Terms and Conditions for the AZSTARYS Copay Assistance Program

This offer is good for eligible commercially insured patients ages 6 and up with valid AZSTARYS prescriptions and may not be used for any other product. Uninsured patients not eligible. This offer is not insurance and is not valid for patients covered under Medicaid, Medicare, TRICARE, or any other federal or state healthcare program. Offer not valid where prohibited by law, taxed or restricted. Valid regardless of choice of prescriber. This offer is not transferable and may not be combined with any other offer. Offer must be presented along with a valid prescription for AZSTARYS at the time of purchase. This offer is valid in the US only. Patient may not seek reimbursement for the value received from this program from other parties, including any health insurance program or plan, flexible spending account, or health care savings account. By using this offer, you are certifying that you meet the eligibility criteria and will comply with the terms and conditions.

First Prescription: Patient pays $0 for maximum of 30 capsules. Subsequent fills: If covered, patient pays $25 for 30 capsules; if not covered: patient pays $50 for 30 capsules.

Corium, Inc. reserves the right to change or discontinue this offer at any time without notice.

Questions and requests to discontinue participation in the program can be directed to 1-800-910-8432 (8:00 am-8:00 pm ET, Monday through Friday).

Important Safety Information

AZSTARYS is a federally controlled substance (CII) because it can be abused or lead to dependence. Keep AZSTARYS in a safe
place to prevent misuse and abuse. Selling or giving away AZSTARYS may harm others and is against the law.

Tell your healthcare provider if you or your child have ever abused or been dependent on alcohol, prescription medicines, or
street drugs.

Who should not take AZSTARYS?

Do not take AZSTARYS if you or your child are:

  • allergic to serdexmethylphenidate, methylphenidate, or any of the ingredients in AZSTARYS.
  • taking or have stopped taking within the past 14 days a medicine used to treat depression called a monoamine oxidase
    inhibitor (MAOI).

Serious problems can occur while taking AZSTARYS. Tell your healthcare provider:

  • if you or your child have heart problems, heart defects, high blood pressure, or a family history of these problems. Sudden death has
    occurred in people with heart problems or defects taking stimulant medicines. Sudden death, stroke and heart attack have happened
    in adults taking stimulant medicines. Your doctor should check you or your child carefully for heart problems before starting
    AZSTARYS. Since increases in blood pressure and heart rate may occur, the doctor should regularly check these during treatment.
    Call your healthcare provider right away or go to the nearest hospital emergency room if you or your child have any signs of
    heart problems such as chest pain, shortness of breath, or fainting while taking AZSTARYS.
  • if you or your child have mental (psychiatric) problems, or a family history of suicide, bipolar illness, or depression. New or worse
    behavior and thought problems or new or worse bipolar illness may occur. New psychotic symptoms (such as seeing or hearing
    things that are not real, believing things that are not true, being suspicious) or new manic symptoms may occur. Call your
    healthcare provider right away if there are any new or worsening mental symptoms or problems during treatment.
  • if you or your child develop painful and prolonged erections (priapism), seek medical help right away. Priapism has occurred with
    methylphenidate (AZSTARYS). Because priapism can cause long-lasting damage, it should be checked by a healthcare professional
    right away.
  • if you or your child have circulation problems in fingers and toes (called peripheral vasculopathy, including Raynaud’s phenomenon).
    Fingers or toes may feel numb, cool, painful, sensitive to temperature, and/or change color from pale, to blue, to red. Call your
    healthcare provider right away if any signs of unexplained wounds appear on fingers or toes while taking AZSTARYS.
  • if your child is having slowing of growth (height and weight). Your child should have his or her height and weight checked often
    while taking AZSTARYS.
  • if you or your child are pregnant or plan to become pregnant. It is not known if AZSTARYS may harm your unborn baby.
  • if you or your child are breastfeeding or plan to breastfeed. AZSTARYS passes into breast milk. Talk to your healthcare provider about
    the best way to feed your baby if you take AZSTARYS.

What are possible side effects of AZSTARYS?

The most common side effects of AZSTARYS include:

  • decreased appetite
  • nausea
  • indigestion
  • weight loss
  • dizziness
  • mood swings
  • increased blood pressure
  • trouble sleeping
  • vomiting
  • stomach pain
  • anxiety
  • irritability
  • increased heart rate

These are not all the possible side effects of AZSTARYS. Call your doctor for medical advice about side effects.

What is AZSTARYS?

AZSTARYS is a central nervous system (CNS) stimulant prescription medicine for the treatment of Attention Deficit Hyperactivity
Disorder (ADHD) in people 6 years of age and older. AZSTARYS may help increase attention and decrease impulsiveness and hyperactivity in people with ADHD.

For additional safety information, click here for Prescribing Information and Medication Guide and discuss with your doctor.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch,
or call 1-800-FDA-1088.

What is AZSTARYS?

AZSTARYS is a central nervous system (CNS)
stimulant prescription medicine for the treatment
of Attention Deficit Hyperactivity Disorder (ADHD)
in people 6 years of age and older. AZSTARYS may
help increase attention and decrease impulsiveness
and hyperactivity in people with ADHD.

IMPORTANT SAFETY INFORMATION

AZSTARYS is a federally controlled substance (CII) because it can be abused or
lead to dependence. Keep AZSTARYS in a safe place to prevent misuse and
abuse. Selling or giving away AZSTARYS may harm others and is against the law.

Tell your healthcare provider if you or your child have ever abused or been
dependent on alcohol, prescription medicines, or street drugs.

Tell your healthcare provider if you or