Comparative Pharmacology
Head-to-head clinical analysis: AZSTARYS versus MODAFINIL.
Peer-Reviewed Evidence
Head-to-head clinical analysis: AZSTARYS versus MODAFINIL.
AZSTARYS vs MODAFINIL
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
AZSTARYS is a prodrug of dexmethylphenidate, a central nervous system stimulant. The exact mechanism of action in attention deficit hyperactivity disorder (ADHD) is unknown, but it is thought to block the reuptake of norepinephrine and dopamine into the presynaptic neuron, increasing their levels in the extraneuronal space.
The precise mechanism of action is unknown. Modafinil is a wakefulness-promoting agent that may have direct or indirect effects on dopamine, norepinephrine, serotonin, GABA, glutamate, and orexin systems. It binds to the dopamine transporter and inhibits dopamine reuptake.
Initial: 39.2 mg oral once daily in the morning; titrate weekly by 19.6 mg increments as needed; maximum dose: 78.4 mg once daily.
200 mg orally once daily in the morning.
None Documented
None Documented
Clinical Note
moderateArmodafinil + Estrone sulfate
"The serum concentration of Estrone sulfate can be decreased when it is combined with Armodafinil."
Clinical Note
moderateModafinil + Estrone sulfate
"The serum concentration of Estrone sulfate can be decreased when it is combined with Modafinil."
Clinical Note
moderateModafinil + Sulfisoxazole
"The metabolism of Sulfisoxazole can be decreased when combined with Modafinil."
Clinical Note
moderateModafinil + Erythromycin
Serdexmethylphenidate: 1.5 hours; dexmethylphenidate: 3.5 hours. The terminal half-life of total dexmethylphenidate after AZSTARYS is approximately 6.5 hours, supporting once-daily dosing.
Terminal elimination half-life is approximately 15 hours (range 10–30 hours). This supports once-daily dosing for sustained wakefulness.
Renal: 90% (primarily as metabolites, with 50-70% as the major metabolite (-)-phensuximide glucuronide). Fecal: <5%.
Primarily renal (as metabolites and unchanged drug); approximately 80% of the dose is recovered in urine, with less than 10% as unchanged modafinil. Fecal excretion accounts for less than 1%.
Category C
Category C
CNS Stimulant
CNS Stimulant
"The metabolism of Erythromycin can be decreased when combined with Modafinil."