If you have attention deficit hyperactivity disorder (ADHD), your doctor might prescribe Azstarys. Azstarys is a prescription drug used in adults and some children to treat ADHD.

ADHD is a mental health disorder that can cause inattentiveness, hyperactivity, and impulsive behavior. To learn more about ADHD and how Azstarys is used, see the “Is Azstarys used for ADHD?” section below.

Azstarys basics

Azstarys contains the active ingredients serdexmethylphenidate and dexmethylphenidate. (An active ingredient is what makes a drug work.) It’s part of a group of drugs called central nervous system stimulants.

Azstarys comes as a capsule that you swallow. It isn’t available in a generic form.

Read on to learn about the uses of Azstarys, its side effects, and more.

Find answers to some commonly asked questions about Azstarys.

How does Azstarys compare with alternatives such as Adderall and Vyvanse?

Azstarys, Adderall, and Vyvanse are three drugs that doctors can use to treat attention deficit hyperactivity disorder (ADHD).

The table below summarizes some of the similarities and differences between these drugs.

AzstarysAdderall†Vyvanse
Use(s)ADHDADHD, narcolepsyADHD, binge eating disorder
Who can take it for ADHDadults and children ages 6 years and olderadults and children ages 3 years and olderadults and children ages 6 years and older
Active ingredient(s)*serdexmethylphenidate/
dexmethylphenidate		amphetamine/
dextropamphetamine		lisdexamfetamine
Form(s), all taken by mouthcapsuletabletcapsule, chewable tablet
Available as a genericnoyesyes

* An active ingredient is what makes a drug work.
† Adderall also comes as an extended-release capsule called Adderall XR. This form is only used to treat ADHD.

In addition to these three drugs, other treatments for ADHD are available. They include methylphenidate (Concerta, Ritalin) and dexmethylphenidate (Focalin).

To learn about drugs used to treat ADHD, talk with your doctor or pharmacist.

How long does Azstarys last?

It takes a few days for your body to clear (get rid of) a dose of Azstarys. But the effect of this drug on your body doesn’t last this long.

Azstarys contains two drugs, dexmethylphenidate and serdexmethylphenidate. Serdexmethylphenidate is a prodrug, which is a medication that your body changes into an active drug. It needs some time to start working in your body.

After both drugs in Azstarys take effect, your body will clear them. It’ll take about 55 hours for your body to clear Azstarys.

The effect of Azstarys is strongest in the hours after you swallow it, which is usually in the morning. It will persist until the afternoon, about 13 hours after taking your dose.

If you have questions about how long the effects of Azstarys last or how long the drug stays in your body, talk with your doctor or pharmacist.

Is Azstarys a controlled substance?

Yes, Azstarys is a controlled substance. Controlled substances are drugs regulated by the United States government because they may cause misuse and dependence. Misuse of a drug means using it in a different way than how it was prescribed. Dependence on a drug means your body gets used to a drug and needs it to function as usual.

Controlled substances are classified by categories called Schedules, numbered I to V. Schedule I drugs have the highest potential for misuse and dependence, and Schedule V drugs have the lowest.

Stimulant ADHD medications, such as Azstarys, are Schedule II drugs. Azstarys has a boxed warning for its high potential for misuse and dependence. A boxed warning is a serious warning from the Food and Drug Administration (FDA). For more information, see the “Can Azstarys be misused or cause dependence?” section below.

Doctors who prescribe Schedule II drugs such as Azstarys must check people for signs of misuse and dependence before and during treatment with the drugs.

If you have questions or concerns about Azstarys being a controlled substance, talk with your doctor or pharmacist.

Azstarys is used to treat attention deficit hyperactivity disorder (ADHD) in adults and in children ages 6 years and older. ADHD is a mental health disorder that can cause inattentiveness, hyperactivity, and impulsive behavior.

Symptoms of ADHD usually occur before the age of 12 years. But doctors sometimes diagnose this disorder in adults. People with ADHD may have the following symptoms:

To be diagnosed with ADHD, you must have these symptoms for at least 6 months. The symptoms must affect daily activities and occur in more than one setting. For example, symptoms may occur at school or work and at home.

Studies have found Azstarys to be generally safe and effective for treating ADHD.

Azstarys increases the amount of dopamine present between cells in the brain. Dopamine is a chemical that sends messages between nerve cells.

It’s unclear how increasing dopamine levels works to ease symptoms of ADHD. But some experts suggest that people living with ADHD have fewer dopamine receptors. (The receptors are a kind of protein on the surface of cells in the brain and other areas of the central nervous system.) In people with ADHD, increasing the amount of dopamine between brain cells may increase the effect of this chemical as a result.

For more information about the use of Azstarys for treating ADHD, talk with your doctor or pharmacist.

Like most drugs, Azstarys may cause mild or serious side effects. The lists below describe some of the more common side effects that Azstarys may cause. These lists don’t include all possible side effects.

Keep in mind that side effects of a drug can depend on:

  • your age
  • other health conditions you have
  • other medications you take

Your doctor or pharmacist can tell you more about the potential side effects of Azstarys. They can also suggest ways to help reduce side effects.

Mild side effects

Here’s a list of some of the mild side effects that Azstarys can cause. To learn about other mild side effects, talk with your doctor or pharmacist, or read the drug’s prescribing information.

Mild side effects of Azstarys that have been reported include:

* To learn more about this side effect, see the “Allergic reaction” section below.

Mild side effects of many drugs may go away within a few days to a couple of weeks. But if they become bothersome, talk with your doctor or pharmacist.

Serious side effects

Serious side effects from Azstarys can occur, but they aren’t common. If you have serious side effects from Azstarys, call your doctor right away. But if you think you’re having a medical emergency, you should call 911 or your local emergency number.

Serious side effects of Azstarys that have been reported include:

* For more information, see the “Can Azstarys be misused or cause dependence?” section below.
† To learn more about this side effect, see the “Allergic reaction” section below.

Allergic reaction

Some people may have an allergic reaction to Azstarys.

Symptoms of a mild allergic reaction can include:

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include swelling under your skin, usually in your eyelids, lips, hands, or feet. They can also include swelling of your tongue, mouth, or throat, which can cause trouble breathing.

Swelling of the ear is also possible, and some people report severe skin reactions with Azstarys.

Call your doctor right away if you have an allergic reaction to Azstarys. But if you think you’re having a medical emergency, call 911 or your local emergency number.

Your doctor will recommend the dosage of Azstarys that’s right for you. Below are commonly used dosages, but always take the dosage your doctor prescribes.

Form

Azstarys comes as a capsule that you swallow.

Recommended dosages

You’ll take Azstarys once daily in the morning.

Questions about the dosing for Azstarys

Below are some common questions about the dosing of Azstarys.

  • What if I miss a dose of Azstarys? If you miss a dose of Azstarys, take it as soon as you remember. But if you’re close to your next dose, skip the missed dose, and take your next scheduled dose. Taking Azstarys too late in the day can cause trouble sleeping. If you’re unsure when to take Azstarys if you’ve missed a dose, talk with your doctor or pharmacist.
  • Will I need to take Azstarys long term? You’ll take Azstarys long term if the medication is effective for you and the side effects aren’t bothersome. To find out how long you’ll need to take Azstarys, talk with your doctor.
  • How long does Azstarys take to work? Azstarys starts to work right away to treat your symptoms of ADHD. If the dose your doctor prescribed isn’t working, they might increase your dose after a week.

Costs of prescription drugs can vary depending on many factors. These factors include what your insurance plan covers (if you have insurance) and which pharmacy you use. To find current prices for Azstarys in your area, talk with your doctor or pharmacist.

If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. You may also be eligible for a program called CoriumCares that could help you save on the cost of Azstarys.

You can also check out this article to learn more about saving money on prescriptions.

Your doctor will explain how you should take Azstarys. They’ll also explain how much to take and how often. Be sure to follow your doctor’s instructions.

Taking Azstarys

Azstarys comes as capsules that you swallow. It’s recommended that you take the drug once daily in the morning.

Accessible medication containers and labels

If it’s hard for you to read the label on your prescription, tell your doctor or pharmacist. Certain pharmacies may provide medication labels that:

  • have large print
  • use braille
  • contain a code you can scan with a smartphone to change the text into audio

Your doctor or pharmacist may be able to recommend a pharmacy that offers these options if your current pharmacy doesn’t.

Also, if you’re having trouble opening your medication bottles, let your pharmacist know. They may be able to put Azstarys in an easy-open container. Your pharmacist may also recommend tools to help make it simpler to open the drug’s container.

Questions about taking Azstarys

Below are some common questions about taking Azstarys.

Can Azstarys be chewed, crushed, or split? No, you cannot chew, crush, or split capsules of Azstarys. It’s recommended that you swallow the capsule whole.

If you have trouble swallowing pills, see this article for a few tips that may help. Or you may open a capsule and sprinkle the contents into applesauce or 2 ounces (50 milliliters) of water. But be sure to consume the applesauce or water mixture right away.

Should I take Azstarys with food? You can take Azstarys with or without food. Choose one way to take it and stick to this pattern daily. This will help keep the amount of medication your body absorbs consistent, which, in turn, helps Azstarys work effectively.

Is there a best time of day to take Azstarys? The best time of the day to take Azstarys is in the morning. Otherwise, the drug may cause you to have trouble sleeping. Taking Azstarys around the same time each day helps keep a steady level of the drug in your body. It also helps the medication to work effectively when you need it during the daytime.

Questions for your doctor

You may have questions about Azstarys and your treatment plan. It’s important to discuss all your concerns with your doctor.

Here are a few tips that might help guide your discussion:

  • Before your appointment, write down questions such as:
    • How will Azstarys affect my body, mood, or lifestyle?
  • Bring someone with you to your appointment if doing so will help you feel more comfortable.
  • If you don’t understand something related to your condition or treatment, ask your doctor to explain it to you.

Remember, your doctor and other healthcare professionals are available to help you. And they want you to get the best care possible. So don’t be afraid to ask questions or offer feedback on your treatment.

Certain factors can determine whether Azstarys is a good treatment option for you. These factors include your overall health, any medical conditions you have, and any medications you take.

These and other considerations to discuss with your doctor are described below.

Interactions

Taking a medication with certain vaccines, foods, and other things can affect how the medication works. These effects are called interactions.

Before taking Azstarys, be sure to tell your doctor about all medications you take, including prescription and over-the-counter drugs. Also, describe any vitamins, herbs, or supplements you use. Your doctor or pharmacist can tell you about any interactions these items may cause with Azstarys.

For information about drug-condition interactions, see the “Other warnings” section below.

Interactions with drugs or supplements

Azstarys can interact with several kinds of drugs. These drugs include:

* If you plan to get surgery, your doctor will likely ask you not to take your Azstarys dose that day.

This list does not contain all kinds of drugs that may interact with Azstarys. Your doctor or pharmacist can tell you more about these interactions and any others that may occur with Azstarys.

Boxed warning

Azstarys has a boxed warning. This is a serious warning from the Food and Drug Administration (FDA) about drug effects that may be dangerous.

Risk of misuse and risk of dependence. Central nervous system stimulants such as Azstarys have high potential for misuse and dependence.

Misuse of a drug means using it in a different way than how it was prescribed. Dependence on a drug means your body gets used to a drug and needs it to function as usual.

To learn more about this boxed warning, see the “Can Azstarys be misused or cause dependence?” section below.

Other warnings

Azstarys can sometimes cause harmful effects in people who have certain conditions. These are known as drug-condition interactions. Other factors may also affect whether Azstarys is a good treatment option for you.

Talk with your doctor about your health history before you take Azstarys. Factors to consider include those described below.

Depression. Azstarys may worsen symptoms of depression. If you have or have ever had depression, tell your doctor before you start taking Azstarys. Your doctor will determine whether it’s safe for you to take this drug.

Psychosis. If you have or have had psychosis, stimulants like Azstarys may worsen your symptoms of this condition. Before you start taking Azstarys, tell your doctor if you have a history of psychosis. If you develop psychosis or your symptoms worsen during treatment, your doctor might have you stop taking Azstarys.

Bipolar disorder. People living with bipolar disorder may experience manic episodes with Azstarys. Tell your doctor if you have bipolar disorder before you start taking Azstarys. They’ll determine whether the benefits of treatment with Azstarys outweigh the risks in your case. If you develop symptoms of mania during Azstarys treatment, your doctor may tell you to stop taking it.

Allergic reaction. If you’ve had an allergic reaction to Azstarys or any of its ingredients, your doctor will likely not prescribe Azstarys. Ask them what other medications are better options for you.

High blood pressure or heart rate. Azstarys, like other stimulants, can increase blood pressure and heart rate. In people who have high blood pressure or a fast heart rate, taking this drug may worsen their condition.

If you have high blood pressure or a fast heart rate, tell your doctor before you start taking Azstarys. During treatment, your doctor will check your blood pressure and heart rate regularly.

If your blood pressure is consistently high while taking Azstarys, they may prescribe blood pressure medications if you’re not already taking them. If your heart rate is too high, your doctor may also prescribe medication to slow your heart rate.

Heart problems. Azstarys can cause serious heart problems. As a result, doctors may not prescribe this drug to people who already have serious heart problems, such as heart disease. Tell your doctor about any heart problems you have before you start Azstarys treatment. They’ll check you for heart problems before prescribing Azstarys.

During Azstarys treatment, your doctor will regularly check your blood pressure and heart rate. If you experience chest pain, fainting, or problems with your heart rate while taking Azstarys, contact your doctor right away.

Azstarys and alcohol

Some medications interact with alcohol, but Azstarys isn’t one of them.

Before starting Azstarys, ask your doctor or pharmacist whether it’s safe for you to drink alcohol during treatment.

Your doctor may ask you questions about how much and how often you drink alcohol. If you’ve ever misused alcohol, Azstarys may not be the right drug for you. Azstarys has a boxed warning about its high potential for misuse and dependence. (To learn more, see the “Can Azstarys be misused or cause dependence?” section below.)

Pregnancy and breastfeeding

It’s unclear whether Azstarys is safe to take during pregnancy.

If you’re pregnant or planning to become pregnant, talk with your doctor about whether Azstarys is a good treatment option for you.

A pregnancy registry is available for drugs that treat attention deficit hyperactivity disorder (ADHD), such as Azstarys. Pregnancy registries collect data about the effects of certain drugs during pregnancy. This can help researchers better understand the risks of taking those drugs during pregnancy.

If you take Azstarys while pregnant, consider having your doctor enroll you in this pregnancy registry. For more information, call 866-961-2388 or visit the National Pregnancy Registry for ADHD Medications website.

It’s not certain whether it’s safe to take Azstarys while breastfeeding. If you’re breastfeeding or planning to breastfeed, let your doctor know. They can help you decide whether the benefits of taking Azstarys outweigh the possible risks to a child who is breastfed.

If you breastfeed while taking Azstarys, doctors will monitor your child for agitation and weight loss.

Azstarys has a boxed warning for risk of misuse and risk of dependence. A boxed warning is a serious warning from the Food and Drug Administration (FDA).

Misuse of a drug means using it in a different way than how it was prescribed. Examples include taking more than the recommended dosage and taking a medication prescribed to someone else. Dependence on a drug means your body gets used to a drug and needs it to function as usual.

Central nervous system (CNS) stimulants such as Azstarys have high potential for misuse and dependence. These are drugs often used to treat ADHD.

People sometimes misuse CNS stimulants to stay alert or increase their focus. Another possible misuse of CNS stimulants is to feel “high.”

Symptoms of Azstarys misuse include:

Tell your doctor if you’ve had trouble with drug misuse in the past. Your doctor will evaluate your risk of misuse and risk of dependence before prescribing Azstarys. Misuse can lead to an addiction to Azstarys, even at prescribed doses. (With addiction, a person keeps taking a drug even though it may be harming them.) So your doctor will continue to check you for signs and symptoms of misuse while you’re taking Azstarys.

Azstarys can cause dependence. If you develop a dependence on Azstarys, you’ll have withdrawal symptoms when you stop taking the drug. Withdrawal symptoms are effects that can occur when you stop taking a drug that your body has become dependent on.

To help prevent dependence, your doctor will routinely evaluate your need for treatment with Azstarys.

Do not take more Azstarys than your doctor prescribes. Taking more than this can lead to serious side effects.

Symptoms of overdose

Symptoms caused by an overdose of Azstarys can include:

  • nausea or vomiting
  • diarrhea
  • restlessness
  • anxiety
  • agitation
  • shaking
  • trouble with muscle movement
  • problems with reflexes
  • confusion
  • euphoria (a state of extreme happiness or excitement)
  • hallucinations
  • sweating
  • fast heart rate
  • uncontrolled blood pressure

What to do in case you take too much Azstarys

Call your doctor if you think you’ve taken too much Azstarys. You can also call 800-222-1222 to reach the American Association of Poison Control Centers or use its online resource. But if you have severe symptoms, immediately call 911 or your local emergency number. Or go to the nearest emergency room.

If you have questions about taking Azstarys, talk with your doctor or pharmacist. Learning more about this drug will help you feel comfortable with taking it. Here are a few questions you may want to ask your doctor about Azstarys:

  • Does Azstarys cause long-term side effects?
  • What is the best way to store and dispose of this drug?
  • Does taking Azstarys increase my child’s risk of misusing drugs later in life?
  • Which natural remedies for brain health can I try to help improve focus during Azstarys treatment?

For information about other available ADHD treatments, you might find these articles helpful:

Your doctor or pharmacist can also tell you about other treatments that may be good options for your condition.

To get information on different conditions and tips for improving your health, subscribe to any of Healthline’s newsletters. You may also want to check out the online communities at Bezzy. It’s a place where people with certain conditions can find support and connect with others.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

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