A clinical briefing for providers on the Zenzedi shortage in 2026. Timeline, prescribing implications, cost data, and tools to help your patients find their medication.
If you prescribe Zenzedi (dextroamphetamine sulfate) for ADHD or narcolepsy, you're likely fielding a growing number of patient calls about availability. This guide provides a comprehensive overview of the current supply landscape, what it means for your prescribing practice, and actionable resources to help your patients navigate access challenges.
October 2022: FDA formally acknowledges a nationwide shortage of amphetamine mixed salts (Adderall), marking the beginning of the broader stimulant shortage. Teva Pharmaceutical (the largest generic Adderall manufacturer) reports supply constraints.
2023: Shortage expands to nearly all amphetamine-based products, including dextroamphetamine formulations. DEA production quotas are cited as a primary bottleneck. Multiple manufacturers report allocation limits from raw material suppliers.
Early 2024: Azurity Pharmaceuticals (manufacturer of Zenzedi, formerly Arbor Pharmaceuticals) issues a voluntary recall of certain Zenzedi lots due to a manufacturing quality issue. The recall further constrains an already limited supply.
Mid-2024: FDA updates shortage listings. Generic lisdexamfetamine (Vyvanse) enters the market, providing some relief for patients willing to switch to a long-acting formulation.
October 2025: DEA announces a 25% increase in aggregate production quotas for amphetamine products. This represents the most significant quota adjustment in recent years, though the effects take months to materialize as manufacturers scale production.
Early 2026: Supply is improving unevenly. High-volume products like generic Adderall see the most improvement. Niche products like brand Zenzedi remain in limited supply, with a findability score of 35/100 (frequent shortages, limited distribution).
Zenzedi's supply chain remains constrained. As a lower-volume brand product manufactured by a single company (Azurity), it lacks the supply diversity of generic amphetamine salts. Wholesaler allocation for Zenzedi is limited or zero at many pharmacy locations, particularly chain pharmacies.
Most commercial insurers and Medicare Part D plans require prior authorization for brand-name Zenzedi, often with step therapy requiring documentation of generic dextroamphetamine trial and failure. The PA process can add 3–7 business days, during which patients may go without medication.
For patients who require the brand specifically (e.g., documented adverse reactions to generic fillers), supporting documentation strengthens the PA appeal and should include specifics about the formulation issue, not just a preference statement.
Coverage for dextroamphetamine varies by indication:
The supply chain for Zenzedi follows the standard manufacturer → wholesaler → pharmacy path, but with additional regulatory constraints:
The bottleneck is primarily at step 1 — the DEA quota. Even with the 25% increase, total amphetamine production capacity hasn't fully absorbed the demand spike driven by rising ADHD diagnosis rates.
Some Zenzedi dose strengths are more available than others. The 10 mg and 20 mg tablets tend to be the most commonly stocked; the 2.5 mg, 7.5 mg, and 15 mg strengths are rarer. When clinically appropriate, prescribing a more common strength may improve your patient's ability to fill.
Availability varies significantly by geography. Urban areas with more pharmacy options tend to have better access, while rural patients may face longer searches. Independent pharmacies — which can source from secondary wholesalers — are often better stocked for niche products like Zenzedi.
Cost is a significant barrier to adherence. Patients on brand Zenzedi without adequate insurance or the manufacturer savings card face the highest burden. Proactively discussing cost during visits can prevent prescription abandonment.
Several factors may improve Zenzedi availability over the coming months:
That said, brand Zenzedi will likely remain a limited-distribution product given its niche status. Providers should continue planning for potential access challenges.
As prescribers, you play a critical role in helping patients navigate the Zenzedi shortage:
For more provider resources:
You focus on staying healthy. We'll handle the rest.
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