for Providers offers real-time pharmacy availability data that can help your practice and patients identify pharmacies with current stock, reducing the burden on your staff and patients.

Cost and Access Considerations

Cost remains a significant barrier for many patients:

• Cash price: $328–$480 per bottle (120 mL) without insurance
• Insurance coverage: Not covered by most Medicare plans. Commercial plans frequently require prior authorization and may impose step therapy requirements (e.g., trial of generic methylphenidate tablets first).
• Tris Pharma Savings Card: Eligible commercially insured and cash-paying patients can pay as little as $20 per prescription. Providers can direct patients to trissavingscard.com.
• Patient assistance: NeedyMeds (needymeds.org) and RxAssist (rxassist.org) may have updated listings for financial assistance programs.

When writing prescriptions for multiple bottle sizes within a single 30-day supply, be aware that this may result in additional copays for patients or require separate prior authorizations.

Tools and Resources for Your Practice

Medfinder for Providers

Medfinder provides real-time pharmacy inventory data that your practice can use to direct patients to pharmacies with Quillivant XR in stock. This reduces phone call burden on your staff and improves the patient experience during the shortage.

Clinical Decision Support

When considering alternatives, the following table summarizes key comparisons:

• Quillivant XR: Liquid, 12-hour duration, methylphenidate, no generic, $328–$480
• QuilliChew ER: Chewable tablet, 12-hour duration, methylphenidate, no generic, ~$359
• Ritalin LA: Capsule (sprinkle option), 8-hour duration, methylphenidate, generic available, ~$30–$80 generic
• Concerta: Tablet (must swallow whole), 12-hour duration, methylphenidate, generic available, ~$30–$90 generic
• Focalin XR: Capsule (sprinkle option), 12-hour duration, dexmethylphenidate, generic available, ~$30–$70 generic
• Dyanavel XR: Liquid, 12-hour duration, amphetamine, no generic, ~$300–$400

Prior Authorization Support

If switching a patient to an alternative requires prior authorization, document:

• Medical necessity for the specific formulation (liquid, chewable, sprinkle)
• Patient's inability to use standard tablet formulations
• Previous treatment history and response
• Impact of the shortage on access to preferred formulation

Looking Ahead

Several factors may influence Quillivant XR availability in the coming months:

• Generic entry: An FDA-approved generic exists but has not yet launched. Market entry could significantly improve supply.
• DEA quota adjustments: Annual quota allocations for methylphenidate may be increased in response to ongoing shortage conditions.
• Tris Pharma manufacturing recovery: The manufacturer has indicated commitment to restoring supply, though no specific timeline has been publicly confirmed.

Final Thoughts

The Quillivant XR shortage requires prescribers to balance clinical best practices with supply reality. Proactive communication with patients, familiarity with alternative formulations, and use of tools like Medfinder for Providers can help maintain continuity of care despite ongoing supply constraints.

For patient-facing resources you can share, see our posts on the 2026 shortage update for patients and alternatives to Quillivant XR. For guidance on helping patients reduce costs, see our provider guide to saving patients money on Quillivant XR.