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Serdexmethylphenidate and dexmethylphenidate (Oral)

Medically reviewed by Last updated on Aug 6, 2022.

Oral route(Capsule)

CNS stimulants, including serdexmethylphenidate/dexmethylphenidate, other methylphenidate-containing products, and amphetamines, have a high potential for abuse and dependence. Assess the risk of abuse prior to prescribing, and monitor for signs of abuse and dependence while on therapy .

Commonly used brand name(s)

In the U.S.

  • Azstarys

Available Dosage Forms:

  • Capsule

Therapeutic Class: CNS Stimulant

Chemical Class: Amphetamine Related

Uses for serdexmethylphenidate and dexmethylphenidate

Serdexmethylphenidate and dexmethylphenidate combination is used to treat attention deficit hyperactivity disorder (ADHD). It belongs to the group of medicines called central nervous system (CNS) stimulants.

Serdexmethylphenidate and dexmethylphenidate is available only with your doctor's prescription.

Before using serdexmethylphenidate and dexmethylphenidate

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For serdexmethylphenidate and dexmethylphenidate, the following should be considered:


Tell your doctor if you have ever had any unusual or allergic reaction to serdexmethylphenidate and dexmethylphenidate or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.


Appropriate studies have not been performed on the relationship of age to the effects of serdexmethylphenidate and dexmethylphenidate combination in children younger than 6 years of age. Safety and efficacy have not been established.


Appropriate studies on the relationship of age to the effects of serdexmethylphenidate and dexmethylphenidate combination have not been performed in the geriatric population.


There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking serdexmethylphenidate and dexmethylphenidate, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using serdexmethylphenidate and dexmethylphenidate with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Furazolidone
  • Iproniazid
  • Isocarboxazid
  • Linezolid
  • Methylene Blue
  • Moclobemide
  • Nialamide
  • Ozanimod
  • Phenelzine
  • Procarbazine
  • Rasagiline
  • Safinamide
  • Selegiline
  • Tranylcypromine

Using serdexmethylphenidate and dexmethylphenidate with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Desflurane
  • Enflurane
  • Halothane
  • Iobenguane I 131
  • Isoflurane
  • Methoxyflurane
  • Risperidone
  • Sevoflurane

Interactions with food/tobacco/alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other medical problems

The presence of other medical problems may affect the use of serdexmethylphenidate and dexmethylphenidate. Make sure you tell your doctor if you have any other medical problems, especially:

  • Alcohol abuse, history of or
  • Drug abuse or dependence, history of—Use with caution. Dependence may be more likely to develop.
  • Bipolar disorder (manic-depressive illness), history of or
  • Coronary artery disease or
  • Depression, history of or
  • Heart disease (eg, cardiomyopathy) or
  • Heart rhythm problems (eg, arrhythmia), or a family history of or
  • Hypertension (high blood pressure) or
  • Priapism (painful and prolonged erection of the penis) or
  • Psychosis (mental illness), history of or
  • Raynaud's phenomenon (blood vessel disease) or
  • Tachycardia (rapid heart rate)—Use with caution. May make these conditions worse.

Proper use of serdexmethylphenidate and dexmethylphenidate

Take serdexmethylphenidate and dexmethylphenidate only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. If you take too much, the medicine may become habit-forming (causing mental or physical dependence).

Serdexmethylphenidate and dexmethylphenidate should come with a Medication Guide. Read and follow these instructions carefully. Ask your doctor if you have any questions. Ask your pharmacist for the Medication Guide if you do not have one.

Serdexmethylphenidate and dexmethylphenidate may be taken with or without food.

You may swallow the capsule whole, or open it and sprinkle the contents into 50 mL of water or over 2 tablespoons of applesauce. Swallow the mixture right away or within 10 minutes of mixing. Do not store the mixture for future use.


The dose of serdexmethylphenidate and dexmethylphenidate will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of serdexmethylphenidate and dexmethylphenidate. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage forms (capsules):
    • For attention deficit hyperactivity disorder (ADHD):
      • Adults and children 13 years of age and older—At first, 39.2 milligrams (mg) serdexmethylphenidate and 7.8 mg dexmethylphenidate once a day in the morning. Your doctor may increase your dose as needed. However, the dose is usually not more than 52.3 mg serdexmethylphenidate and 10.4 mg dexmethylphenidate.
      • Children 6 to 12 years of age—At first, 39.2 mg serdexmethylphenidate and 7.8 mg dexmethylphenidate once a day in the morning. Your doctor may adjust your dose as needed. However, the dose is usually not more than 52.3 mg serdexmethylphenidate and 10.4 mg dexmethylphenidate.
      • Children younger than 6 years of age—Use and dose must be determined by the doctor.

Missed dose

If you miss a dose of serdexmethylphenidate and dexmethylphenidate, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.


Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Mixed unused medicine with used coffee grounds or kitty litter, then place it in a sealable bag, empty can, or other container before throwing into the trash.

Precautions while using serdexmethylphenidate and dexmethylphenidate

It is very important that your doctor check your or your child's progress at regular visits to make sure serdexmethylphenidate and dexmethylphenidate is working properly and to decide if you should continue to take it. Blood tests may be needed to check for unwanted effects.

Do not take serdexmethylphenidate and dexmethylphenidate combination with or within 14 days of taking a drug with monoamine oxidase (MAO) inhibitor activity (eg, isocarboxazid [Marplan®], phenelzine [Nardil®], procarbazine [Matulane®], selegiline [Eldepryl®], or tranylcypromine [Parnate®]). If you do, you may develop extremely high blood pressure.

If you have been using serdexmethylphenidate and dexmethylphenidate for a long time and you think you may have become mentally or physically dependent on it, check with your doctor right away. Some signs of dependence may include:

  • A strong desire or need to continue using the medicine.
  • A need to increase the dose to receive the same effects.
  • Withdrawal effects after stopping the medicine, such as irritability, anxiety, unusual tiredness or weakness, nightmares, trouble sleeping or oversleeping, increased appetite, agitation, or slowing of mental and physical activity.

You or your child will also need to have your blood pressure and heart rate measured before starting serdexmethylphenidate and dexmethylphenidate and while you are using it. If you notice any change in your blood pressure, call your doctor right away. If you have questions about this, talk to your doctor.

Serdexmethylphenidate and dexmethylphenidate may cause serious heart or blood vessel problems. This may be more likely to occur in patients who have a family history of heart disease. Check with your doctor right away if you have chest pain, trouble breathing, or fainting while using serdexmethylphenidate and dexmethylphenidate.

Tell your doctor right away if you or your family notice any unusual changes in behavior, such as an increase in aggression, hostility, agitation, irritability, or suicidal thinking or behavior. Also tell your doctor if you or your child see, hear, or feel things that are not there, or have any unusual thoughts, especially if they are new or getting worse quickly.

If you or your child experience a prolonged or painful erection of the penis, check with your doctor right away.

Serdexmethylphenidate and dexmethylphenidate may cause Raynaud's phenomenon, which is a problem with blood circulation in the fingers or toes. Tell your doctor if you have tingling or pain, a cold feeling, paleness, or skin color changes in the fingers or toes, especially when exposed to cold temperatures. Call your doctor right away if you have unexplained sores or ulcers on your fingers or toes.

Serdexmethylphenidate and dexmethylphenidate may cause slow growth and weight loss. If your child is using serdexmethylphenidate and dexmethylphenidate, the doctor will need to keep track of your child's height and weight.

Tell any doctor or dentist who treats you that you are using serdexmethylphenidate and dexmethylphenidate. You may need to stop using serdexmethylphenidate and dexmethylphenidate on the day you have your surgery.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines, and especially those for appetite control, asthma, colds, cough, hay fever, allergies, or sinus problems.

Serdexmethylphenidate and dexmethylphenidate side effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

  • Actions that are out of control
  • anxiety
  • blurred vision
  • chest pain or discomfort
  • confusion
  • difficulty in speaking
  • dizziness
  • double vision
  • enlarged pupils
  • false beliefs that cannot be changed by facts
  • fast, slow, pounding, or irregular heartbeat or pulse
  • headache
  • inability to move the arms, legs, or facial muscles
  • inability to speak
  • increased sensitivity of the eyes to light
  • increased sweating, possibly with fever or cold, clammy skin
  • irritability
  • lack or slowing of normal growth in children
  • loss in sexual ability, desire, drive, or performance
  • nausea
  • nervousness
  • pain or discomfort in the arms, jaw, back, or neck
  • pounding in the ears
  • seeing, hearing, or feeling things that are not there
  • stiff or sore neck
  • talking, feeling, and acting with excitement
  • trouble breathing
  • trouble sleeping
  • vomiting
  • weight loss

Incidence not known

  • Agitation
  • arm, jaw, or back pain
  • bleeding gums
  • blood in the urine or stools
  • bloody nose
  • bloody, black, or tarry stools
  • chest tightness or heaviness
  • chills
  • cough
  • dark-colored urine
  • decreased interest in sexual intercourse
  • diarrhea
  • difficulty in moving
  • difficulty swallowing
  • double vision
  • dry mouth
  • extra heartbeats
  • fainting
  • feeling of constant movement of self or surroundings
  • fever
  • hair loss, thinning of hair
  • heavier menstrual periods
  • hives, itching, skin rash
  • inability to have or keep an erection
  • increased in sexual ability, desire, drive, or performance
  • increased interest in sexual intercourse
  • large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, sex organs
  • light-colored stools
  • lightheadedness
  • muscle aches, cramps, pain, stiffness, or twitching
  • overactive reflexes
  • pain in the joints
  • painful or prolonged erection of the penis
  • pale skin
  • paleness or cold feeling in the fingertips and toes
  • pinpoint red spots on the skin
  • poor coordination
  • redness of the skin
  • restlessness
  • seeing double
  • seizures
  • sensation of spinning
  • shakiness in the legs, arms, hands, feet
  • sores, ulcers, or white spots on the lips or in the mouth
  • swollen glands
  • swollen joints
  • tingling or pain in the fingers or toes when exposed to cold
  • trembling or shaking of the hands or feet
  • twitching, twisting, uncontrolled repetitive movements of the tongue, lips, face, arms, or legs
  • unusual bleeding or bruising
  • unusual tiredness or weakness
  • yellow eyes or skin

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose

  • Bigger, dilated, or enlarged pupils
  • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  • false or unusual sense of well-being
  • flushing

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

  • Acid or sour stomach
  • belching
  • decreased appetite
  • heartburn
  • indigestion
  • stomach discomfort, upset, or pain

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

More about dexmethylphenidate / serdexmethylphenidate

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Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.