Methylphenidate ER evening-dosed
JORNAY PM
Pronunciation: meth-il-FEN-i-dayt (JOR-nay)
“(Overnight) Journey”
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 ↗
| 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
Available strengths
- ER cap 20, 40, 60, 80, 100 mg
- cap 20, 40, 60, 80, 100 mg
- tab 5, 10, 20 mg
- ER tab 10, 18, 20, 27, 36, 45, 54, 63, 72 mg
- ODT 8.6, 17.3, 25.9 mg
- chew tab 2.5, 5, 10, 20, 30, 40 mg
- ER susp 600 mg/120 mL
- ER susp 750 mg/150 mL
- + 5 other marketed forms not shown
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
Cost
| Strength | #/mo | generic $/mo | CostPlus | |
|---|---|---|---|---|
| 20 mg | ER cap | 30 qd | $46.25 | not offered |
| 40 mg | ER cap | 30 qd | $49.43 | not offered |
| 60 mg | ER cap | 30 qd | $175.22 | not offered |
| 80 mg | ER cap | 30 qd | not offered | |
| 100 mg | ER cap | 30 qd | not offered |
Other forms: Methylphenidate (RITALIN) · Methylphenidate ER chewable (QUILLICHEW ER) · Methylphenidate ER suspension (QUILLIVANT XR) · Methylphenidate ER (Relexxii) · Methylphenidate LA (RITALIN LA) · Methylphenidate ER (OROS) (CONCERTA) · Methylphenidate XR-ODT (COTEMPLA XR-ODT) · Methylphenidate patch (DAYTRANA) · Methylphenidate CD (METADATE CD) · Methylphenidate oral solution (METHYLIN SOLUTION)
⚠ BOXED WARNING
- Abuse, misuse and addiction
Classes and tags
Clinical profile
Legacy pregnancy categoryC
Defining liabilityHypertension, appetite/weight effects, misuse and stimulant-induced psychosis or arrhythmia.
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