What are the FDA indications for AZSTARYS (serdexmethylphenidate and dexmethylphenidate)?

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Last updated: November 19, 2025View editorial policy

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AZSTARYS FDA Indications

AZSTARYS (serdexmethylphenidate and dexmethylphenidate) is FDA-approved for the treatment of Attention Deficit Hyperactivity Disorder (ADHD) in patients 6 years of age and older. 1

Specific Indication Details

  • Age range: Approved for patients ≥6 years of age 1
  • Condition: Attention Deficit Hyperactivity Disorder (ADHD) 1
  • Drug classification: Central nervous system (CNS) stimulant 1

Clinical Context and Evidence Base

AZSTARYS fits within the FDA-approved stimulant medication class recommended as first-line pharmacological treatment for elementary and middle school-aged children (6-12 years) with ADHD. 2

Supporting Efficacy Data

  • In a randomized, double-blind laboratory classroom study of children ages 6-12 with ADHD, SDX/d-MPH demonstrated significant improvement in ADHD symptoms compared with placebo (p < 0.001), with a rapid onset (0.5 hours) and extended duration of treatment effect (up to 13 hours post-dose) 3

  • A 12-month open-label safety study in 238 children aged 6-12 years demonstrated that SDX/d-MPH was safe and well tolerated, with no unexpected safety findings compared to other methylphenidate products 4

  • The most common treatment-emergent adverse events were decreased appetite (18.5%), upper respiratory tract infection (9.7%), nasopharyngitis (8.0%), decreased weight (7.6%), and irritability (6.7%) 4

Important Caveats

  • AZSTARYS is NOT FDA-approved for preschool-aged children (4-5 years), as methylphenidate use in this age group remains off-label despite moderate evidence for safety and efficacy 2

  • Growth effects were minimal and not clinically significant over 12 months of treatment, with mean Z-score changes from baseline of -0.20 for weight and -0.21 for height (changes <0.5 SD are not considered clinically significant) 5

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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