Key Points
Azstarys and Adderall are both central nervous system (CNS) stimulants used to treat attention-deficit hyperactivity disorder (ADHD). Azstarys is a long-acting medication taken once per day, while Adderall is used 2 to 3 times per day. Azstarys is not available as a generic option and is more expensive than Adderall.
How do they work?
Both medications adjust chemicals in the brain and nerves that contribute to symptoms of ADHD, such as hyperactivity and impulse control. Azstarys contains serdexmethylphenidate, a prodrug of dexmethylphenidate, co-formulated with immediate-release dexmethylphenidate. This combination provides a fast onset and a longer duration of action without the spikes in dexmethylphenidate concentrations. Adderall contains a quick-acting mixture of mixed amphetamine salts and may require multiple doses per day.
How do I take them?
Take these medicines exactly as prescribed by your doctor. Azstarys capsules are taken once daily with or without food. The capsules can be opened and sprinkled on 2 tablespoons of applesauce or dissolved into 50 mL of water if the child has trouble swallowing the capsules. All of the applesauce or water mixture should be swallowed within 10 minutes. Adderall comes as an oral tablet or capsule and can be taken with or without food.
What are the side effects?
Common side effects of both medications include decreased appetite, trouble sleeping, stomach ache, weight loss, dizziness, mood changes, increased heart rate or blood pressure, nausea, vomiting, heartburn or indigestion, anxiety, irritability, nervousness, headache, and dry mouth. Serious side effects can include drug abuse and dependence, painful and prolonged erections, circulation problems in fingers and toes, slowing of growth in children, heart problems, and mental problems.
Which is more expensive?
Azstarys is more expensive than Adderall and is not available as a generic option. The cash price for 30 capsules of Azstarys is about $410. The cash price for 100 generic Adderall 5 mg tablets costs about $14.00, while the brand name Adderall 5 mg costs $953 for 100 tablets. The cash price for 30 capsules of generic Adderall XR 10 mg costs about $58 and the brand name costs about $230.
How can I get financial assistance?
The CoriumCares program from the Azstarys manufacturer may be able to provide copay assistance or other financial support. Eligible patients pay $0 for their first prescription. For refills, patients pay $25 if their insurance covers the medicine or $50 if their insurance does not cover it. Adderall and Adderall XR are available as generic options and may be more affordable.