Jornay PM (methylphenidate delayed and extended release capsules) Full Prescribing Information DailyMed Drug Information Forms/Strengths Capsules: 20 mg, 40 mg, 60 mg, 80 mg, 100 mg Dosing Age: ≥ 6 y/o Onset: delayed until early morning (~10-12 hours after evening dose) Duration: 12-14 hours Considerations: Take in the evening between 6:30-9:30 pm. Capsules can be opened and sprinkled on applesauce. Initial Dose: 20 mg once daily in the evening Titration: 20 mg weekly Max Dose: 60 mg/day Quick Facts Inhibits dopamine/norepinephrine reuptake Enhances focus, attention, and impulse control Extended-release methylphenidate with delayed-release profile designed for bedtime dosing Unique evening dosing provides early morning onset and sustained symptom control throughout the day Common side effects: decreased appetite, insomnia, headache, gastrointestinal discomfort Indications   ADHD (ICD-10: F90.0) Off-Label Uses   How to Take Take once daily in the evening between 6:30 PM and 9:30 PM to allow for morning symptom control. Can be taken with or without food ; high-fat meals may delay absorption. Swallow the capsule whole ; do not crush or chew. If needed, the capsule may be opened and sprinkled on applesauce —consume immediately without chewing. Side Effects   Monitoring / Labs Cardiovascular : Baseline and routine monitoring of heart rate and blood pressure. Growth in Pediatrics : Regular monitoring of height and weight to detect growth suppression. Psychiatric Symptoms : Observe for mood changes, anxiety, or psychosis. Abuse Potential : Monitor for misuse or diversion. Education When to Call the Doctor: Severe mood changes, aggression, or suicidal thoughts . Chest pain, rapid heartbeat, shortness of breath ( cardiovascular concerns ). Uncontrolled movements, tics, or worsening anxiety. Numbness, coldness, or color changes in fingers or toes ( circulatory issues ). Unexplained weight loss or delayed growth in pediatric patients . Safety Tips: Monitor blood pressure and heart rate , especially in patients with cardiovascular risk. Use caution in patients with anxiety, bipolar disorder, or psychosis , as symptoms may worsen. Avoid caffeine and other stimulants , which may amplify side effects. Ensure adequate hydration and nutrition , as appetite suppression is common. Tapering may be required if discontinuing after long-term use. Parent Tips for Pediatric Patients: Encourage a nutrient-dense diet to counteract appetite suppression. Administer exactly as prescribed in the evening for proper morning symptom control. Monitor school performance and behavioral changes . Observe for sleep disturbances ; adjust timing if necessary. Communicate regularly with teachers and caregivers about medication effects. Additional Information Contraindications: Hypersensitivity to methylphenidate or formulation components. Use within 14 days of MAOI therapy (risk of hypertensive crisis). Symptomatic cardiovascular disease, moderate-to-severe hypertension, hyperthyroidism, glaucoma . History of substance use disorder , unless benefits outweigh risks. Pregnancy: Category C ; use only if benefits outweigh risks. May cause neonatal withdrawal symptoms or low birth weight . Lactation: Excreted in breast milk ; not recommended due to potential infant exposure. Drug Interactions: Serotonergic drugs (e.g., SSRIs, SNRIs, MAOIs) increase serotonin syndrome risk . Acidifying agents (e.g., ascorbic acid) may reduce drug absorption. Alkalinizing agents (e.g., sodium bicarbonate) may increase methylphenidate levels. May potentiate hypertensive effects of certain medications (e.g., decongestants, beta-agonists).