Drug & supplement interaction

Sida Cordifolia + Serdexmethylphenidate Chloride, Dexmethylphenidate Hydrochloride

Serdexmethylphenidate Chloride, Dexmethylphenidate Hydrochloride brand name: Azstarys.

Major Interaction
Medically reviewed by · Updated September 2026
The bottom line Major

Serdexmethylphenidate Chloride, Dexmethylphenidate Hydrochloride falls into 2 drug categories that Sida Cordifolia can interact with; the most serious is rated major. Theoretically, Sida cordifolia might increase the risk of additive QT interval prolongation when taken with QT interval-prolonging drugs.

Read the full interaction report
SeverityMajor
LikelihoodProbable
Interactions2
EvidenceB
What do Severity, Likelihood & Evidence mean?
Know someone taking this? Share
Facebook Post Reddit Email
On this page
Interaction report

Sida Cordifolia and Serdexmethylphenidate Chloride, Dexmethylphenidate Hydrochloride

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Sida Cordifolia interacts with whole categories of medication. Serdexmethylphenidate Chloride, Dexmethylphenidate Hydrochloride falls into 2 of those categories, so it can interact with Sida Cordifolia in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Major).

Major

QT INTERVAL-PROLONGING DRUGS

1 of 2

Why this applies to Serdexmethylphenidate Chloride, Dexmethylphenidate Hydrochloride

Serdexmethylphenidate Chloride, Dexmethylphenidate Hydrochloride falls under QT INTERVAL-PROLONGING DRUGS — the group Sida Cordifolia interacts with.

Theoretically, Sida cordifolia might increase the risk of additive QT interval prolongation when taken with QT interval-prolonging drugs.
Sida cordifolia contains ephedrine. Clinical research shows that ephedrine from another herb, ephedra, can prolong the QT interval.
Severity Major Likelihood Probable Evidence B

Interaction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the concern with pairing Sida cordifolia with your Azstarys (the serdexmethylphenidate/dexmethylphenidate combo). Sida cordifolia naturally contains ephedrine, a stimulant that can nudge your heart rhythm. Specifically, it may stretch out the QT interval, which is the electrical reset between heartbeats. Azstarys is itself a stimulant that can already raise heart rate and blood pressure, so stacking the two could add up.

Together, you might notice a pounding or racing heart, jitteriness, higher blood pressure, or in rare cases a dangerous irregular rhythm. The evidence here is on the theoretical side, drawn from related ephedra research, so I'm not trying to scare you. But because both products are stimulants, I'd really run this by your pharmacist or doctor before combining them.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. McBride BF, Karapanos AK, Krudysz A, et al. Electrocardiographic and hemodynamic effects of a multicomponent dietary supplement containing ephedra and caffeine: a randomized controlled trial. JAMA 2004;291:216-21. PubMed
Major

STIMULANT DRUGS

2 of 2

Serdexmethylphenidate Chloride, Dexmethylphenidate Hydrochloride also falls under STIMULANT DRUGS.

Theoretically, Sida cordifolia might increase the risk of adverse cardiovascular effects when taken with stimulant drugs.
Sida cordifolia contains ephedrine. Drugs with CNS stimulant properties, such as phenylpropanolamine, pseudoephedrine, and diethylpropion, and many others can increase the risk of hypertension and adverse cardiovascular effects when taken with ephedrine.
Severity Major Likelihood Probable Evidence D

Interaction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here is the simple version: Azstarys (the serdexmethylphenidate/dexmethylphenidate combo) is already a stimulant that nudges your heart rate and blood pressure up. Sida cordifolia naturally contains ephedrine, which is also a stimulant. Stacking two stimulants together can pile on those effects, so the real worry is your cardiovascular system. We are talking about things like a racing or pounding heart, jitteriness, higher blood pressure, anxiety, and trouble sleeping.

This concern is based on how these compounds work rather than on hard human studies, but the potential downside is serious enough that I would not take the chance. Please loop in your pharmacist or doctor before mixing the two, and do not stop or change your Azstarys on your own.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Anon. Sida Cordifolia. Metro Marketing, Inc. Available at: http://metromkt.net/viable/1sidacor.shtml (Accessed 9 March 2000).

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Sida Cordifolia Also Interacts With Other Medications

Sida Cordifolia has 336 major, 108 moderate known drug interactions in our database — the Serdexmethylphenidate Chloride, Dexmethylphenidate Hydrochloride one above is among them. If you take anything else, check it against the full list below.

Major 336 Moderate 108 No known interaction 2,386 (incl. Serdexmethylphenidate Chloride, Dexmethylphenidate Hydrochloride)
Taking anything else?

Check Another of Your Medications Against Sida Cordifolia

Covers the 2,830 medications we’ve checked against Sida Cordifolia. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Serdexmethylphenidate Chloride, Dexmethylphenidate Hydrochloride

This page covers Sida Cordifolia only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Serdexmethylphenidate Chloride, Dexmethylphenidate Hydrochloride page lists 92 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), Arsenic (major), Cesium (major) and Ephedra (major).

By severity: 10 major · 68 moderate · 14 minor.

From our pharmacist’s overview on the Serdexmethylphenidate Chloride, Dexmethylphenidate Hydrochloride page

“Ephedra tops my concerns for anyone taking Azstarys (serdexmethylphenidate and dexmethylphenidate), a stimulant medication for ADHD. It stacks a second stimulant onto the drug and carries a major rating for disturbing heart rhythm.”

Reviewed by 2 · Jul 18, 2026

Open the Serdexmethylphenidate Chloride, Dexmethylphenidate Hydrochloride interaction page

One more smart check

Taking Sida Cordifolia as Part of a Dietary Supplement Product? Check It for Interactions

We hold 48 real supplement products containing Sida Cordifolia, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Sida Cordifolia. Your product may carry other ingredients that interact with Serdexmethylphenidate Chloride, Dexmethylphenidate Hydrochloride too, on top of Sida Cordifolia — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Sida Cordifolia and Serdexmethylphenidate Chloride, Dexmethylphenidate Hydrochloride Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Sida Cordifolia
Top half

#558 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Serdexmethylphenidate Chloride, Dexmethylphenidate Hydrochloride
Steady interest

#2,205 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Sida Cordifolia

What is Sida Cordifolia?

Sida Cordifolia
  • Weight loss and energy
  • Asthma and breathing problems
  • Joint and muscle pain
  • Fever and cough
  • General fatigue or 'tonic'

Sida cordifolia (bala or country mallow) is a traditional Ayurvedic plant that naturally contains ephedrine, a powerful stimulant. Because of this, many supplements containing it have been banned or restricted, and it carries real risks to the heart and blood pressure. There is little reliable human evidence that it works, so most people should avoid it and talk with a pharmacist or doctor first.

Read the full Sida Cordifolia monograph & all interactions
Medication

About Serdexmethylphenidate and Dexmethylphenidate

What Is Serdexmethylphenidate and Dexmethylphenidate Used For?

Brand name: Azstarys

Azstarys (serdexmethylphenidate/dexmethylphenidate) is approved to treat Attention Deficit Hyperactivity Disorder (ADHD) in patients 6 years of age and older. It is not recommended for children younger than 6 because they experience higher drug levels in the blood and more side effects at the same doses used in older patients.

See full Serdexmethylphenidate and Dexmethylphenidate drug information
Keep checking

Other Drugs & Sida Cordifolia

Browse every other medication we’ve checked against Sida Cordifolia — both the ones with a known interaction and the ones without. Select any drug for the full detail.

336Major
108Moderate
0Minor
2,385No known interaction
336 Major 108 Moderate 2,385 No interaction
Major

336 interactions

Showing 60 of 336 major interactions — see all 336 on the Sida Cordifolia page.

Moderate

108 interactions

Showing 60 of 108 moderate interactions — see all 108 on the Sida Cordifolia page.

No interaction 2,385 drugs checked — show the list

We also checked Sida Cordifolia against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,385 medications checked with no known interaction — see the full Sida Cordifolia list.

See the full Sida Cordifolia interactions page
See every supplement checked against Serdexmethylphenidate Chloride, Dexmethylphenidate Hydrochloride, ranked by severity
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Keep exploring
Sida Cordifolia monograph › Uses, safety, and every drug interaction in one place Serdexmethylphenidate Chloride, Dexmethylphenidate Hydrochloride supplement interactions › Every supplement checked against Serdexmethylphenidate Chloride, Dexmethylphenidate Hydrochloride, ranked by severity Serdexmethylphenidate and Dexmethylphenidate drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Sida Cordifolia and Serdexmethylphenidate Chloride, Dexmethylphenidate Hydrochloride Together: Common Questions

Can you take Sida Cordifolia with Serdexmethylphenidate Chloride, Dexmethylphenidate Hydrochloride?
This is rated a major interaction, so the combination is best avoided unless your doctor or pharmacist has specifically told you otherwise. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 2 interactions listed for Sida Cordifolia and Serdexmethylphenidate Chloride, Dexmethylphenidate Hydrochloride?
Serdexmethylphenidate Chloride, Dexmethylphenidate Hydrochloride belongs to more than one drug category, and Sida Cordifolia interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Sida Cordifolia and Serdexmethylphenidate Chloride, Dexmethylphenidate Hydrochloride interaction?
We rate it Major. This is a clinically significant combination that is generally best avoided, or used only under the direct supervision of your physician or pharmacist.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Serdexmethylphenidate Chloride, Dexmethylphenidate Hydrochloride and Sida Cordifolia?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.