Methylphenidate ER evening-dosed

JORNAY PM

Open Methylphenidate ER evening-dosed in the interactive console ↗

What it isDelayed- then extended-release dopamine and norepinephrine reuptake inhibitor; ADHD.

Why this oneThe capsule is taken 6:30-9:30 PM - onset 8-10 h later; Duration of action 8-12 h after delay (Carlat Table 1).

What limits itInsomnia, appetite loss and blood-pressure elevation limit use; timing must be individualized, and misuse risk remains.

FDA-approved for

ADHD (2018)

FDA label

Read the full label on DailyMed ↗

BOXED WARNING Abuse, misuse, and addiction — high potential; can lead to substance use disorder; misuse/abuse can result in overdose and death. Assess risk before prescribing and monitor throughout treatment

FDA dosing	Population	Start	Target	Max
Attention deficit hyperactivity disorder (ADHD)	Patients 6 years and older	20 mg QD in the evening	Individualized	100 mg/day

Titration May titrate weekly in increments of 20 mg

Renal No experience in renal insufficiency; renal impairment expected to have little effect on pharmacokinetics

Hepatic Undefined

Evening dosing only (delayed- plus extended-release design)

Instructions

Take once daily in the evening only; initiate at 8:00 p.m. and adjust between 6:30 p.m. and 9:30 p.m. to optimize next-morning tolerability/efficacy
Do not take in the morning
Take consistently with or without food
Swallow whole or open and sprinkle entire contents on applesauce (consume immediately, do not chew; do not divide dose)
Do not substitute for other methylphenidate products on a mg-per-mg basis

Contraindications

Concurrent treatment with a monoamine oxidase inhibitor (MAOI), or use of an MAOI within the preceding 14 days, because of the risk of hypertensive crisis

Cautions

Risks to patients with serious cardiac disease (avoid in structural cardiac abnormalities/serious cardiac disease)
Increased blood pressure and heart rate
Psychiatric adverse reactions (may induce manic/psychotic symptoms)
Priapism
Peripheral vasculopathy including Raynaud's phenomenon
Long-term suppression of growth in pediatric patients
Acute angle closure glaucoma
Increased intraocular pressure and glaucoma
Motor/verbal tics and worsening of Tourette's syndrome

Adverse reactions

Decreased appetite
Insomnia
Nausea
Vomiting
Dyspepsia
Abdominal pain
Weight decreased
Anxiety
Dizziness
Irritability
Affect lability
Tachycardia
Blood pressure increased
Headache (pediatric)

Pregnancy Insufficient data to inform drug-associated risk; CNS stimulants may cause vasoconstriction and decrease placental perfusion

Lactation Methylphenidate present in human milk (infant dose 0.16-0.7% of maternal weight-adjusted dose); monitor infant for agitation, insomnia, anorexia, reduced weight gain

⚠ BOXED WARNING