Azstarys (serdexmethylphenidate/dexmethylphenidate) is a brand-name drug prescribed for ADHD in adults and some children. Azstarys comes as an oral capsule that’s typically taken once per day. The dosage can vary based on several factors.

Azstarys belongs to a drug class called central nervous system (CNS) stimulants. Azstarys isn’t available in a generic version.

Keep reading for specific information about the dosage of Azstarys, including its strengths and how to take the medication. For a comprehensive look at Azstarys, see this article.

Note: This article describes typical dosages for Azstarys provided by the drug’s manufacturer. When taking Azstarys, always follow the dosage prescribed by your doctor.

The typically recommended dosages for Azstarys are described below.

Azstarys form

Azstarys comes as an oral capsule.

Azstarys strengths

Azstarys comes in three strengths:

  • 26.1 milligrams (mg) serdexmethylphenidate/5.2 mg dexmethylphenidate
  • 39.2 mg/7.8 mg
  • 52.3 mg/10.4 mg

Typical dosages

Typically, your doctor will start by prescribing a low dosage. Then, they’ll adjust it over time to reach the amount that’s right for you. Your doctor will ultimately prescribe the smallest dosage that provides the desired effect.

The following information describes dosages that are commonly prescribed or recommended in adults. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Dosage for attention deficit hyperactivity disorder (ADHD)

Doctors may prescribe Azstarys to treat ADHD.

If your doctor prescribes Azstarys for your ADHD, your starting dose will likely be 39.2 mg serdexmethylphenidate/7.8 mg dexmethylphenidate. Typically, you’ll take this once per day in the morning. After 1 week, your doctor may recommend increasing your dosage to 52.3 mg/10.4 mg per day. This is the typically recommended dosage of Azstarys for adults with ADHD.

The maximum daily dose of Azstarys is 52.3 mg/10.4 mg.

For more information about your specific dosage, talk with your doctor.

Children’s dosage

Azstarys is approved to treat ADHD in children ages 6 years and older.

For children ages 6–12 years, the recommended starting dosage is 39.2 mg serdexmethylphenidate/7.8 mg dexmethylphenidate, taken once per day in the morning. After 1 week, your child’s doctor may adjust their dose. For example, if the drug is not managing ADHD well, the doctor may increase your child’s dose to 52.3 mg/10.4 mg. In some cases, your child’s doctor may decrease their dose to 26.1 mg/5.2 mg.

For children ages 13 years and older, the recommended starting dosage is 39.2 mg/7.8 mg, taken once per day. After 1 week, your child’s doctor may increase their dose to 52.3 mg/10.4 mg.

The maximum daily dose of Azstarys is 52.3 mg/10.4 mg.

Talk with your child’s doctor if you have questions about their dosage.

Long-term treatment

Azstarys is meant to be a long-term treatment. If you and your doctor determine that Azstarys is safe and effective for you, you’ll likely take it long term.

Before you start taking Azstarys, your doctor will discuss your treatment plan with you. They can give you more information about how long you can expect to take the medication.

The Azstarys dosage your doctor prescribes will depend on several factors. These include:

  • your age
  • side effects you may have with Azstarys
  • other medical conditions you may have

Dosage adjustments

Your doctor may need to reduce your dosage in certain situations. This includes experiencing bothersome side effects from the drug. They may also reduce your dosage if your ADHD symptoms get worse instead of better while taking Azstarys. (To learn about side effects of Azstarys, see the “Side effects” section of this article.)

Be sure to tell your doctor about all medications you take or any health conditions you may have. In addition, tell your doctor about any symptoms you’re experiencing.

Azstarys comes as a capsule you swallow whole, with or without food. You should take your dose in the morning.

With your doctor’s approval, you can open the capsule and sprinkle the pellets on applesauce or add them to water. You should swallow the mixture right away without chewing the pellets. Then, drink a glass of water to make sure you’ve swallowed all the pellets.

If you have trouble swallowing capsules, see this article for tips on how to take this form of medication. You can also talk with your doctor or pharmacist.

If you have questions about how to take Azstarys, talk with your doctor or pharmacist.

ACCESSIBLE DRUG LABELS AND CONTAINERS

Some pharmacies offer labels with large print, braille, or a code you scan with a smartphone to convert text to speech. If your local pharmacy doesn’t have these options, your doctor or pharmacist might be able to recommend a pharmacy that does.

If you’re having trouble opening medication bottles, ask your pharmacist about putting Azstarys in an easy-open container. They also may recommend tools that can make it easier to open bottles.

If you miss a dose of Azstarys, take it as soon as you remember. If it’s almost time for your next dose, skip the missed dose and take your next scheduled dose. Do not take two doses to make up for the missed one. If you’re not sure whether you should take a missed dose or skip it, talk with your doctor or pharmacist.

To help make sure that you don’t miss a dose, try using a medication reminder. This can include setting an alarm or putting a note where you’ll see it, such as on your bathroom mirror or bedside table. You could also download a reminder app on your phone.

Azstarys has a boxed warning for the risk of misuse and addiction. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). It alerts doctors and patients about drug effects that may be dangerous.

With misuse, a drug is taken or used in a way other than how it’s prescribed. With addiction (also known as dependence), a drug is taken even though it’s causing harm.

Azstarys has a risk of misuse and addiction because it’s a CNS stimulant. Misuse of Azstarys may lead to overdose and, in rare cases, death. Taking the medication at higher doses than prescribed increases the risk.

Before prescribing Azstarys, your doctor will determine whether it’s safe for you to take. They may not prescribe Azstarys if you’ve ever had substance use disorder.

Talk with your doctor if you have questions about Azstarys and misuse.

It’s important that you do not take more Azstarys than your doctor prescribes. For some medications, taking more than the recommended amount may lead to harmful effects or overdose.

Effects of an overdose

Overdose effects of Azstarys can include:

If you take more than the recommended amount of Azstarys

Call your doctor right away if you believe you’ve taken too much Azstarys. Another option is to call America’s Poison Centers at 800-222-1222 or use its online tool. If you have severe symptoms, immediately call 911 or your local emergency number, or go to the nearest emergency room.

Below are some frequently asked questions about Azstarys and dosage.

Is the dosage of Azstarys similar to the dosage of Adderall or Vyvanse?

The dosage of Azstarys has some similarities to the dosages of Adderall (amphetamine/dextroamphetamine) and Vyvanse (lisdexamfetamine dimesylate). However, there are some important differences.

Both Azstarys and Vyvanse come as oral capsules that are taken once per day. Vyvanse also comes as a chewable tablet that’s taken once per day. Adderall comes as an immediate-release* oral tablet that’s typically taken once or twice per day. Adderall also comes as an extended-release† oral capsule that’s taken once per day.

The dose in milligrams (mg) for each drug differs because they have different active ingredients. All three drugs are FDA-approved to treat ADHD in adults and some children. Vyvanse and Adderall also have other approved uses. Your doctor will prescribe the drug and dosage that are right for you.

To learn more about how these drugs compare, talk with your doctor.

* With immediate-release drugs, the active ingredient quickly releases into your body after you take a dose.
† With extended-release drugs, the active ingredient slowly releases into your body over a period of time.

What is the recommended maximum dosage of Azstarys?

The maximum dosage of Azstarys that’s recommended is 52.3 mg serdexmethylphenidate/10.4 mg dexmethylphenidate per day.

Typically, doctors prescribe a low dosage to start. In some cases, doctors may increase the drug’s dosage. The highest dose of Azstarys recommended per day is the same as the maximum dose. For details about Azstarys dosages, see the “Azstarys dosage” section above.

If you have questions or concerns about your dosage of Azstarys, talk with your doctor or pharmacist. If it seems like you need a higher dosage, ask your doctor whether a dosage increase is right for you. Do not increase your dosage unless your doctor recommends doing so.

The dosages in this article are typical dosages provided by the drug’s manufacturer. If your doctor recommends Azstarys for you, they’ll prescribe the dosage that’s right for you. Always follow the dosage that your doctor prescribes.

As with any drug, never change your dosage of Azstarys without your doctor’s recommendation. If you have questions about the dosage of Azstarys that’s best for you, talk with your doctor.

Besides learning about dosage, you may want other information about Azstarys. These additional articles might be helpful:

  • More about Azstarys: For information about other aspects of Azstarys, refer to this article.
  • Details about ADHD: For details about ADHD, see our ADHD hub.

Disclaimer: Medical News Today 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.