Azstarys vs. Vyvanse: Comparing CNS stimulants

In this article:

• What are the main differences between Azstarys and Vyvanse?
• Conditions treated by Azstarys and Vyvanse
• Is Azstarys or Vyvanse more effective?
• Coverage and cost comparison of Azstarys vs. Vyvanse
• Common side effects of Azstarys vs.Vyvanse
• Drug interactions of Azstarys vs. Vyvanse
• Warnings of Azstarys and Vyvanse
• Frequently asked questions about Azstarys vs. Vyvanse

In this article

• What are the main differences between Azstarys and Vyvanse?
• Conditions treated by Azstarys and Vyvanse
• Is Azstarys or Vyvanse more effective?
• Coverage and cost comparison of Azstarys vs. Vyvanse
• Common side effects of Azstarys vs.Vyvanse
• Drug interactions of Azstarys vs. Vyvanse
• Warnings of Azstarys and Vyvanse
• Frequently asked questions about Azstarys vs. Vyvanse

Azstarys and Vyvanse are prescription medications used to treat attention deficit hyperactivity disorder (ADHD). They work similarly to central nervous system (CNS) stimulants that increase certain chemicals or neurotransmitters in the brain. By increasing dopamine and norepinephrine, these medications may help manage ADHD symptoms, such as hyperactivity, impulsiveness, and inattentiveness.

Azstarys is a newer ADHD medication that may be garnering interest as a potential treatment option. While Azstary and Vyvanse have proven efficacy in managing ADHD symptoms, they differ in how long they last and their active ingredients. Insurance coverage and the cost of ADHD medications can also influence treatment decisions. It’s best to consult a healthcare provider for medical advice when searching for the best treatment option.

Read on to learn more about the similarities and differences between Azstarys and Vyvanse. 

RELATED: What is Azstarys What is Vyvanse

What are the main differences between Azstarys and Vyvanse?

Azstarys and Vyvanse are CNS stimulants that differ primarily in their active ingredients. Azstarys is a brand-name drug manufactured by Corium that contains two active ingredients: dexmethylphenidate and serdexmethylphenidate. Serdexmethylphenidate is a prodrug of dexmethylphenidate. In other words, dexmethylphenidate is converted into an active drug after absorption into the body.

Because Azstarys also contains immediate-release dexmethylphenidate, it can start producing effects quickly while delivering a steady release of the active drug over time. Its effects last for around 13 hours. Azstarys is only available as a brand-name drug. It comes as an oral capsule taken once daily in the morning.

Vyvanse is a brand-name manufactured by Takeda Pharmaceuticals that contains the active ingredient lisdexamfetamine dimesylate. Like the active ingredient of Azstarys, lisdexamfetamine is a prodrug that is converted into dextroamphetamine in the body. Its effects last for around 10 to 14 hours. 

Unlike Azstarys, Vyvanse is available in brand-name and generic versions. It is also available as an oral capsule or chewable tablet taken once daily in the morning. 

	Azstarys	Vyvanse
Drug class	CNS stimulant	CNS stimulant
Brand/generic status	Brand only	Brand and generic versions available
What is the generic name?	Serdexmethylphenidate and dexmethylphenidate	Lisdexamfetamine dimesylate
What form(s) does the drug come in?	Oral capsule	Oral capsule Chewable tablet
What is the standard dosage?	One 39.2 mg/7.8 mg oral tablet once daily in the morning. The dosage may be increased to one 52.3 mg/10.4 mg tablet after one week	30 to 70 mg once daily in the morning
How long is the typical treatment?	Long-term	Long-term
Who typically uses the medication?	Adults and children 6 years of age and older	Adults and children 6 years of age and older

Conditions treated by Azstarys and Vyvanse

Azstarys and Vyvanse are approved by the U.S. Food and Drug Administration (FDA) for the treatment of ADHD in adults, adolescents, and children. These medications may be prescribed to help improve focus, reduce impulsivity, and control hyperactivity in individuals with ADHD.

In addition to ADHD, Vyvanse is also FDA-approved to treat binge eating disorder (BED). Binge eating disorder is a medical condition characterized by recurrent episodes of consuming large quantities of food in a short period, often feeling a lack of control during these episodes. More specifically, it can be prescribed to treat moderate to severe binge eating disorder in adults. 

Condition	Azstarys	Vyvanse
ADHD	Yes	Yes
Binge eating disorder	No	Yes

Is Azstarys or Vyvanse more effective?

Azstarys and Vyvanse have both been shown to be effective in treating ADHD. The better option will vary from person to person based on the individual’s response to treatment, preferences, and whether they experience certain side effects. Limited head-to-head clinical trials have been conducted to compare Azstarys and Vyvanse.

A clinical trial demonstrated the effectiveness of Azstarys for treating ADHD in children aged six to 12. After an initial phase where the optimal dose was determined, the children received either Azstarys or a placebo for a week. Their attention and behavior were assessed using a specialized rating scale in a simulated classroom setting. The results showed a significant improvement in the children taking Azstarys, with their scores improving by an average of 5.4 points more than those who received the placebo.

In another study, researchers assessed the efficacy of Vyvanse in treating ADHD in children aged six to 12 years. Over four weeks, 290 children were given daily doses of either 30 mg, 50 mg, or 70 mg of Vyvanse or a placebo. The children’s ADHD symptoms were evaluated using the ADHD Rating Scale, which measures the severity of both hyperactive/impulsive and inattentive behaviors. Results showed that all doses of Vyvanse were more effective than the placebo in reducing ADHD symptoms, with the highest dose of 70 mg proving to be the most effective. This effect was consistent throughout the day, as reported by parents in morning, afternoon, and early evening assessments.

Azstarys and Vyvanse may provide prolonged symptom control and a smooth transition as they wear off. However, Azstarys starts working within 30 minutes, while Vyvanse works within one to two hours. 

Coverage and cost comparison of Azstarys vs. Vyvanse

The availability and cost of Azstarys and Vyvanse can vary greatly depending on insurance coverage and pharmacy choice. Azstarys, being relatively new to the market, may not have the same level of insurance coverage as Vyvanse, a longer-established medication. However, both medications are typically covered by many private insurance plans to some degree. The coverage for Medicare Part D can be more complicated, with each having different levels of acceptance and copay amounts depending on the individual’s plan. 

In addition, Vyvanse is available as a generic option, while Azstarys is only available as a brand-name drug at this time. Therefore, Vyvanse may be more likely to be covered than Azstarys. 

The cost of these medications without insurance can also vary. Savings options like the SingleCare discount card may help to reduce out-of-pocket expenses. The typical cost of Azstarys and Vyvanse with coupons can be significantly lower than the retail price. However, the exact savings will depend on the pharmacy and the specific coupon used.

	Azstarys	Vyvanse
Typically covered by insurance?	Sometimes	Yes
Typically covered by Medicare Part D?	No	No
Quantity	30, 39.2/7.8 mg capsules	30, 30 mg capsules
Typical Medicare copay	Varies	Varies
SingleCare cost	$380	$86

Common side effects of Azstarys vs.Vyvanse

Both medications share some common side effects. Azstarys and Vyvanse can cause decreased appetite, trouble sleeping, and nausea. Weight loss is another potential side effect due to the appetite suppression often seen with these medications. However, Vyvanse is more likely to cause side effects like diarrhea and fever. While these side effects are common, they vary in how often patients report experiencing them. 

Both drugs can affect heart rate and blood pressure and, in some cases, may lead to heart problems; this is especially a concern for individuals with a history of heart conditions. It is important to recognize that both medications could cause other serious side effects, such as an increased risk of misuse and dependency, as well as worsened tics or Tourette’s syndrome.

	Azstarys		Vyvanse
Side Effect	Applicable?	Frequency	Applicable?	Frequency
Insomnia	Yes	>5%	Yes	27%
Loss of appetite	Yes	>5%	Yes	27%
Nausea	Yes	>5%	Yes	7%
Abdominal pain	Yes	>5%	Yes	12%
Indigestion	Yes	>5%	No	–
Dry mouth	Yes	N/A	Yes	26%
Fever	No	–	Yes	2%
Dizziness	Yes	>5%	Yes	5%
Diarrhea	No	–	Yes	7%
Headache	Yes	N/A	Yes	1%
Drowsiness	Yes	N/A	Yes	2%

This may not be a complete list of adverse effects that can occur. Please refer to your doctor or healthcare provider to learn more.

Source: DailyMed (Azstarys), DailyMed (Vyvanse) 

Drug interactions of Azstarys vs. Vyvanse

Azstarys and Vyvanse share similar drug interactions. They can both interact with monoamine oxidase inhibitors (MAOIs). Combining these medications with MAOIs could lead to a dangerous increase in blood pressure or other severe side effects. Therefore, they should not be taken with MAOIs or within 14 days of stopping them. 

Both medications can also interact with antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and tricyclic antidepressants (TCAs). Taking Azstarys or Vyvanse with these antidepressants may lead to increased serotonin levels, which may increase the risk of serotonin syndrome, which can be a life-threatening condition. 

It’s always important to discuss potential drug interactions with a healthcare professional. Be sure to mention any prescription drugs, over-the-counter medications, and herbal supplements you take before starting Azstarys or Vyvanse. 

Drug	Drug Class	Azstarys	Vyvanse
Nardil (phenelzine) Parnate (tranylcypromine) Marplan (isocarboxazid)	MAOI	Yes	Yes
Norvasc (amlodipine) Cozaar (losartan) Lopressor (metoprolol) Diovan (valsartan)	Blood pressure medication	Yes	Yes
Prozac (fluoxetine) Zoloft (sertraline) Paxil (paroxetine) Celexa (citalopram)	SSRIs	Yes	Yes
Cymbalta (duloxetine) Effexor (venlafaxine) Pristiq (desvenlafaxine)	SNRIs	Yes	Yes
Elavil (amitriptyline) Tofranil (imipramine) Pamelor (nortriptyline)	TCA	Yes	Yes
Isoflurane Desflurane Sevoflurane	Halogenated anesthetic	Yes	Yes
Risperdal (risperidone)	Antipsychotic	Yes	Yes
Ammonium chloride Methenamine	Acidifying agent	Yes	Yes
Sodium bicarbonate Potassium citrate Citric acid Magnesium hydroxide	Alkalinizing agent	Yes	Yes

This is not a complete list of drug interactions. Please consult your doctor before taking these medications.

Warnings of Azstarys and Vyvanse

Azstarys and Vyvanse share similar warnings and precautions. Both drugs carry a boxed warning, the strongest warning from the FDA, due to their high potential for dependence and abuse. As such, Azstarys and Vyvanse are classified as Schedule II controlled substances. 

Other warnings of Azstarys and Vyvanse include: 

• Cardiac risks: Azstarys and Vyvanse can make existing heart problems worse, which could be dangerous. Closely monitoring your blood pressure and heart rate is important to avoid complications.
• Psychiatric effects: Taking this medication might cause new mental health challenges like sudden mood changes or seeing things that aren’t there. If you experience these, stopping the medication may be necessary.
• Suppressed growth in children: Children taking these medications might grow more slowly than usual, which could affect how they develop. If their growth seems off track, it might be necessary to pause the treatment.
• Vasculopathy concerns: Pay attention to changes in your fingers or toes, like color or feeling different, as this could signal problems with your blood vessels. If you notice these changes, it’s important to get checked by a doctor.
• Serotonin syndrome: Some medications can increase the chances of serotonin syndrome, a serious condition that can cause confusion, restlessness, and a fast heartbeat. If you start experiencing these symptoms, stop the medication immediately and seek medical help.
• Tics and Tourette’s: Watch for sudden movements or sounds (tics), especially if they run in your family. If you notice these tics getting worse, stopping the medication might be necessary to manage them effectively.

Consult a healthcare provider for other potential warnings and precautions associated with Azstarys and Vyvanse. 

Frequently asked questions about Azstarys vs. Vyvanse

Are Azstarys and Vyvanse the same?

No, Azstarys and Vyvanse are not the same. Azstarys is a newer brand-name medication that combines two active ingredients: serdexmethylphenidate and dexmethylphenidate. It is available as an oral capsule. Vyvanse, on the other hand, contains lisdexamfetamine as its active ingredient and comes as an oral capsule and chewable tablet. Both drugs, however, are used to treat ADHD. 

Is Azstarys or Vyvanse better?

Azstarys and Vyvanse are both effective treatment options for ADHD. Determining the best option depends on an individual’s response to the medications and specific needs, as everyone may react differently. For some, Azstarys may offer a smoother experience as it wears off. Others might find that Vyvanse’s effects are more consistent for them. It’s also important to compare costs, as Azstarys is only available as a brand-name drug, while Vyvanse comes as a brand-name and generic drug.

Can I use Azstarys or Vyvanse while pregnant?

Using Azstarys or Vyvanse while pregnant may carry risks. Any medication, especially stimulants, should only be used during pregnancy if the potential benefit justifies the potential risk to an unborn baby. It’s important to discuss the safety of these medications with a healthcare provider before starting or continuing them during pregnancy.

Can I use Azstarys or Vyvanse with alcohol?

It is not recommended to use Azstarys or Vyvanse with alcohol. Both medications are CNS stimulants, and combining them with alcohol can worsen side effects such as dizziness and headache. Using them together can also potentially increase the risk of heart complications. Always consult a healthcare provider for further advice on combining medications with alcohol.