Azstarys and Interactions: Other Drugs, Supplements, and More

Azstarys (serdexmethylphenidate/dexmethylphenidate) is a prescription drug used to treat ADHD. This drug can interact with other medications. For example, Azstarys can interact with metoprolol (Lopressor, Toprol XL, others) and risperidone (Risperdal, Rykindo, others).

Azstarys is used in adults and certain children to treat attention deficit hyperactivity disorder (ADHD).

Azstarys contains two active ingredients: serdexmethylphenidate and dexmethylphenidate. It’s available as an oral capsule.

An interaction can occur because one substance causes another substance to have a different effect than expected. Interactions can also occur if you have certain health conditions.

Keep reading to learn about Azstarys’s possible interactions. And for more information about Azstarys, including details about its uses, see this article.

Boxed warning: Risk of misuse and addiction

Azstarys has a boxed warning about 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.

Azstarys carries a risk of misuse and addiction. Misuse refers to taking a drug in a way other than how a doctor prescribes it. Addiction refers to feeling unable to stop taking a drug even though it may be causing harm.

Azstarys misuse or addiction may lead to uncomfortable effects, such as:

• increased heart rate, blood pressure, or breathing rate
• excessive sweating
• dilated pupils
• feeling more aggressive, anxious, or restless than usual
• insomnia
• uncoordinated movements

In some cases, Azstarys misuse and addiction may lead to overdose or death. These risks are higher when Azstarys is taken at higher doses or differently than the way it was prescribed.

Before they prescribe Azstarys, your doctor will talk with you about the risks of misuse and addiction. They’ll keep monitoring your risk during Azstarys treatment.

Does Azstarys interact with other drugs?

Before you start taking Azstarys, tell your doctor and pharmacist about any prescription, over-the-counter, or other drugs you take. Sharing this information with them may help prevent possible interactions. (To learn whether Azstarys interacts with herbs or vitamins and supplements, see the “Are there other interactions with Azstarys?” section below.)

If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist.

The table below lists drugs that may interact with Azstarys. Keep in mind that this table does not include all drugs that may interact with Azstarys. For more information about some of these interactions, see the “Drug interactions explained” section below.

Drug group or drug name	Drug examples	What can happen
monoamine oxidase inhibitors (MAOIs)*	• isocarboxazid (Marplan) • linezolid (Zyvox) • selegiline (Emsam, Zelapar)	may lead to very high blood pressure
angiotensin converting enzyme (ACE) inhibitors	• enalapril (Epaned, Vasotec) • lisinopril (Qbrelis, Zestril) • ramipril (Altace)	could make the ACE inhibitor less effective
beta-blockers	• metoprolol (Lopressor, Toprol XL, others) • nadolol (Corgard) • propranolol (Hemangeol, Inderal LA, others)	could make the beta-blocker less effective
calcium channel blockers (CCBs)	• amlodipine (Katerzia, Norvasc, others) • diltiazem (Cardizem, Tiazac, others) • verapamil (Verelan, Verelan PM)	could make the CCB less effective
angiotensin II receptor blockers (ARBs)	• losartan (Cozaar) • olmesartan (Benicar) • valsartan	could make the ARB less effective
certain inhaled forms of anesthesia	• isoflurane (Forane) • desflurane (Suprane) • sevoflurane (Sojourn, Ultane)	may lead to sudden increases in heart rate or blood pressure during the procedure
risperidone (Risperdal, Rykindo, others)	—	may lead to uncontrolled muscle movements

* To learn more about this interaction, see the “When should I avoid Azstarys?” section below.

When should I avoid Azstarys?

Certain health conditions or other factors could raise your risk of harm if you take Azstarys. In such cases, your doctor may not prescribe Azstarys for you. These are known as contraindications. The list below includes contraindications of Azstarys.

If you take an MAOI: If you take an MAOI, your doctor likely won’t prescribe Azstarys for you. MAOIs are prescribed for depression and other conditions.

Examples of MAOIs include:

• isocarboxazid (Marplan)
• linezolid (Zyvox)
• selegiline (Emsam, Zelapar)

Taking Azstarys with an MAOI may lead to very high blood pressure. This can be life threatening or lead to other serious effects, including heart attack or stroke.

Due to this risk, your doctor will not prescribe Azstarys until at least 2 weeks have passed since your last dose of the MAOI.

If you have questions about Azstarys and MAOIs, talk with your doctor or pharmacist.

If you’ve had an allergic reaction: If you’ve had an allergic reaction to Azstarys or any of its ingredients, your doctor likely won’t prescribe Azstarys for you. This is because taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better options for you.

Before you start taking Azstarys, talk with your doctor if any of the factors above apply to you. Your doctor can determine whether Azstarys is safe for you to take.

Does Azstarys interact with alcohol?

Azstarys is not known to interact with alcohol. But Azstarys and alcohol can cause some similar side effects. Examples include dizziness, abdominal pain, and nausea. You may have a higher risk of experiencing these side effects of Azstarys if you combine the drug with alcohol.

If you have questions about consuming alcohol while taking Azstarys, talk with your doctor or pharmacist.

Interaction with beta-blockers

Azstarys can interact with beta-blockers, which are used to treat high blood pressure and other heart conditions.

Examples of beta-blockers include:

• metoprolol (Lopressor, Toprol XL, others)
• nadolol (Corgard)
• propranolol (Hemangeol, Inderal LA, others)

What could happen

Azstarys may increase your blood pressure, and beta-blockers help manage blood pressure. So taking these drugs together could make the beta-blocker less effective.

What you can do

If you take Azstarys with a beta-blocker, your doctor may check your blood pressure more often than usual. They’ll review your blood pressure levels and determine whether your beta-blocker dosage needs to be adjusted. You should not take a higher dose of either medication than your doctor prescribes.

If you have questions about taking Azstarys with a beta-blocker, talk with your doctor or pharmacist.

Interaction with certain inhaled forms of anesthesia

Azstarys can interact with certain inhaled forms of anesthesia. These drugs are used to help prevent pain during surgery and other procedures.

Examples of inhaled forms of anesthesia that may interact with Azstarys include:

• isoflurane (Forane)
• desflurane (Suprane)
• sevoflurane (Sojourn, Ultane)

What could happen

Taking Azstarys may increase your blood pressure or heart rate. Inhaled forms of anesthesia could make your body more sensitive to the effects of Azstarys. As a result, taking Azstarys with inhaled forms of anesthesia could lead to a sudden increase in your heart rate or blood pressure during the procedure.

What you can do

Before your surgery or procedure, talk with your surgeon about whether it’s safe to take Azstarys with the anesthesia you’ll receive. Your surgeon can tell you whether it’s safe to take Azstarys on the day of your procedure.

If you have questions about taking Azstarys with certain inhaled forms of anesthesia, talk with your doctor or pharmacist.

Interaction with risperidone

Azstarys can interact with risperidone (Risperdal, Rykindo, others). The drug is used to treat mental health conditions, including schizophrenia.

What could happen

Risperidone may cause uncontrolled muscle movements. Taking Azstarys with risperidone can increase this risk, particularly when the dosage of either drug is changed.

What you can do

If you take Azstarys and risperidone together, tell your doctor right away if you have symptoms of uncontrolled muscle movements. These may include muscle cramps, rigid muscles, or tremors. They’ll recommend how to manage your symptoms and will determine whether you need to stop using either drug.

If you have questions about taking Azstarys with risperidone, talk with your doctor or pharmacist.

Are there other interactions with Azstarys?

Azstarys may have other interactions. They could occur with supplements, foods, vaccines, or even lab tests. See below for details. Note that the information below does not include all other possible interactions with Azstarys.

Does Azstarys interact with supplements?

Before you start taking Azstarys, talk with your doctor and pharmacist about any herbs or vitamins and supplements you take. Sharing this information with them may help you avoid possible interactions.

If you have questions about interactions that may affect you, talk with your doctor or pharmacist.

Azstarys and herbs

There are currently no reports of Azstarys interacting with herbs. But this doesn’t mean that interactions with herbs won’t be recognized in the future.

For this reason, it’s still important to check with your doctor or pharmacist before taking any of these products while taking Azstarys.

Azstarys and vitamins

There are currently no reports of Azstarys interacting with vitamins. But this doesn’t mean that vitamin interactions won’t be recognized in the future.

For this reason, it’s still important to check with your doctor or pharmacist before taking any of these products while taking Azstarys.

Does Azstarys interact with food?

There are currently no reports of Azstarys interacting with food. If you have questions about eating certain foods during your treatment with Azstarys, talk with your doctor.

Does Azstarys interact with vaccines or lab tests?

There are currently no reports of Azstarys interacting with vaccines or lab tests. If you have questions about receiving certain vaccines or having lab tests done during your Azstarys treatment, talk with your doctor.

Does Azstarys interact with cannabis or CBD?

There are currently no reports of Azstarys interacting with cannabis (commonly called marijuana) or cannabis products such as cannabidiol (CBD). But as with any drug or supplement, talk with your doctor before using cannabis with Azstarys.

Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.

Does my health history affect whether I should take Azstarys?

Certain medical conditions or other health factors may raise the risk of interactions with Azstarys. Before taking Azstarys, talk with your doctor about your health history. They’ll determine whether Azstarys is right for you.

Health conditions or other factors that might interact with Azstarys include:

Substance use disorder: Azstarys has a boxed warning about the risk of misuse and addiction. People with substance use disorder may have a higher risk of misuse and addiction while taking the drug. For details, see the “Boxed warning” section at the top of the article.

Glaucoma: Azstarys may increase the pressure inside of your eye, which could worsen glaucoma. Before you take Azstarys, tell your doctor if you have glaucoma. They’ll determine whether it’s safe to prescribe Azstarys for you.

Problems with circulation: Azstarys may worsen problems with circulation, including Raynaud phenomenon. Before you take Azstarys, tell your doctor about any circulation problems you have. They can advise you on whether Azstarys is a safe treatment option.

Tics or Tourette syndrome: If you have tics or Tourette syndrome, taking Azstarys may worsen your condition. (Tics are uncontrollable movements or sounds often related to Tourette syndrome.) If you have either condition, your doctor can help determine whether Azstarys is a safe treatment option.

Heart conditions, including high blood pressure: Taking Azstarys may result in life threatening heart problems for people who already have heart conditions, such as cardiomyopathy and irregular heart rhythm. Azstarys may also worsen high blood pressure.

If you have a heart condition or high blood pressure, talk with your doctor about whether Azstarys is safe for you to take.

Certain mental health conditions: Azstarys may worsen certain mental health conditions, such as bipolar disorder and psychosis. Before starting Azstarys treatment, talk with your doctor about any mental health conditions you have. They can help determine whether it’s safe for you to take Azstarys.

Pregnancy: It’s not known whether Azstarys is safe to take during pregnancy. If you’re pregnant or planning a pregnancy, talk with your doctor before taking Azstarys.

If you do take Azstarys while pregnant, consider enrolling in the drug’s pregnancy registry. This registry collects details about pregnancy issues reported with Azstarys. For more details or to sign up, call 866-961-2388 or visit the registry website. You can also talk with your doctor to learn more.

Breastfeeding: It’s not known whether it’s safe to take Azstarys while breastfeeding or if the drug passes into breast milk. If you’re breastfeeding or planning to do so, talk with your doctor about your options.

Allergic reaction: If you’ve had an allergic reaction to Azstarys or any of its ingredients, your doctor will likely not prescribe Azstarys. This is because taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better choices for you.

How can I prevent interactions?

Taking certain steps can help you avoid interactions with Azstarys. Before starting treatment, talk with your doctor and pharmacist. Things to discuss with them include:

It’s also important to understand Azstarys’s label and other paperwork that may come with the drug. Colored stickers that describe interactions may be on the label. And the paperwork (sometimes called the patient package insert or medication guide) may have other details about interactions. (If you did not get paperwork with Azstarys, ask your pharmacist to print a copy for you.)

If you have trouble reading or understanding this information, your doctor or pharmacist can help.

Taking Azstarys exactly as prescribed can also help prevent interactions.

FAQ: Azstarys and Interactions with⁢ Other Drugs, Supplements, and More

What is⁣ Azstarys?

Azstarys is a prescription medication used to ‌treat attention ‌deficit ⁢hyperactivity disorder (ADHD) in patients ‍aged six years and older. It is a central nervous system ⁣stimulant that helps increase attention and decrease impulsiveness and hyperactivity in patients with ADHD.

How does Azstarys interact with other drugs?

Azstarys can interact with various medications, which may either increase the risk of side effects or reduce the effectiveness of Azstarys or the other ​drugs. Some interactions can be serious and require‌ medical attention. It is crucial to inform ⁢your healthcare provider about​ all the medications you are currently taking, including prescription drugs, over-the-counter medications, and any herbal supplements.

Can Azstarys be taken with antidepressants?

Azstarys ​may interact with certain ⁣types of antidepressants, particularly monoamine​ oxidase inhibitors (MAOIs). Taking these drugs together can lead to dangerous increases​ in blood pressure. Always ​consult with your healthcare provider ⁢before combining any antidepressant with Azstarys to ensure safety and ‌proper management.

Is it safe to consume alcohol while taking Azstarys?

Alcohol can exacerbate the side effects ‌of ⁤Azstarys, such as dizziness, drowsiness,‍ and ⁣difficulties⁤ concentrating. It‍ is generally advisable to avoid alcohol while taking⁢ Azstarys to prevent any potential adverse effects and⁤ to ensure the medication’s effectiveness.

What should ⁣I know about Azstarys and dietary supplements?

Certain ‌dietary supplements may interact with Azstarys, which could either alter ⁢the medication’s effects or increase⁤ the risk of side effects. Specifically, supplements containing caffeine or other stimulants can intensify the stimulant effects of Azstarys.‍ Always inform your healthcare provider about any supplements ‍you are taking to avoid unwanted interactions.

Can Azstarys affect how other medications work?

Yes, ⁤Azstarys can ​potentially affect the⁤ way other drugs work in your body, and vice versa. This can lead to reduced efficacy of either drug or an increased risk of side effects. It is essential to have a healthcare professional evaluate any potential interactions⁣ when Azstarys is prescribed alongside other medications.

Are there any special precautions when taking Azstarys?

Patients should follow their healthcare provider’s instructions carefully and report any unusual symptoms or ​side effects. Regular ‌monitoring may be necessary to ⁤determine the appropriate dosage​ and‍ to ensure that Azstarys is working ‌effectively ‍without causing adverse effects.

Who should avoid taking Azstarys?

Individuals with certain medical conditions, such as severe anxiety, tension, agitation, glaucoma, or a history of drug abuse, may be⁤ advised ⁣against using Azstarys. Furthermore, patients with hypersensitivity⁢ to amphetamines, or those using monoamine‌ oxidase inhibitors (MAOIs)⁤ currently or ‌within the past 14 days, ⁣should avoid Azstarys.

What should you do if ⁢you miss a dose of Azstarys?

If⁤ you miss a dose of Azstarys, take it as soon as you remember, ⁢provided it is not late⁢ in the ⁤day. If it is already⁣ late, skip the missed dose‍ and‍ resume your regular dosing schedule. Do not double the dose to make up for the missed one, as this can‌ increase the risk of side effects. Always ‍consult your​ healthcare provider if⁤ you have questions ‍about dosing.

By understanding ⁢these interactions and precautions, patients can better ⁢manage their treatment plan with Azstarys ⁤effectively and safely.‌ Always consult a healthcare professional for personalized advice‌ and guidance tailored to your ⁣specific health needs and conditions.

Disclaimer: adoctor 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.