Key takeaways
Azstarys (serdexmethylphenidate/dexmethylphenidate) and methylphenidate extended-release (ER) are both stimulant medications used to treat attention deficit-hyperactivity disorder (ADHD) in adults and children aged 6 years and older. While they share this primary indication, Azstarys is a combination of serdexmethylphenidate, a prodrug of dexmethylphenidate, and dexmethylphenidate itself, allowing it to start working quickly and last throughout the day. In contrast, methylphenidate ER is a single active ingredient that typically starts working within 2 hours. Azstarys is only available as a brand-name medication, whereas methylphenidate ER is available in various formulations and some generic options, making it potentially more affordable. Both medications have similar side effects, such as low appetite and trouble sleeping, but Azstarys may also cause nausea and vomiting more frequently. Additionally, both medications carry risks of misuse and dependence, and they can interact with other medications, especially monoamine oxidase inhibitors (MAOIs) and carry a warning for serotonin syndrome when combined with other serotonin-boosting medications.
