Azstarys (serdexmethylphenidate/dexmethylphenidate) is a prescription drug that’s taken to treat ADHD. The drug comes as an oral capsule that you take once per day.
Azstarys is approved for adults and certain children to treat attention deficit hyperactivity disorder (ADHD).
Azstarys has two active ingredients: serdexmethylphenidate and dexmethylphenidate. (An active ingredient is what makes a drug work.)
Azstarys belongs to a group of drugs called central nervous system stimulants.
This article describes the dosages of Azstarys, as well as its strengths and how to take it. To learn more about Azstarys, see this in-depth article.
This section describes the usual dosages of Azstarys. Keep reading to learn more.
What is Azstarys’s form?
Azstarys is available as an oral capsule.
What strengths does Azstarys come in?
Azstarys comes in three strengths:
- 26.1 milligrams (mg) serdexmethylphenidate/5.2 mg dexmethylphenidate
- 39.2 mg serdexmethylphenidate/7.8 mg dexmethylphenidate
- 52.3 mg serdexmethylphenidate/10.4 mg dexmethylphenidate
What are the usual dosages of Azstarys in adults?
Your doctor likely will start your treatment with an Azstarys dosage of 39.2 mg/7.8 mg once per day. They may increase the dosage after 1 week depending on how you respond to treatment. They’ll ultimately prescribe the smallest dosage that provides the desired effect. The maximum dosage of Azstarys is 52.3 mg/10.4 mg per day.
The information below describes dosages that are commonly taken or recommended. But be sure to take the dosage your doctor prescribes for you. They’ll determine the best dosage to fit your needs.
Dosage for ADHD
To treat ADHD in adults, the typical starting dosage of Azstarys is 39.2 mg/7.8 mg once per day. After 1 week, your doctor likely will increase your dosage based on your response to Azstarys treatment. If so, they’ll increase it to 52.3 mg/10.4 mg, to be taken once per day. (This is the maximum dosage of Azstarys.) In some cases, if you experience side effects, your doctor may lower your dosage. With any dosage adjustment, your doctor will watch to see how you respond to that dosage.
In some cases, Azstarys may not reduce your ADHD symptoms. If this occurs after 1 month of treatment, your doctor likely will stop the medication. They’ll discuss other treatment options with you.
If you have questions about your dosage of Azstarys, talk with your doctor or pharmacist.
What’s the dosage of Azstarys for children?
Azstarys is approved to treat ADHD in children ages 6 years and older. A child’s dosage depends on their age.
Note: Taking Azstarys long term can cause problems with growth and weight gain in children. Your child’s doctor will routinely monitor their growth and weight. If they have concerns about either, they may stop your child’s treatment temporarily or permanently.
Dosage for children ages 6–12 years
The starting dosage of Azstarys in children ages 6–12 years is typically 39.2 mg/7.8 mg once per day. After 1 week, your child’s doctor may either increase or decrease the dosage. They may increase it to 52.3 mg/10.4 mg once per day. Or they may lower it to 26.1 mg/5.2 mg once per day. Ultimately, your child’s dosage depends on how they respond to Azstarys treatment.
The maximum dosage of Azstarys in children ages 6–12 years is 52.3 mg/10.4 mg once per day.
In some cases, Azstarys may not reduce your child’s ADHD symptoms. If this occurs after 1 month of treatment, your doctor likely will stop the medication. They’ll discuss other treatment options with you.
Dosage for children ages 13–17 years
The dosage of Azstarys in children ages 13–17 years is the same as the recommended adult dosage. To learn more, see the “What are the usual dosages of Azstarys in adults?” section above.
For more information about Azstarys’s dosage for children, talk with your child’s doctor or a pharmacist.
Is Azstarys taken long term?
Yes, Azstarys is usually taken as a long-term treatment. If you and your doctor determine that it’s safe and effective for your condition, you’ll likely take it long term.
The dosage of Azstarys your doctor prescribes may depend on several factors. These include:
- the severity of the condition the drug is treating
- your age
Azstarys is available as an oral capsule. You’ll swallow it once per day in the morning with or without food. If you take Azstarys too late in the day, it can make it difficult for you to fall asleep.
Try to take the medication around the same time each day. This helps keep steady levels of the medication in your body. And that helps the medication work effectively to treat your condition.
Some people have difficulty swallowing capsules. If you do, open the capsules and sprinkle the contents on applesauce or in water. If you choose water, use only 50 milliliters (mL), or about 2 ounces. Be sure to take the full contents of applesauce or water with the medication right away. You can also see this article for tips on how to take this form of medication.
For information on the expiration, storage, and disposal of Azstarys, talk with your doctor or pharmacist.
Accessible drug containers and labels
Some pharmacies provide medication labels that:
- have large print
- use braille
- feature a code you can scan with a smartphone to change the text to audio
Your doctor or pharmacist may be able to recommend pharmacies that offer these accessibility features if your current pharmacy doesn’t.
Let your pharmacist know if you have difficulty opening medication bottles. They may have tips to help, or they may be able to supply Azstarys in an easy-open container.
Note: Azstarys is a controlled substance (Schedule II), which means it has a high potential for misuse. (A controlled substance is a drug the government regulates due to the risk of dependence or misuse.) So always keep the medication in a secure place, and keep accurate counts of the capsules to help prevent misuse. See the “Is there risk of misuse with Azstarys?” section below for a discussion about dependence and misuse.
If you miss a dose of Azstarys, take it as soon as you remember. But if it’s almost time for your next dose, skip the missed dose and take your next dose at its usual time. If you’re not sure whether you should take a missed dose, talk with your doctor or pharmacist.
Be aware that taking Azstarys too late in the day can cause problems with sleep.
If you need help remembering to take your dose of Azstarys on time, try using a medication reminder. This can include setting an alarm or downloading a reminder app on your phone.
Yes, there is a risk. Azstarys has a boxed warning for the risk of misuse. A boxed warning is the most serious warning from the Food and Drug Administration (FDA).
Misuse means taking a drug in a way other than how a doctor prescribes it. Examples of misuse include taking the drug more often or at doses higher than your doctor prescribes.
Symptoms of misuse may include:
- sweating
- high blood pressure
- fast heart and breathing rates
- difficulty sleeping
- loss of appetite
- hyperactivity
- overdose*
* See the “What should be done in case of overdose?” section below for more information.
Azstarys also can cause drug dependence. With dependence, your body needs the drug to function as usual. Dependence can cause withdrawal symptoms if you suddenly stop taking the medication after taking it for a while. See the “Azstarys and withdrawal and dependence” section below for more information about these side effects.
Your doctor will discuss these serious risks of Azstarys with you. Tell your doctor if you have a history of drug misuse or have a substance use disorder (addiction). (Azstarys also has a risk of addiction. Addiction is when you feel unable to stop taking a drug, even though it may be causing harm.)
You should take Azstarys only as your doctor prescribes. Misuse increases the risk of overdose, which can lead to difficulty breathing. In extreme cases or if untreated, overdose can lead to coma or death.
Your doctor will regularly monitor you for signs of signs of misuse, dependence, and addiction while you’re taking Azstarys. They’ll also routinely check whether you need to continue treatment with Azstarys.
Do not take more Azstarys than your doctor prescribes, as this can lead to harmful effects.
Symptoms of overdose
Symptoms caused by an overdose can include:
- restlessness
- fast heart rate
- anxiety
- agitation
- high blood pressure or low blood pressure
- confusion
- serotonin syndrome (too much serotonin builds up in the body)
- seizure
- hallucinations
In extreme cases or if untreated, overdose can lead to coma or death.
What to do in case you take too much Azstarys
Call your doctor right away if you think you’ve taken too much Azstarys. You can also call 800-222-1222 to reach America’s Poison 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.
Taking Azstarys can lead to physical dependence. This condition occurs when your body relies on a drug to function as usual.
If you suddenly stop taking Azstarys, you may experience withdrawal symptoms. These side effects can occur when you stop taking a drug that your body has become dependent on.
Examples of withdrawal symptoms include:
- uneasy, unhappy, or dissatisfied mood
- depression
- fatigue
- vivid, unpleasant dreams
- sleep problems, such as lack of or prolonged sleep
- increased appetite
- disrupted connection between mental and muscle functions (increase or decrease)
If you need to stop taking Azstarys, your doctor will lower your dosage gradually over time. This can help reduce your risk of withdrawal symptoms after you stop treatment.
If you have withdrawal symptoms after you’ve stopped taking Azstarys, talk with your doctor. They can recommend ways to ease these symptoms.
Below are answers to some commonly asked questions about Azstarys’s dosage.
Is Azstarys’s dosage similar to the dosages of Adderall or Vyvanse?
Azstarys (serdexmethylphenidate/dexmethylphenidate), Adderall (dextroamphetamine/amphetamine), and Vyvanse (lisdexamfetamine) all are approved to treat attention deficit hyperactivity disorder (ADHD). But Adderall and Vyvanse also are approved to treat certain other conditions.
The following table summarizes other similarities and differences of the three drugs when used to treat ADHD. Your doctor will prescribe the drug and the dosage that’s right for you.
| Azstarys | Adderall | Vyvanse | |
|---|---|---|---|
| Approved for | • adults and children ages 6 years and older | • adults and children ages 3 years and older | • adults and children ages 6 years and older |
| Forms | • oral capsule | • oral tablet | • oral capsule • chewable tablet |
| Dose frequency | • once per day | • once or twice per day depending on the dosage form prescribed | • once per day |
Adderall and Vyvanse are available as generics, while Azstarys comes only as a brand-name medication.
To learn more about how these drugs compare, talk with your doctor.
How long does it take for Azstarys to start working?
Azstarys starts to work soon after you start taking the medication. Your doctor will monitor you during treatment. They’ll check how you respond to the medication and make sure the drug is working to treat your condition. If needed, they may adjust your dose accordingly.
It may take up to 1 month after starting treatment for Azstarys to take full effect at treating your ADHD symptoms. But in some cases, Azstarys may not work to reduce your symptoms. In this instance, your doctor will likely stop your treatment and discuss other treatment options.
If you have other questions about what to expect from your Azstarys treatment, talk with your doctor.
The sections above describe the usual dosages provided by the drugmaker. If your doctor recommends Azstarys for you, they’ll prescribe the dosage that’s right for you.
You should not change your dosage of Azstarys without your doctor’s recommendation. Only take Azstarys exactly as prescribed. Remember, misusing Azstarys can increase your risk of serious side effects, including overdose. Misusing it means taking the drug in a way other than how a doctor prescribes it, such as at a higher dose or more often.
Talk with your doctor if you have questions or concerns about your current dosage.
Here are some examples of questions you may want to ask your doctor:
- Will I need a dosage adjustment for Azstarys if I’m taking other ADHD medications?
- Can taking a higher dose of Azstarys increase my risk of addiction?
- Would my child need a lower dosage if they lose weight during Azstarys treatment?
To learn more about Azstarys, see the “All About Azstarys” article.
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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.