Provider Briefing: The Relexxii Shortage in 2026

If your patients have been struggling to fill prescriptions for Relexxii (Methylphenidate Hydrochloride Extended-Release), you're not alone. The broader stimulant shortage that began in late 2022 continues to affect methylphenidate ER formulations heading into 2026, creating real challenges for clinicians managing ADHD in both pediatric and adult populations.

This guide covers the current state of the Relexxii shortage, what's driving it, and practical steps you can take to keep your patients on effective therapy.

Shortage Timeline: How We Got Here

The stimulant shortage traces back to a surge in ADHD diagnoses during and after the COVID-19 pandemic, coupled with DEA production quota limits on Schedule II substances. Key milestones include:

• Late 2022: FDA first acknowledges widespread shortages of amphetamine mixed salts and methylphenidate products.
• 2023–2024: ASHP lists multiple methylphenidate ER oral presentations as "currently in shortage." Sun Pharma discontinues its generic. Teva discontinues Metadate CD. Trigen places its product on allocation.
• October 2025: DEA increases methylphenidate production quotas by up to 25%, signaling a policy response to the ongoing crisis.
• December 2025–present: Shortages continue but show improvement. Relexxii brand supply from Vertical Pharmaceuticals has been more stable than many generic alternatives.

The CDC also issued Health Advisory HAN-00510 regarding disrupted access to prescription stimulant medications, underscoring the public-health dimension of the problem.

Prescribing Implications

The shortage creates several clinical challenges:

• Treatment interruptions: Patients who cannot fill their prescriptions may experience symptom relapse, affecting work, school, and daily functioning.
• Forced switching: Patients stabilized on Relexxii or a specific generic may need to transition to a different methylphenidate formulation or even a different stimulant class.
• Pharmacy shopping concerns: Patients calling multiple pharmacies to find stock may trigger prescription-monitoring alerts, even when their behavior is medically appropriate.
• Prior authorization delays: When switching formulations, insurance plans may require new prior authorizations, adding days or weeks of delay.

It's important to document the clinical rationale for any formulation changes and proactively communicate with patients about what to expect during transitions.

Current Availability

As of early 2026, availability varies by formulation and region:

• Relexxii (brand): Supply has been more consistent than many generics. Available in strengths from 18 mg to 72 mg.
• Generic Methylphenidate ER (OROS): Spotty availability. Some manufacturers remain on allocation.
• Concerta (brand): Intermittently available, often at higher cost.
• Aptensio XR, Jornay PM: Alternative formulations that may have better availability in some markets.

For a deeper look at alternative options, see our guide on alternatives to Relexxii.

Cost and Access Considerations

Cost remains a significant barrier, particularly for uninsured or underinsured patients:

• Brand Relexxii: Cash price ranges from $350 to $505 per month for 30 tablets.
• Generic Methylphenidate ER: With discount coupons (GoodRx, SingleCare), patients may pay $32 to $45 per month.
• Insurance coverage: Generic methylphenidate ER is typically Tier 2–3. Brand Relexxii is often Tier 3–4 or non-preferred and may require prior authorization or step therapy.

Eligible commercially insured patients can access the Relexxii Savings Card at relexxii.com/savings, potentially reducing their copay to as little as $0. For patients facing financial hardship, resources like NeedyMeds and RxAssist can help identify assistance programs.

For more on cost-saving strategies, see our post on how to save money on Relexxii.

Tools and Resources for Providers

Several tools can help you and your staff navigate the shortage more efficiently:

1. MedFinder for Providers: medfinder.com/providers lets you check real-time pharmacy stock for Relexxii and other methylphenidate products, saving time on phone calls.
2. ASHP Drug Shortage Database: Monitor current shortage status and estimated resolution timelines at ashp.org/drug-shortages.
3. State PDMP systems: When patients are forced to pharmacy-shop, reviewing your state's prescription drug monitoring program can document legitimate fill attempts and avoid red flags.
4. Pre-written patient letters: Consider preparing a standardized letter explaining the shortage that patients can share with pharmacies, employers, or schools.
5. Electronic prior authorization (ePA): If available in your EHR, ePA can speed up formulary exception requests when switching formulations.

Looking Ahead

The DEA's decision to increase production quotas by up to 25% in October 2025 is a positive signal, but manufacturing ramp-up takes time. Industry analysts expect gradual improvement through mid-2026, with the following developments to watch:

Through a partnership with Relexxii's manufacturer, Medfinder offers complimentary medication locating services for Relexxii patients.

• New generic entrants responding to increased quota allocations
• FDA guidance on substitution protocols during shortages
• Potential telehealth prescribing rule changes for Schedule II medications

Staying informed is key. We recommend bookmarking medfinder.com/providers and checking shortage databases regularly.

Final Thoughts

The Relexxii shortage puts providers in a difficult position—balancing patient needs against supply realities. By understanding the landscape, using real-time availability tools, and proactively planning for formulation switches, you can minimize treatment disruptions for your ADHD patients.

The manufacturer of Relexxii has partnered with Medfinder to provide medication locating services free of charge. Visit medfinder.com to find Relexxii in stock near you at no cost.

For related reading, see our posts on why Relexxii is hard to find and how to help patients find Relexxii in stock.