Converting Adderall XR 25mg to Jornay PM Dosage
When converting from Adderall XR 25mg to Jornay PM (methylphenidate), the recommended equivalent starting dose is 40mg of Jornay PM. 1, 2
Conversion Rationale
- Adderall XR (mixed amphetamine salts) and Jornay PM (methylphenidate) belong to different stimulant classes, requiring careful conversion 2
- The American Academy of Child and Adolescent Psychiatry recommends considering potency differences between amphetamine and methylphenidate formulations when switching between medications 1
- Amphetamine formulations are generally considered more potent on a milligram-per-milligram basis than methylphenidate formulations 3, 4
Conversion Guidelines
- For converting from amphetamine to methylphenidate products, a 1:1.5-2 ratio is typically used (meaning 25mg of Adderall XR would convert to approximately 37.5-50mg of methylphenidate) 2
- Jornay PM's unique evening dosing and delayed-release mechanism requires specific consideration in the conversion process 5
- The recommended starting dose when converting from Adderall XR 25mg would be 40mg of Jornay PM 1, 2
Administration Considerations
- Unlike Adderall XR which is taken in the morning, Jornay PM is administered in the evening (typically between 6:30-9:30 PM) 5
- The delayed-release mechanism of Jornay PM allows for evening dosing with therapeutic effects beginning the following morning 5
- Jornay PM should be taken consistently with or without food, but the timing should remain consistent relative to meals 5
Titration Protocol
- After initiating Jornay PM at 40mg, allow at least one week before considering dose adjustments 2
- Titrate by 20mg increments weekly based on clinical response and tolerability 2
- Maximum recommended dose of Jornay PM is 100mg daily 2
Monitoring Recommendations
- Assess for efficacy using standardized rating scales when possible 2
- Monitor blood pressure and pulse regularly, especially during the titration period 2
- Evaluate for common side effects including insomnia, decreased appetite, headache, and mood changes 6
Important Considerations
- If the patient shows inadequate response to the maximum dose of Jornay PM, consider returning to Adderall XR or trying another stimulant formulation 2
- The unique pharmacokinetic profile of Jornay PM may provide different coverage patterns compared to Adderall XR, potentially requiring adjustment of the dosing schedule 5
- Some patients may be preferential responders to either amphetamine or methylphenidate formulations, so clinical response should be carefully monitored 4
Common Pitfalls to Avoid
- Assuming direct milligram-to-milligram equivalence between Adderall XR and Jornay PM 2, 4
- Administering Jornay PM in the morning (like Adderall XR) rather than in the evening as indicated 5
- Increasing the dose too rapidly without allowing sufficient time to assess response 2
- Exceeding maximum recommended doses if therapeutic effect is not achieved 6