Jornay Pm

— THERAPEUTIC CATEGORIES —
  • ADHD

Jornay Pm Generic Name & Formulations

General Description

Methylphenidate HCl 20mg, 40mg, 60mg, 80mg, 100mg; ext-rel caps.

Pharmacological Class

CNS stimulant.

How Supplied

Ext-rel caps—100

Generic Availability

NO

Mechanism of Action

The mode of therapeutic action of methylphenidate HCl in ADHD is not known. Methylphenidate is thought to block the reuptake of norepinephrine and dopamine into the presynaptic neuron and increases the release of these monoamines into the extraneuronal space.

Jornay Pm Indications

Indications

Attention deficit hyperactivity disorder.

Jornay Pm Dosage and Administration

Adults and Children

<6yrs: not established. Swallow whole or may open caps and sprinkle contents onto applesauce; do not chew beads. Give only in the PM; avoid AM dose. Take at same time every day. Individualize. ≥6yrs: initially 20mg once daily at 8PM (may adjust between 6:30PM–9:30PM). May titrate in 20mg increments weekly; daily dose >100mg: not recommended. Discontinue if no improvement seen after 1 month. Switching from other methylphenidate products: discontinue and follow Jornay PM titration schedule. Not interchangeable on a mg-per-mg basis.

Jornay Pm Contraindications

Contraindications

During or within 14 days of MAOIs.

Jornay Pm Boxed Warnings

Boxed Warning

Abuse, misuse, and addiction.

Jornay Pm Warnings/Precautions

Warnings/Precautions

High potential for abuse, misuse, and addiction; assess patient’s risk before prescribing. Assess for presence of cardiac disease before initiating. Avoid in known structural cardiac abnormalities, cardiomyopathy, serious arrhythmias, coronary artery disease, or other cardiac disease. Pre-existing psychotic disorder. Bipolar disorder. Screen for risk factors of developing a manic episode prior to initiation. Consider discontinuing if new psychotic/manic symptoms occur. Risk for acute angle glaucoma. History of increased IOP or open angle glaucoma; monitor closely. Assess family history and evaluate for tics or Tourette’s syndrome before initiating; monitor for emergence or worsening, and discontinue if clinically appropriate. Peripheral vasculopathy, including Raynaud's phenomenon; monitor for digital changes. Monitor BP, HR, growth in children. Reduce dose or discontinue if paradoxical aggravation of symptoms occur. Reevaluate periodically. Pregnancy. Nursing mothers: monitor infants.

Jornay Pm Pharmacokinetics

Absorption

Median Tmax: 14 hours. Relative bioavailability vs methylphenidate immediate-release (given 3 times a day): 73.9%.

Metabolism

Primarily by de-esterification to α-phenyl-piperidine acetic acid (PPAA).

Elimination

Renal (90%). Half-life: ~5.9 hours.

Jornay Pm Interactions

Interactions

See Contraindications. Hypertensive crisis with MAOIs. May decrease effectiveness of antihypertensive agents; monitor and adjust dose of antihypertensives as needed. Concomitant halogenated anesthetics may increase the risk of sudden BP and HR increase during surgery; avoid use. Concomitant risperidone may increase risk of extrapyramidal symptoms; monitor.

Jornay Pm Adverse Reactions

Adverse Reactions

Appetite decreased, insomnia, nausea, vomiting, dyspepsia, abdominal pain, weight decreased, anxiety, dizziness, irritability, affect lability, tachycardia, BP increased; priapism, hypersensitivity, cardiovascular reactions, motor/verbal tics, glaucoma. Children also: headache, psychomotor hyperactivity, mood swings.

Jornay Pm Clinical Trials

See Literature

Jornay Pm Note

Notes

Register pregnant patients in the National Pregnancy Registry for Psychostimulants by calling (866) 961-2388.

Jornay Pm Patient Counseling

See Literature