Azstarys vs Vyvanse: ADHD Drugs Compared

When it comes to managing attention-deficit/hyperactivity disorder (ADHD), comparing Azstarys® vs Vyvanse® has become a common starting point. These two newer once-daily stimulants, Azstarys® often top the shortlist because they promise steady focus from breakfast through homework (or that late-afternoon budget meeting). Both can be effective, but they're not the same. Understanding how they differ could help you and your healthcare provider make the best choice for your needs.

Azstarys vs Vyvanse: What's the difference?

Azstarys® belongs to the methylphenidate family, which is the same chemical line as Ritalin. Vyvanse®, belongs to the amphetamine family. Both start as "prodrugs," meaning they need a chemical step inside your body to unlock the active stimulant. The magic of prodrugs is steady delivery. You swallow once in the morning, and your bloodstream handles the slow-release math for you.

What is Azstarys?

Azstarys® (serdexmethylphenidate + dexmethylphenidate) is a prescription medication approved by the FDA in 2021 to treat ADHD in children, teens, and adults. It's unique because it combines two forms of the same active ingredient in one capsule. One part works quickly to improve focus soon after you take it. The other part is designed to release slowly throughout the day, offering extended symptom relief without needing a midday dose. This combination may be helpful for people who need coverage during both school or work hours and into the late afternoon. It's often a good option for children or adults who respond well to methylphenidate-based medications (the same family as Ritalin or Concerta) but want the convenience of a once-daily dose.

How Azstarys is taken

Azstarys comes in capsule and tablet form, and you only need to take it once in the morning. If swallowing pills is a challenge, the contents can be sprinkled onto soft foods like applesauce or yogurt. Your prescriber will help you start at a dose that makes sense for your needs and adjust as needed based on how you feel. And function throughout the day.

What is Vyvanse?

Vyvanse® (lisdexamfetamine) is another once-daily medication used to treat ADHD. It starts out as an inactive ingredient, which your body slowly converts into a stimulant after taking it. This gradual release may help provide more consistent focus and attention throughout the day, with less of a "rush" in the morning or a "crash" in the afternoon. Vyvanse was FDA-approved in 2007 and is often recommended for people who benefit from amphetamine-based medications (the same group as Adderall). It may be a better choice for those who want smoother, extended symptom control, especially if previous treatments wore off too quickly or caused unwanted ups and downs.

How Vyvanse is taken

Vyvanse is available in several strength options. It's taken once in the morning and can be adjusted over time to help find the right balance of focus and minimal side effects. Your healthcare provider will work with you to choose the dose that fits your schedule, your symptoms, and how your body responds.

Why take Azstarys vs Vyvanse for treating ADHD?

Choosing between Azstarys and Vyvanse often comes down to how your body responds and what your daily routine looks like. While both are long-acting ADHD medications taken once in the morning, they work a little differently, and that can make one a better fit for you than the other. You might prefer Azstarys if:

• You need a quick start to the day: Azstarys includes an immediate-release component that often begins working within the first 30 minutes.
• You want extended coverage into the afternoon and evening: Its slow-release formula is designed to last long enough to support focus during after-school activities or evening tasks.
• You've done well on methylphenidate in the past: Azstarys belongs to the same medication family as Ritalin and Concerta, offering a familiar option in a more convenient, once-daily format.

You might prefer Vyvanse if:

• You're sensitive to fast-acting stimulants: Vyvanse tends to have a smoother, more gradual onset, which may reduce early-morning side effects like jitteriness.
• You need flexibility in dosing: Vyvanse comes in a wide range of strengths, allowing for more precise dose adjustments to help find what works best for you.
• You're also managing binge-eating disorder: In addition to treating ADHD, Vyvanse is FDA-approved for adults with moderate to severe binge-eating disorder.

Keep in mind that what works well for one person may not work the same for another. If one option doesn't feel quite right, talk to your healthcare provider. Another medication might be a better match for your needs.

Vyvanse vs Azstarys: What is the difference?

This table compares some of the differences between Ayvanse and Vyvanse:

Key Question	Vyvanse	Azstarys
Active ingredient	Lisdexamfetamine (a prodrug of dextroamphetamine)	Serdexmethylphenidate (prodrug) + dexmethylphenidate (active)
Formulations	Prodrug only (converted to active form in the body)	Combination of immediate-release dexmethylphenidate and extended-release serdexmethylphenidate
Onset	Approximately 1.5 to 2 hours; may be delayed by 30 to 60 minutes if taken with food	Dexmethylphenidate component provides rapid onset within 30 to 60 minutes; serdexmethylphenidate extends duration
Duration	Up to 14 hours	Up to 13 hours
Dosing frequency	Once daily	Once daily
Abuse potential	Lower (must be metabolized)	Potential for abuse and misuse
FDA extras	Also treats binge-eating disorder	Also treats narcolepsy
Generic availability	Yes (lisdexamfetamine)	Yes

Your healthcare provider will work with you to determine which one is best for you.

Azstarys vs Vyvanse dosage chart

This chart shows you the medication strengths that are available, along with doses:

Medication	Available Strengths	Typical Starting Dose	Maximum Recommended Dose
Azstarys	26.1 mg/5.2 mg 39.2 mg/7.8 mg 52.3 mg/10.4 mg	39.2 mg/7.8 mg once daily in the morning	52.3 mg/10.4 mg once daily
Vyvanse	10 mg to 70 mg	30 mg once daily in the morning	70 mg once daily

These doses are generally intended for patients ages six and older. Because Azstarys and Vyvanse work through different chemical pathways, their doses aren't directly interchangeable. Looking for an Azstarys dose equivalent to Vyvanse is a bit like comparing miles to kilometers. You'll need careful calculations and clinical judgment. That's why any dosage changes should always be made with guidance from a healthcare professional.

Is Azstarys the same as Vyvanse?

Short answer: No. Azstarys ultimately break down into methylphenidate. Vyvanse releases dextroamphetamine. They both increase dopamine and norepinephrine in the brain but through different starting blocks. Think cousins, not twins.

Is Vyvanse as good as Azstarys?

Both medicines cut ADHD symptom scores, and neither has proven outright superior. Your personal "good" comes down to:

• Speed of onset you need
• Dose flexibility you prefer
• Side-effects you can live with
• Insurance or cash price you're willing to pay

If Azstarys feels too quick or upsets your stomach, a Vyvanse to Azstarys conversion and vice versa is possible. Your healthcare provider can help you make the switch safely and determine the right starting dose based on your specific needs and response to treatment.

What side effects are common between Azstarys and Vyvanse?

Most people tolerate long-acting stimulants well, but you may notice:

• Loss of appetite
• Trouble falling asleep
• Irritability or mood swings during peaks or as the dose wears off
• Slight rise in heart rate or blood pressure
• Stomach upset, or nausea often fades after week two

Like many ADHD medications, Azstarys and Vyvanse share a few common side effects that are usually mild and tend to improve over time.

What side effects are not common between Vyvanse and Azstarys?

These side effects occur more with one medication than another, but they can still occur in either one:

• Azstarys: Heartburn, early-dose jitteriness, mild metallic taste
• Vyvanse: Dry mouth, constipation, mild headache

Side effects are personal. Keep a daily diary to help your prescriber fine-tune your dose.

Frequently Asked Questions

 

How successful is Azstarys in treating ADHD?

Clinical trials have shown that Azstarys significantly reduces ADHD symptoms in children compared to placebo. It works quickly and lasts most of the day, which helps with school and after-school activities. Because of its two-part formulation, it may also reduce the "afternoon crash" that some people experience with other stimulants.

How successful is Vyvanse in treating ADHD?

Vyvanse has over 15 years of real-world use and clinical study behind it. It's been shown to improve focus, attention, and impulse control in children, teens, and adults. Many people also appreciate its once-daily dosing and long-lasting effects. A 2024 meta-analysis pooling 11 randomized trials confirmed lisdexamfetamine delivers significant symptom relief across all age groups with no extra safety trade-offs at higher doses.

Is Azstarys better than Vyvanse for ADHD treatment?

There’s no clear winner here. There's more about what works best for your unique brain and body. If you need something that kicks in quickly and has a smooth effect, Azstarys might be a good option. If you've had success with amphetamines or prefer a medication with a long safety record, Vyvanse could be the better choice.

The bottom line

Choosing between Azstarys and Vyvanse doesn't have to be stressful. The right medication is the one that works best for your needs and lifestyle. Talk to your healthcare provider, track your symptoms, and don't hesitate to make a change if needed. At ScriptSave® WellRx, we've been helping people save on prescriptions for over 25 years. Our free savings program offers up to 80% savings* on thousands of medications, including ADHD treatments like Azstarys and Vyvanse. Visit WellRx.com to compare prices and start saving today. *DISCOUNT ONLY – NOT INSURANCE. The program is administered by Medical Security Card Company, LLC.

References

https://www.wellrx.com/news/how-common-is-adhd-as-an-adult/

https://www.wellrx.com/azstarys/drug-information/

https://www.wellrx.com/lisdexamfetamine-dimesylate/drug-information/

https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=00b5e716-5564-4bbd-acaf-df2bc45a5663&audience=consumer

https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=704e4378-ca83-445c-8b45-3cfa51c1ecad&audience=consumer

https://pubmed.ncbi.nlm.nih.gov/34714120/

https://pmc.ncbi.nlm.nih.gov/articles/PMC11441986/