Azstarys (serdexmethylphenidate/dexmethylphenidate) is a brand-name oral capsule that’s prescribed for attention deficit hyperactivity disorder (ADHD) in adults and some children. Azstarys has interactions with some other drugs. Examples include caffeine, risperidone, and others.

Azstarys is prescribed for attention deficit hyperactivity disorder (ADHD) in adults. The drug is also prescribed for ADHD in children ages 6 years and older.

An interaction occurs when one substance causes another substance to have a different effect than expected.

To learn more about Azstarys’s interactions, keep reading. For additional information about Azstarys, including details about its uses, see this article.

Before you start treatment with Azstarys, tell your doctor and pharmacist which prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions. (To learn whether Azstarys interacts with supplements, herbs, or vitamins, see the “Azstarys and other interactions” section below.)

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

Here’s a table of drugs that can interact with Azstarys. Keep in mind that this table doesn’t include all drugs that may interact with Azstarys. Some of these interactions are described in detail just below in “Drug interactions in depth.”

Drug class or drug nameDrug examplesInteraction result with Azstarys
risperidone (Risperdal)can increase the risk of
increase the risk of extrapyramidal
symptoms (EPS)
monoamine oxidase inhibitors (MAOIs)• selegiline (Emsam)
• phenelzine (Nardil)
• linezolid (Zyvox)
• transylcypromine (Parnate)
can increase the risk of hypertensive crisis (severe high blood pressure)
blood pressure medicationsbeta-blockers, such as atenolol (Tenormin)
• angiotensin-converting-enzyme inhibitors (ACE inhibitors), such as benazepril (Lotensin)
• angiotensin II receptor blockers (ARBs), such as valsartan (Diovan)
• potassium-sparing diuretics, such as spironolactone (Aldactone)
• thiazide diuretics, such as hydrochlorothiazide
• loop diuretics, such as furosemide (Lasix)
can decrease the effect of blood pressure medications
certain anesthetics• desflurane (Suprane)
• sevoflurane (Ultane)
• isoflurane (Forane)
may increase the risk of increased heart rate or high blood pressure

In some cases, factors or conditions could prevent your doctor from prescribing Azstarys due to the risk of harm. These are known as contraindications. The contraindications of Azstarys include:

Taking a monoamine oxidase inhibitor

Doctors typically will not prescribe Azstarys in combination with a type of antidepressant called a monoamine oxidase inhibitor (MAOI).

This is because taking Azstarys with an MAOI can increase your risk of hypertensive crisis. With hypertensive crisis, your blood pressure gets unusually high. This can cause damage to major organs and blood vessels and may lead to complications, such as heart attack or stroke.

Below are a few examples of MAOIs that can interact with Azstarys:

  • methylene blue (Provayblue)
  • linezolid (Zyvox)
  • phenelzine (Nardil)
  • selegiline (Emsam)
  • isocarboxazid (Marplan)

Before you start treatment with Azstarys, it’s important to tell your doctor if you take an MAOI. They’ll likely have you stop taking the MAOI and wait at least 2 weeks before starting treatment with Azstarys. Likewise, after you stop taking Azstarys, your doctor will typically have you wait at least 2 weeks before starting treatment with an MAOI.

Having had an allergic reaction to Azstarys or any of its ingredients

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

Note: Before you start treatment with Azstarys, it’s important to tell your doctor if these contraindications apply to you. They can determine whether to prescribe Azstarys.

There aren’t any known interactions between Azstarys and alcohol. However, your doctor may advise you to avoid or limit alcohol consumption during Azstarys treatment.

This is because drinking alcohol while taking the drug may worsen some of Azstarys side effects. For example, you may experience:

  • nausea
  • vomiting
  • headache
  • dizziness

In addition, consuming large amounts of alcohol can cause liver damage. Azstarys may also cause liver damage as a side effect. This means that drinking alcohol during Azstarys treatment may increase the risk of liver problems.

If you have questions about drinking alcohol while taking Azstarys, talk with your doctor.

Here’s a closer look at certain drug interactions of Azstarys.

Risperidone

Risperidone (Risperdal) is a medication that’s prescribed to treat certain mood disorders, such as bipolar disorder or schizophrenia.

Interaction result: Taking risperidone and Azstrys together may increase the risk of a side effect called extrapyramidal symptoms (EPS) if the dose of either drug is changed.

Interaction explained: Risperidone and Azstrys both affect natural chemicals in the brain called neurotransmitters. A change in the balance of chemicals in your brain can cause symptoms of EPS.

Steps you or your doctor may take: Tell your doctor if you’re taking risperidone before starting treatment with Azstarys. Your doctor will likely monitor you closely for symptoms of EPS, such as tremors or uncontrollable movements, when you start taking Azstarys. They’ll also monitor you for symptoms if there’s a change in the dose of either risperidone or Azstarys.

Monoamine oxidase inhibitors

MAOIs are typically used to treat depression or Parkinson’s disease.

Interaction result: Taking an MAOI medication with Azstarys can cause a hypertensive crisis (severely high blood pressure). This can lead to complications, such as kidney failure, heart attack, or stroke.

Interaction explained: MAOIs and Azstarys both affect the levels of neurotransmitters (natural chemicals) in the brain. Too much of these natural brain chemicals can cause a sudden increase in blood pressure.

Examples of MAOIs: Here are some MAOIs that may interact with Azstarys:

  • phenelzine (Nardil)
  • selegiline (Emsam)
  • tranylcypromine (Parnate)
  • linezolid (Zyvox)

Steps you or your doctor may take: Be sure to tell your doctor if you’re taking an MOAI or have taken one in the last 14 days. Your doctor will recommend a different medication for you if you’re taking an MAOI. If you’ve taken an MAOI in the last 14 days, your doctor can tell you when it’s safe to start taking Azstarys.

Blood pressure medications

Blood pressure medications are typically prescribed to help manage high blood pressure. Some medications may also be used to treat other conditions such as edema, migraine, or anxiety.

Interaction result: Azstarys can lessen how well your medication works to lower your blood pressure.

Interaction explained: Astyarys can cause an increase in blood pressure by increasing some of the brain’s natural chemicals. When your blood pressure is higher, you may need a higher dose of blood pressure medication to manage your blood pressure.

Examples of blood pressure medications: Here are some medications that may interact with Azstarys:

  • angiotensin II receptor blockers (ARBs), such as valsartan (Diovan)
  • angiotensin-converting-enzyme inhibitors (ACE inhibitors), such as benazepril (Lotensin)
  • beta-blockers, such as atenolol (Tenormin)
  • potassium-sparing diuretics, such as spironolactone (Aldactone)
  • thiazide diuretics, such as hydrochlorothiazide
  • loop diuretics, such as furosemide (Lasix)

Steps you or your doctor may take: Tell your doctor if you have a history of or taking medication for high blood pressure. Because Azstarys can increase your blood pressure, your doctor will regularly check your blood pressure during treatment with Azstarys. They may need to prescribe a medication to lower your blood pressure or may increase your dose of blood pressure medication if you’re already on one if your blood pressure gets too high.

Azstarys may have other interactions, such as with supplements, foods, vaccines, or even lab tests. You’ll find details below. Keep in mind that the following information does not include all other possible interactions with Azstarys.

Azstarys interactions with supplements

It’s possible for drugs to interact with supplements such as vitamins and herbs.

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

Azstarys and herbs

There are no specific reports of herbs interacting with Azstarys. However, that doesn’t mean herbal interactions won’t occur or be recognized in the future. Because of this, it’s important to check with your doctor or pharmacist before taking any of these products during Azstarys treatment.

Azstarys and vitamins

There are no specific reports of vitamins interacting with Azstarys. However, that doesn’t mean vitamin interactions won’t occur or be recognized in the future. Because of this, you should talk with your doctor or pharmacist before taking any vitamin product with Azstarys.

Azstarys interactions with food

Azstarys may interact with caffeine. Consuming too much caffeine while taking Azstarys can increase the risk of high blood pressure. Examples of foods and beverages that contain caffeine include:

Because of this interaction, your doctor will likely recommend limiting how much caffeine you consume during Azstarys treatment.

If you’d like to learn more about eating certain foods during treatment with Azstarys, talk with your doctor.

Azstarys and vaccines

There aren’t any known interactions between Azstarys and vaccines. Talk to your doctor or pharmacist to see whether you’re due for any vaccines.

Azstarys and lab tests

Azstarys isn’t known to interact with any lab tests. If you have concerns about this medication interacting with lab tests, talk to your doctor.

AZSTARYS INTERACTION WITH CANNABIS OR CBD

Cannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have not been specifically reported to interact with Azstarys. However, as with any drug or supplement, talk with your doctor before using cannabis in combination with Azstarys. The impact of cannabis may affect how well you stick to your Azstarys treatment plan.

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

Certain medical conditions and other factors may increase the risk of interactions with Azstarys. Before you take this drug, be sure to talk with your doctor about your health history. Azstarys may not be the right treatment option if you have certain medical conditions or other factors affecting your health.

Health conditions or factors that might interact with Azstarys include:

  • High blood pressure: Azstarys can increase blood pressure in some people. Tell your doctor if you have high blood pressure before taking Azstarys. Your doctor will likely check your blood pressure before and during treatment with Azstarys. If your blood pressure is high, they may prescribe a blood pressure medication or may need to adjust the dose if you’re already taking one.
  • Mental health conditions: Tell your doctor if you have a family history of or currently have any mental health disorders before starting treatment with Azstarys. Azstarys may cause or worsen mood disorders, such as depression or bipolar disorder. Your doctor will want to monitor you for any changes in your mood while taking Azstarys.
  • Heart problems: Treatment with Azstarys can increase the risk of serious heart problems. Be sure to tell your doctor if you have a history of heart disease or any other heart problems. If you have any heart problems, taking Azstarys could worsen them. Your doctor can determine whether treatment with Azstarys is safe for you.
  • Problem with circulation in your fingers or toes: Azstarys has been reported to cause circulation problems in some people. If you have circulation problems, taking Azstarys could worsen your condition. Tell your doctor if you have any circulation problems, such as Raynaud’s disease, before taking Azstarys. Your doctor can determine if Azstarys is the best treatment option for you.
  • Allergic reaction: If you’ve had an allergic reaction to Azstarys or any of its ingredients, your doctor will likely not prescribe Azstarys. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.
  • Breastfeeding: There isn’t enough information to determine whether the drug passes into breast milk or what effects Azstarys may have on a child who is breastfed. If you’re breastfeeding or planning to, talk with your doctor before using Azstarys. They can talk with you about treatment options and ways to feed your child.
  • Pregnancy: There haven’t been enough clinical trials to determine whether Azstarys is safe to use while pregnant. If you’re pregnant or planning to become pregnant, tell your doctor before starting Azstarys. They can advise you on the right treatment plan for you.

Suicide prevention

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

  • Ask the tough question: “Are you considering suicide?”
  • Listen to the person without judgment.
  • Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
  • Stay with the person until professional help arrives.
  • Try to remove any weapons, medications, or other potentially harmful objects if it’s safe to do so.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.

Find more links and local resources.

You can take certain steps to help prevent interactions with Azstarys. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan to do the following:

  • Let them know if you drink alcohol or use cannabis.
  • Tell them about any other medications you take, as well as any supplements, herbs, and vitamins.
  • Create a medication list, which your doctor and pharmacist can help you fill out.

It’s also important to read the Azstarys label and other paperwork that may come with the drug. The label may have colored stickers that mention an interaction. And the paperwork, sometimes called the medication guide or patient package insert, may contain details about interactions.

If Azstarys doesn’t come with paperwork, you can ask your pharmacist to print a copy. If you need help reading or understanding this information, ask your doctor or pharmacist.

You can also help prevent interactions with Azstarys by taking it exactly as your doctor prescribes.

Disclaimer: Medical News Today 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.