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).