Your Patients Need Azstarys — Here's How to Help Them Get It

When your ADHD patients are stable on Azstarys, the last thing anyone wants is a disruption in their treatment because they can't fill a prescription. But in 2026, that's exactly what many patients are facing.

Azstarys (Serdexmethylphenidate/Dexmethylphenidate) is not in a formal FDA-listed shortage, yet real-world availability remains spotty. As a prescriber, you're in a unique position to help your patients navigate these challenges. This guide covers the current availability situation, why patients are struggling, five concrete steps you can take, alternative options, and workflow tips to make the process smoother.

Current Azstarys Availability

Azstarys is manufactured exclusively by Corium (a Sun Pharmaceutical company). No generic exists as of early 2026. The medication is available in three capsule strengths:

• 26.1 mg/5.2 mg (Serdexmethylphenidate/Dexmethylphenidate)
• 39.2 mg/7.8 mg
• 52.3 mg/10.4 mg

While Azstarys is not on the FDA shortage list, availability varies significantly by region and pharmacy type. Chain pharmacies frequently report out-of-stock status, while independent and specialty pharmacies may have more consistent supply.

Why Your Patients Can't Find Azstarys

Understanding the root causes helps you counsel patients and plan proactively:

• Single-source manufacturing: With only Corium producing Azstarys, any supply disruption affects the entire market
• DEA quotas: Schedule II manufacturing quotas constrain total stimulant production capacity
• Low pharmacy stocking: Many pharmacies don't routinely stock Azstarys due to low prescription volume and high unit cost
• Insurance barriers: Prior authorization requirements and step therapy reduce the number of patients filling Azstarys, which further reduces pharmacy stocking incentives
• Stimulant demand surge: Increased ADHD diagnoses and treatment initiation since 2020 have outpaced supply growth across the stimulant class

5 Steps You Can Take to Help

Step 1: Check Availability Before Prescribing

Use Medfinder for Providers to check which pharmacies near your patient's location currently have Azstarys in stock. Then send the e-prescription to a pharmacy you've confirmed has it. This one step can prevent days or weeks of patient frustration.

Step 2: Build Relationships With Pharmacies That Stock Azstarys

Identify 2-3 pharmacies in your area that reliably carry Azstarys. Independent pharmacies and mental health specialty pharmacies are good candidates. Having a short list of "go-to" pharmacies for Azstarys saves time for your team and your patients.

Some pharmacies will stock Azstarys more consistently if they know they'll receive a steady stream of prescriptions from your practice. A brief call to the pharmacy manager to establish this relationship can go a long way.

Step 3: Proactively Submit Prior Authorizations

Don't wait for the pharmacy to notify you about a PA denial. If you know the patient's insurance requires prior authorization for Azstarys, submit it when you write the prescription — or even before. Many electronic health records (EHRs) and e-prescribing platforms support real-time benefit checks that can flag PA requirements upfront.

Having the PA approved before the patient arrives at the pharmacy eliminates one of the most common reasons for fill failures.

Step 4: Offer Dose Flexibility

If a patient's prescribed strength is unavailable, consider whether an alternative strength could work. For example, if 52.3 mg/10.4 mg is out of stock, could the patient temporarily use 39.2 mg/7.8 mg? This isn't ideal long-term, but it can prevent treatment interruptions.

Document the clinical rationale for the dose change and schedule a follow-up to reassess once the preferred strength is available.

Step 5: Equip Patients With Tools and Information

Share these resources with your patients:

• Medfinder — to search pharmacy availability by zip code
• Corium copay card — to reduce out-of-pocket cost to $60 or less (commercially insured patients)
• Finding Azstarys in stock — our patient guide with practical search tips
• Saving money on Azstarys — comprehensive cost-saving guide

Alternatives When Azstarys Isn't Available

When Azstarys cannot be sourced, having a pre-discussed backup plan with your patient minimizes treatment gaps. The most clinically appropriate alternatives include:

• Dexmethylphenidate ER (generic Focalin XR): Same active metabolite, generic available, typically $30-$80/month. Closest pharmacological match.
• Methylphenidate ER (generic Concerta): Well-established, multiple generic manufacturers, $30-$100/month.
• Lisdexamfetamine (generic Vyvanse): Amphetamine-based prodrug, generic available since 2023, $30-$100/month. Consider if the patient's history supports amphetamine use.
• Jornay PM: Evening-dosed methylphenidate for patients requiring early-morning symptom control. Brand only, approximately $300-$400/month.

For a detailed comparison, see our alternatives to Azstarys guide or the provider shortage briefing.

Workflow Tips for Your Practice

Integrating availability awareness into your prescribing workflow can dramatically improve patient outcomes:

• Real-time benefit checks: Use your EHR's e-prescribing module to check formulary status and PA requirements before sending the prescription
• Pharmacy availability check: Make checking Medfinder a standard step before prescribing Azstarys
• Backup prescription protocol: Discuss with the patient at the time of prescribing: "If the pharmacy can't fill Azstarys, here's what we'll switch to." Document the backup plan in the chart.
• Staff training: Ensure your nursing and administrative staff know how to use Medfinder, how to submit prior authorizations for Azstarys, and which pharmacies in your area reliably stock it
• Patient handouts: Create a one-page handout with Medfinder instructions, copay card information, and tips for finding Azstarys. Hand it out with every new Azstarys prescription.

Final Thoughts

Helping your patients find Azstarys in 2026 requires a proactive approach. By checking availability before prescribing, building pharmacy relationships, streamlining prior authorizations, and equipping patients with the right tools, you can significantly reduce treatment disruptions.

The supply situation isn't perfect, but it's manageable with the right workflow. Your patients are relying on you — and tools like Medfinder for Providers make it easier to deliver.