What Is Azstarys?

Azstarys is a once-daily prescription stimulant medication used to treat attention deficit hyperactivity disorder (ADHD) in patients 6 years of age and older.

It contains two active ingredients: Serdexmethylphenidate (SDX) and Dexmethylphenidate (d-MPH). The serdexmethylphenidate component is a prodrug — meaning it's inactive when you swallow it and gradually converts into dexmethylphenidate in your body. This two-part design provides both quick-onset and long-lasting ADHD symptom control in a single capsule.

Azstarys is manufactured by Corium, a Sun Pharmaceutical company. It was FDA-approved in March 2021 and is classified as a Schedule II controlled substance due to its potential for abuse and dependence.

What Is Azstarys Used For?

Azstarys is FDA-approved for one indication:

• ADHD (Attention Deficit Hyperactivity Disorder) in patients aged 6 years and older

ADHD is a neurodevelopmental condition characterized by persistent patterns of inattention, hyperactivity, and impulsivity that interfere with daily functioning. Azstarys helps manage these symptoms by increasing levels of dopamine and norepinephrine in the brain.

Some healthcare providers may also prescribe methylphenidate-based medications off-label for conditions like narcolepsy or as an adjunct in treatment-resistant depression, though Azstarys is not specifically approved for these uses.

How Is Azstarys Taken?

Azstarys comes in oral capsules in three strengths:

• 26.1 mg SDX / 5.2 mg d-MPH (lowest dose)
• 39.2 mg SDX / 7.8 mg d-MPH (middle dose)
• 52.3 mg SDX / 10.4 mg d-MPH (highest dose)

Dosing Instructions

• Take once daily in the morning
• Can be taken with or without food
• Capsules can be swallowed whole or opened and sprinkled on applesauce and consumed immediately
• Do not crush or chew the capsule contents
• Do not store opened capsules for later use

Your doctor will typically start you on a lower dose and adjust based on how well it works and how you tolerate it. Most patients take between 26.1 mg/5.2 mg and 52.3 mg/10.4 mg per day.

Because Azstarys is a Schedule II controlled substance, your doctor must write a new prescription each month — no automatic refills are allowed.

Who Should Not Take Azstarys?

Azstarys is not right for everyone. You should not take it if you:

• Are allergic to serdexmethylphenidate, methylphenidate, or any ingredients in the capsule
• Are currently taking a monoamine oxidase inhibitor (MAOI) such as Phenelzine (Nardil), Tranylcypromine (Parnate), Selegiline (Emsam), or Isocarboxazid (Marplan) — or have taken one within the last 14 days

Use Azstarys with caution if you have:

• Heart problems, high blood pressure, or a family history of sudden cardiac death
• A history of mental health conditions such as psychosis, bipolar disorder, or severe anxiety
• A history of substance abuse or addiction
• Glaucoma (narrow-angle type)
• Tics or Tourette's syndrome

Azstarys has not been well studied in pregnant or breastfeeding women. If you're pregnant or planning to become pregnant, discuss the risks and benefits with your doctor.

For a complete list of side effects, read our guide on Azstarys side effects.

How Much Does Azstarys Cost?

Azstarys is a brand-name medication with no generic available as of early 2026. That means it can be expensive:

• Without insurance: $350 to $571 per month for 30 capsules
• With the manufacturer copay card: Eligible commercially insured patients may pay as little as $60 per month
• With insurance: Coverage varies widely. Many plans require prior authorization and may require you to try generic alternatives first (step therapy).

Ways to Save

• Manufacturer copay savings card — Available at azstarys.com/savings-and-support. Not valid for Medicare, Medicaid, or Tricare patients.
• Discount cards — GoodRx, SingleCare, and other prescription discount programs may offer savings at certain pharmacies.
• Patient assistance — Check NeedyMeds or RxAssist for third-party programs that may help with costs.

For a full breakdown of savings options, see our guide on how to save money on Azstarys.

How Does Azstarys Compare to Other ADHD Medications?

Azstarys sits in the methylphenidate family of stimulants. Here's how it compares to some common alternatives:

• Concerta (Methylphenidate ER) — Uses OROS extended-release technology. Available as a generic, making it much cheaper. Same drug class, different delivery mechanism.
• Focalin XR (Dexmethylphenidate ER) — Contains the same active metabolite as Azstarys (dexmethylphenidate) but without the prodrug component. Available as a generic.
• Vyvanse (Lisdexamfetamine) — A prodrug stimulant like Azstarys, but amphetamine-based rather than methylphenidate-based. Now available as generic Lisdexamfetamine.
• Jornay PM (Methylphenidate) — A delayed-release methylphenidate taken at bedtime for morning symptom control. Brand-only.

For more options, read our guide on alternatives to Azstarys.

Final Thoughts

Azstarys offers a unique approach to ADHD treatment by combining an immediate-release component with a prodrug for sustained coverage throughout the day. It's a good option for patients who need long-acting symptom control and prefer a methylphenidate-based medication.

If you're considering Azstarys, talk to your doctor about whether it's the right fit for your needs. When you're ready to fill your prescription, use Medfinder to find a pharmacy near you that has it in stock. And to understand the science behind the medication, check out our article on how Azstarys works.